Two medicines, side by side
Escitalopram vs venlafaxine
Escitalopram and venlafaxine are both labeled for depression and anxiety. Drugs@FDA records approvals of escitalopram since 2002 and of venlafaxine since 1993. Pharmacies paid $0.0632 per escitalopram 20 mg tablet and $0.0799 per venlafaxine HCl ER 75 mg capsule (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, escitalopram is a serotonin reuptake inhibitor and venlafaxine a serotonin and norepinephrine reuptake inhibitor.
Check it at the source: the escitalopram FDA label on DailyMed (effective October 1, 2023); the venlafaxine FDA label on DailyMed (effective August 15, 2023).
Highlights of the escitalopram record
Escitalopram (Lexapro) · label of October 1, 2023
SUICIDAL THOUGHTS AND BEHAVIORS Antidepressants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients in short-term studies. Closely monitor all antidepressant-treated patients for clinical worsening, and for emergence of suicidal thoughts and behaviors [see Warnings and Precautions ( 5.1 )]. Lexapro is not approved for use in pediatric patients less than 7 years of age [ s ee Use in Specific Populations ( 8.4 )].
Used for
From the label: indicationsLexapro is indicated for the treatment of: • major depressive disorder (MDD) in adults and pediatric patients 12 years of age and older. • generalized anxiety disorder (GAD) in adults and pediatric patients 7 years of age and older. […]
On the market
- Earliest approval on file
- August 14, 2002
- Generic labelers
- 43 labelers
- Pharmacy cost
- $0.0632 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 1
Highlights of the venlafaxine record
Venlafaxine (Effexor) · label of August 15, 2023
SUICIDAL THOUGHTS AND BEHAVIORS Antidepressants increased the risk of suicidal thoughts and behavior in pediatric and young adult patients in short-term studies. Closely monitor all antidepressant-treated patients for clinical worsening, and emergence of suicidal thoughts and behaviors [see Warnings and Precautions (5.1) ]. Effexor XR is not approved for use in pediatric patients [see Use in Specific Populations (8.4) ].
Used for
From the label: indicationsEffexor XR is indicated in adults for the treatment of: • Major Depressive Disorder (MDD) [see Clinical Studies (14.1) ] • Generalized Anxiety Disorder (GAD) [see Clinical Studies (14.2) ] • Social Anxiety Disorder (SAD) [see Clinical Studies (14.3) ] • Panic Disorder (PD) [see Clinical Studies (14.4) ] Effexor XR is a serotonin and norepinephrine reuptake inhibitor (SNRI) indicated for the treatment of adults with: • Major Depressive Disorder (MDD) ( 1 ) • Generalized Anxiety Disorder (GAD) ( 1 ) • Social Anxiety Disorder (SAD) ( 1 ) • Panic Disorder (PD) […]
On the market
- Earliest approval on file
- December 28, 1993
- Generic labelers
- 61 labelers
- Pharmacy cost
- $0.0799 per capsule
Supply and safety
- Shortage
- No current entry
- Recalls
- 21
Source: FDA drug labels via openFDA (Escitalopram label of October 1, 2023, Venlafaxine label of August 15, 2023); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do escitalopram and venlafaxine differ on the record?
In FDA's classes, escitalopram is a serotonin reuptake inhibitor and venlafaxine a serotonin and norepinephrine reuptake inhibitor.
How each works, in its label's words: Escitalopram, “The mechanism of antidepressant action of escitalopram, the S-enantiomer of racemic citalopram, is presumed to be linked to potentiation of serotonergic activity in the central nervous system (CNS) …”; Venlafaxine, “The mechanism of action of venlafaxine in the treatment of MDD, GAD, SAD, and PD is unclear, but is thought to be related to the potentiation of serotonin and norepinephrine in the central nervous …”
Half-life, in each label's words: Escitalopram, “Elimination Biotransformation of escitalopram is mainly hepatic, with a mean terminal half-life of about 27-32 hours.”; Venlafaxine, “The apparent elimination half-life is 5 ± 2 hours for venlafaxine and 11 ± 2 hours for ODV.”
Both labels carry a boxed warning; the records quote them.
Generics: escitalopram since 2007; venlafaxine since 2006 (Drugs@FDA).
| Escitalopram | Venlafaxine | |
|---|---|---|
| Labeled for | Depression, Anxiety | Depression, Anxiety |
| Pharmacologic class | Serotonin Reuptake Inhibitor | Serotonin and Norepinephrine Reuptake Inhibitor |
| How it works (label) | The mechanism of antidepressant action of escitalopram, the S-enantiomer of racemic citalopram, is presumed to be linked to potentiation of serotonergic activity in the central nervous system (CNS) resulting from its inhibition of CNS … | The mechanism of action of venlafaxine in the treatment of MDD, GAD, SAD, and PD is unclear, but is thought to be related to the potentiation of serotonin and norepinephrine in the central nervous system, through inhibition of their … |
| Half-life (label) | Elimination Biotransformation of escitalopram is mainly hepatic, with a mean terminal half-life of about 27-32 hours. | The apparent elimination half-life is 5 ± 2 hours for venlafaxine and 11 ± 2 hours for ODV. |
| Earliest approval on file (Drugs@FDA) | August 14, 2002 | December 28, 1993 |
| First generic approved | July 31, 2007 | August 3, 2006 |
| Generic labelers (NDC) | 43 labelers | 61 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0632 per tablet (Escitalopram 20 mg tablet) | $0.0799 per capsule (Venlafaxine HCl ER 75 mg capsule) |
| 12-month price change | -12% | -13% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 1 | 21 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 139,519 | 131,560 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What do the labels say about using others of their kind?
Escitalopram label, drug interactionsConcomitant use of Lexapro and other serotonergic drugs (including other SSRIs, SNRIs, triptans, tricyclic antidepressants, opioids, lithium, buspirone, amphetamines, tryptophan, and St. John's Wort) increases the risk of serotonin syndrome.
Venlafaxine label, drug interactionsOther Serotonergic Drugs Clinical Impact Concomitant use of Effexor XR with other serotonergic drugs (including other SNRIs, SSRIs, triptans, tricyclic antidepressants, opioids, lithium, buspirone, amphetamines, tryptophan, and St. John's Wort) increases the risk of serotonin syndrome.
Source: FDA drug labels via openFDA
What next?
- Alternatives to escitalopram
- every medicine labeled for the same conditions