Two medicines, side by side
Olanzapine vs escitalopram
Olanzapine and escitalopram are both labeled for depression. Drugs@FDA records approvals of olanzapine since 1996 and of escitalopram since 2002. Pharmacies paid $0.147 per olanzapine 20 mg tablet and $0.0632 per escitalopram 20 mg tablet (NADAC, October 7, 2026). In FDA's classes, olanzapine is an atypical antipsychotic and escitalopram a serotonin reuptake inhibitor.
Check it at the source: the olanzapine FDA label on DailyMed (effective March 5, 2026); the escitalopram FDA label on DailyMed (effective October 1, 2023).
Highlights of the olanzapine record
Olanzapine (Zyprexa) · label of March 5, 2026
INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Analyses of seventeen placebo-controlled trials (modal duration of 10 weeks), largely in patients taking atypical antipsychotic drugs, revealed a risk of death in drug-treated patients of between 1.6 to 1.7 times the risk of death in placebo-treated patients.
Used for
From the label: indicationsOlanzapine is an atypical antipsychotic indicated: As oral formulation for the: · Treatment of schizophrenia. ( 1.1 ) · Adults: Efficacy was established in three clinical trials in patients with schizophrenia: two 6-week trials and one maintenance trial. ( 14.1 ) · Adolescents (ages 13-17): Efficacy was established in one 6-week trial in patients with schizophrenia ( 14.1 ). […]
On the market
- Earliest approval on file
- September 30, 1996
- Generic labelers
- 43 labelers
- Pharmacy cost
- $0.147 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 14
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
Source: FDA drug labels via openFDA (Olanzapine label of March 5, 2026, Escitalopram label of October 1, 2023); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do olanzapine and escitalopram differ on the record?
In FDA's classes, olanzapine is an atypical antipsychotic and escitalopram a serotonin reuptake inhibitor.
How each works, in its label's words: Olanzapine, “The mechanism of action of olanzapine, in the listed indications is unclear.”; 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) …”
Half-life, in each label's words: Olanzapine, “Its half-life ranges from 21 to 54 hours (5th to 95th percentile; mean of 30 hr), and apparent plasma clearance ranges …”; Escitalopram, “Elimination Biotransformation of escitalopram is mainly hepatic, with a mean terminal half-life of about 27-32 hours.”
Both labels carry a boxed warning; the records quote them.
Generics: olanzapine since 2011; escitalopram since 2007 (Drugs@FDA).
| Olanzapine | Escitalopram | |
|---|---|---|
| Labeled for | Schizophrenia, Bipolar disorder, Depression | Depression, Anxiety |
| Pharmacologic class | Atypical Antipsychotic | Serotonin Reuptake Inhibitor |
| How it works (label) | The mechanism of action of olanzapine, in the listed indications is unclear. However, the efficacy of olanzapine in schizophrenia could be mediated through a combination of dopamine and serotonin type 2 (5HT 2 ) antagonism. | 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 … |
| Half-life (label) | Its half-life ranges from 21 to 54 hours (5th to 95th percentile; mean of 30 hr), and apparent plasma clearance ranges from 12 to 47 L/hr (5th to 95th percentile; mean of 25 L/hr). | Elimination Biotransformation of escitalopram is mainly hepatic, with a mean terminal half-life of about 27-32 hours. |
| Earliest approval on file (Drugs@FDA) | September 30, 1996 | August 14, 2002 |
| First generic approved | October 24, 2011 | July 31, 2007 |
| Generic labelers (NDC) | 43 labelers | 43 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.147 per tablet (Olanzapine 20 mg tablet) | $0.0632 per tablet (Escitalopram 20 mg tablet) |
| 12-month price change | -5% | -12% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 14 | 1 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 107,881 | 139,519 |
| 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.
Source: FDA drug labels via openFDA
What next?
- Alternatives to olanzapine
- every medicine labeled for the same conditions