Two medicines, side by side
Quetiapine vs escitalopram
Quetiapine and escitalopram are both labeled for depression. Drugs@FDA records approvals of quetiapine since 1997 and of escitalopram since 2002. Pharmacies paid $0.127 per quetiapine fumarate 300 mg tablet and $0.0632 per escitalopram 20 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, quetiapine is an atypical antipsychotic and escitalopram a serotonin reuptake inhibitor.
Check it at the source: the quetiapine FDA label on DailyMed (effective April 10, 2026); the escitalopram FDA label on DailyMed (effective October 1, 2023).
Highlights of the quetiapine record
Quetiapine (Seroquel) · label of April 10, 2026
INCREASED MORTALITY IN ELDERLY PATIENTS WITH DEMENTIA-RELATED PSYCHOSIS; and SUICIDAL THOUGHTS AND BEHAVIORS 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 [see Warnings and Precautions (5.1) ]. SEROQUEL is not approved for the treatment of patients with dementia-related psychosis [see Warnings and Precautions (5.1) ].
Used for
From the label: indicationsSEROQUEL is an atypical antipsychotic indicated for the treatment of: • Schizophrenia ( 1.1 ) • Bipolar I disorder manic episodes (1.2) • Bipolar disorder, depressive episodes (1.2) 1.1 Schizophrenia SEROQUEL is indicated for the treatment of schizophrenia. The efficacy of SEROQUEL in schizophrenia was established in three 6-week trials in adults and one 6-week trial in adolescents (13-17 years). […]
On the market
- Earliest approval on file
- September 26, 1997
- Generic labelers
- 48 labelers
- Pharmacy cost
- $0.127 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 10
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 (Quetiapine label of April 10, 2026, Escitalopram label of October 1, 2023); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do quetiapine and escitalopram differ on the record?
In FDA's classes, quetiapine is an atypical antipsychotic and escitalopram a serotonin reuptake inhibitor.
How each works, in its label's words: Quetiapine, “The mechanism of action of quetiapine 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: Quetiapine, “Elimination of quetiapine is mainly via hepatic metabolism with a mean terminal half-life of about 6 hours within the …”; 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: quetiapine since 2012; escitalopram since 2007 (Drugs@FDA).
| Quetiapine | 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 quetiapine in the listed indications is unclear. However, the efficacy of quetiapine in these indications could be mediated through a combination of dopamine type 2 (D 2 ) 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) | Elimination of quetiapine is mainly via hepatic metabolism with a mean terminal half-life of about 6 hours within the proposed clinical dose range. | 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 26, 1997 | August 14, 2002 |
| First generic approved | March 27, 2012 | July 31, 2007 |
| Generic labelers (NDC) | 48 labelers | 43 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.127 per tablet (Quetiapine fumarate 300 mg tablet) | $0.0632 per tablet (Escitalopram 20 mg tablet) |
| 12-month price change | -9% | -12% |
| Boxed warning | Yes | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 10 | 1 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 191,480 | 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 quetiapine
- every medicine labeled for the same conditions