Zoloft vs Prozac: which antidepressant is right for you?

Zoloft vs Prozac — both are well-known selective serotonin reuptake inhibitors (SSRIs) that work by increasing serotonin levels in the brain to help regulate mood and reduce symptoms of anxiety and depression. But subtle differences may make 1 better for you than the other.

To help you have an informed conversation with your healthcare provider about which medication, if either,  is best for your symptoms, this article compares Zoloft (sertraline) and Prozac (fluoxetine) uses, dosages, side effects, interactions, and costs.

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If you think you need anxiety treatment or depression treatment, find a provider on Klarity Health today for affordable online treatment. Your provider can diagnose your symptoms and create a personalized treatment plan, including prescription medication, like Zoloft or Prozac, if appropriate.

Zoloft vs Prozac: which is right for you?

Choosing between Zoloft vs Prozac depends on your specific symptoms and needs. Both are good options for anxiety and depression, but a provider can help determine which is best — and medically appropriate — for you. When comparing Zoloft vs Prozac, both medications are effective SSRIs used to treat anxiety and depression. There are some differences to consider though.

Efficacy

• Zoloft is FDA-approved for social anxiety disorder and may be more suitable for individuals with social anxiety symptoms.
• Prozac is approved for panic disorder and preferred for general anxiety symptoms.

Side effects

• Zoloft may cause more gastrointestinal side effects like diarrhea.
• Prozac may be more stimulating and lead to insomnia or increased anxiety in some individuals.

Drug interactions

• Both medications have numerous drug interactions. But Prozac has a longer half-life, which means it stays in the body longer and can have prolonged interactions.

Cost

• Generic versions of both medications are affordable and often covered by insurance.
• Brand-name Prozac is significantly more expensive than brand-name Zoloft.

Individual response

• Individual body chemistry can affect how people respond to each medication.
• It may require trial and error under medical supervision to determine which medication works best for you.

Consulting with a healthcare provider, so they can understand your medical history, current medications, and specific symptoms when considering Zoloft vs Prozac or another medication is the best way to find out what medication, if any, is best for you.

Here’s a closer look at the specifics of Zoloft vs Prozac.

What is Zoloft?

Zoloft (sertraline) is a prescription selective serotonin reuptake inhibitor (SSRI) medication approved by the U.S. Food and Drug Administration (FDA). It is commonly prescribed to treat a variety of mental health conditions by increasing serotonin levels in the brain, which helps regulate mood, reduce anxiety, and improve emotional balance.

Conditions Zoloft treats

FDA-approved uses

• Major depressive disorder (MDD)
• Obsessive-compulsive disorder (OCD)
• Panic disorder (PD)
• Post-traumatic stress disorder (PTSD)
• Social anxiety disorder (SAD)
• Premenstrual dysphoric disorder (PMDD)

Off-label uses

• Generalized anxiety disorder (GAD)
• Eating disorders
• Fibromyalgia
• Premature ejaculation
• Migraine prevention

Symptoms Zoloft addresses

Anxiety symptoms

• Intrusive or unwanted thoughts
• Panic attacks
• Persistent feelings of fear
• Chronic anxiety

Depression symptoms

• Persistent low mood or irritability
• Sleep disturbances
• Appetite changes
• Fatigue or low energy levels
• Loss of interest in daily activities

Learn more about a Zoloft prescription online

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Zoloft forms and dosages

Forms

• Tablets: 25, 50, and 100 milligram
• Oral solution: 20 milligrams per milliliter

Standard dosages

• Initial dose: Typically 50 milligrams per day for adults, with lower starting doses for certain conditions or patient populations.
• Maximum dose: Up to 200 milligrams per day, depending on the condition and individual response.

Dosing adjustments are made gradually based on the tolerance and treatment progress.

Zoloft costs

The cost of Zoloft (sertraline) varies depending on the dosage and whether you choose the brand-name or generic version. The prices below are from drugs.com and reflect the cost with their discount card at the time of publication. Insurance coverage may reduce costs. 

Brand-name Zoloft costs for 30 tablets

• 25-milligrams: $420
• 50-milligram: $466
• 100-milligram: $500 

Generic Sertraline costs for 30 tablets

• 25-milligram: $10
• 50-milligram: $33
• 100-milligram: $33.

Prices for both brand-name and generic versions vary based on the pharmacy, discount card, and geographic location. For the most accurate and updated costs, consult your local pharmacy or explore online options with prescription savings programs like drugs.com, GoodRx, WellRx, SingleCare Rx, or NeedyMeds.

Zoloft side effects

Each person will experience side effects differently. You should always contact your healthcare provider if any of these side effects worsen or are ongoing. 

Common Zoloft side effects

• Nausea, loss of appetite, diarrhea, and/or indigestion
• Dry mouth
• Increase sweating
• Tremors or shaking
• Agitation
• Change in sleep habits, including sleepiness or insomnia
• Sexual problems, including decreased libido and ejaculation failure
• Feeling tired or fatigued
• Anxiety 

Serious Zoloft side effects

• Suicidal thoughts or actions
• Serotonin syndrome (symptoms include confusion, rapid heart rate, and muscle rigidity)
• Increased risk of bleeding
• Manic episodes
• Seizures or convulsions
• Glaucoma (angle-closure glaucoma) 
• Changes in appetite or weight
• Low sale (sodium) levels
• Sexual problems (dysfunction) 
• QTc prolongation that may cause heart rhythm issues

If you experience severe side effects, contact your healthcare provider immediately. You’re also encouraged to report negative side effects of prescription drugs to the FDA by visiting MedWatch or calling 1-800-FDA-1088.

Zoloft warnings and drug interactions

Before starting Zoloft be sure to understand possible interactions with other medications and in general. 

Warnings

• Don’t stop Zoloft abruptly: Sudden discontinuation may cause discontinuation syndrome and withdrawal symptoms like dizziness, sensory disturbances, or agitation. Consult your provider to taper safely.
• FDA-boxed warning: Zoloft may increase the risk of suicidal thoughts in children, adolescents, and young adults. Monitor mood changes closely.

Drug interactions

• Monoamine oxidase inhibitors (MAOIs)
• Pimozide
• Other SSRIs, serotonin and norepinephrine reuptake inhibitors (SNRIs), triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, and St. John’s Wort
• Antiplatelet agents and anticoagulants, such as aspirin, clopidogrel, heparin, and warfarin
• Drugs metabolized by CYP2D6, such as propafenone, flecainide, atomoxetine, desipramine, dextromethorphan, metoprolol, nebivolol, perphenazine, thioridazine, tolterodine, venlafaxine
• Phenytoin
• Drugs that prolong the QTc interval, such as specific antipsychotics. antibiotics, and antiarrhythmic medications 

Always inform your healthcare provider of all medications and supplements you’re taking.

What is Prozac?

Prozac (fluoxetine) is an FDA-approved SSRI used to treat various mental health conditions. By increasing serotonin levels in the brain, it helps regulate mood, reduce anxiety, and improve emotional well-being.

Conditions Prozac treats

FDA-approved uses

• Major depressive disorder (MDD) in adults and children 8 years and older
• Obsessive-compulsive disorder (OCD) in adults and children 7 years and older
• Bulimia nervosa
• Panic disorder, with or without agoraphobia
• Depressive episodes associated with Bipolar I Disorder (when combined with olanzapine)
• Treatment-resistant depression (when combined with olanzapine)

Off-label uses

• GAD
• PTSD
• SAD
• PMDD
• Chronic pain
• Migraine prevention
• Binge eating disorder (BED)
• Borderline personality disorder (BPD)
• Persistent depressive disorder (dysthymia)

Prozac forms and dosages

Forms

• Capsules: 10, 20, and 40 milligrams
• Oral solution: 20 milligrams per 5 mL

Dosages

• MDD
  • Adults: 20 milligrams per day in the morning
  • Pediatric patients 8 years and older: 10 to 20 milligrams per day
• OCD
  • Adults: 20 milligrams per day in the morning
  • Pediatric patients 7 years and older: 10 milligrams per day, with a maximum therapeutic range of 20 to 60 milligrams per day.
• Bulimia nervosa
  • Adults: 60 milligrams per day in the morning
• Panic disorder
  • Adults: 10 milligrams per day, increased to 20 milligrams after the first week, with a therapeutic range of 20 to 60 milligrams per day.
• Depressive episodes associated with Bipolar I disorder (in combination with olanzapine)
  • Adults: 20-milligram fluoxetine + 5-milligram olanzapine per day, with dosage adjustments based on tolerability.

Doses may be increased by 10-milligram increments weekly, depending on tolerability and treatment response, up to a maximum dose of 80 milligrams per day. A lower starting dose or less frequent dosing may be necessary for elderly patients, those with hepatic impairment, or those on multiple medications.

Consult your healthcare provider for individualized dosage adjustments and recommendations based on your condition and response to treatment.

Symptoms Prozac address

Anxiety 

• Persistent worry or fear
• Panic attacks
• Obsessive thoughts
• Avoidance behaviors

Depression 

• Depressed mood
• Sleep disturbances
• Changes in appetite
• Fatigue or low energy
• Loss of interest in activities

Prozac costs

Brand-name Prozac can cost up to $1,500 per month, depending on the strength and supply. On drugs.com with its discount, the cost for 30 capsules for Prozac or fluoxetine is as follows.

Brand-name Zoloft costs for 30 tablets

• 10 milligrams: $1,490.53
• 20 milligrams: $4666.21
• 40 milligrams: $802.90

Generic fluoxetine costs for 30 tablets

• 10 milligrams: $11.31
• 20 milligrams: $11.50
• 40 milligrams: $12.40

If your insurance covers Prozac or generic fluoxetine, your costs will likely be limited to your copay or deductible, depending on your plan.

Prescription discount programs, like those offered by drugs.com, GoodRx, SingleCare Rx, NeedyMeds, or Optum Perks, can reduce your out-of-pocket costs by up to 80%. Be sure to check these platforms for additional savings.

Prozac side effects

Common Prozac side effects

The most commonly reported side effects of Prozac (fluoxetine) include:

• Unusual dreams
• Sexual problems (such as decreased libido or difficulty achieving orgasm)
• Loss of appetite
• Digestive issues: diarrhea, indigestion, nausea, or vomiting
• Weakness or fatigue
• Dry mouth
• Flu-like symptoms (e.g., sore throat or sinus infection)
• Changes in sleep habits (insomnia or excessive sleepiness)
• Yawning
• Tremor or shaking
• Increased sweating
• Feeling anxious or nervous
• Hot flashes
• Rash

Serious side effects

• Suicidal thoughts or actions
• Serotonin Syndrome
• Severe allergic reactions
• Visual problems
• Seizures or convulsions
• Manic episodes
• Changes in appetite or weight
• Low salt (sodium) levels
• Changes in the electrical activity of your heart (QT prolongation or ventricular arrhythmia)
• Sexual problems or dysfunction
• Problems with blood sugar control.
• Feeling anxious or trouble sleeping

Seek immediate medical attention if you experience severe side effects. Also consider reporting any negative side effects of prescription drugs to the FDA by visiting MedWatch or calling 1-800-FDA-1088.

Prozac warnings and drug interactions

Warnings

• Avoid MAOIs: Don’t use Prozac within 14 days of taking an MAOI; wait 5 weeks after stopping Prozac before starting an MAOI.
• Serotonin syndrome: Risk increases with serotonergic drugs; monitor for agitation, hallucinations, or rapid heart rate.
• Use with caution in patients with:
  • Liver disease, diabetes
  • A history of seizures
  • Untreated narrow-angle glaucoma
• Other risks:
  • Hyponatremia (low sodium levels)
  • Increased bleeding with NSAIDs, aspirin, or anticoagulants
  • Mania or hypomania in bipolar disorder

Consult your provider or pharmacist for more information.

Drug interactions

Prozac can interact with:

• MAOIs
• Central nervous system (CNS) acting drugs
• Other SSRIs, serotonin and norepinephrine reuptake inhibitors (SNRIs), triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, and St. John’s Wort
• Antiplatelet agents and anticoagulants, such as aspirin, clopidogrel, heparin, and warfarin
• Electroconvulsive therapy (ECT)

Other drugs may also affect Prozac or be affected by Prozac, such as Pimozide, thioridazine, drugs metabolized by CyP2D6, tricyclic antidepressants (TCAs), benzodiazepines, antipsychotics, anticonvulsants, lithium, drugs metabolized by CYP3A4, and olanzapine. 

Inform your healthcare provider about all medications and supplements you take before starting Prozac.

Work with a professional to find the right medication for you

Find a licensed healthcare professional on Klarity Health today and take the first step toward managing your mental health with Zoloft, Prozac, another medication, and/or therapy if medically necessary.