Lexapro vs Zoloft - Experiences?

March 21, 2022 11:55 AM

After trying and trying to get good medical advice from standard medical providers on my cyclical depression and anxiety I have two prescriptions "to try." They are generic versions of lexapro and zoloft. Any advice or experiences with either or both of these? Would especially love to hear experiences from those in their perimenopause/menopause years. YANMD and all that.
posted by amanda to Health & Fitness (21 answers total)

I am in menopause and Lexapro has saved my sanity. No ill effects, good results on a small dose. I don't even notice it, I just feel normal. I did go off it once, and withdrawal was a beast because my doc had me do it too rapidly, so if you do go on it and need to go off, make sure your weaning-down time is properly managed.
posted by Miko at 12:08 PM on March 21, 2022 [1 favorite]

does your doc want you to take both at once? or try one and see if it works and if not try the other one? what are the starting doses you were given? usually there is a titration period when you start a med like that. how long should you try one before trying the other? did they tell you about tapering off? if you don't have answers to those questions, i would try to get them.

my personal experience is that neither of those did anything for me.
posted by misanthropicsarah at 12:19 PM on March 21, 2022

Sent you a memail.
posted by Maude_the_destroyer at 12:24 PM on March 21, 2022

I have anxiety and depression that seems to be linked to menopause. (I'm 50 and have had a partial hysterectomy)
I have been taking Lexapro for a few months now, first time I'm on any kind of meds for mental health stuff.
It's helping me a lot. I have still got things to figure out as there seems to be a link between my monthly cycle and my anxiety so I'm not sure if I have the dosage right yet.
But in general I feel like about 80 to 90 % less anxious.
And my husband commented today that when I do get anxious, I bounce back much faster and seem to cope better.
The EMDR therapy and ACT type therapy was also important but it wasn't enough by itself.
I experienced significant side effects for the first 5 weeks of lexapro, nausea, and feeling very weepy, and an upset stomach. It helped to know that they were normal side effects and would taper off (they did). Eating regularly during that time, not letting myself get too hungry, snacks between meals helped with the side effects.

I got dangerously thin over the last 2 years, and put on most of the weight I lost in the last 2 months but my weight seems to have settled now.
I'm on the maximum daily dose of 20 mg at the moment. My anxiety occasionally gets triggered by highly stressful events (family conflict for example ) and I have to employ the techniques my therapist taught me, but I no longer have that grinding, unrelenting, "will it ever end" feeling.
I take my dose early in the morning after eating something. It's not supposed to make a difference but I found it helps keep the side effects low.
posted by Zumbador at 12:24 PM on March 21, 2022 [2 favorites]

I've been on and, for a while, off, zoloft, for a while for chronic depression. I take a small-ish dose, which works for me. Try it. Lexapro vs. Zoloft drug companies get a bit weird about what any drug is used for, because they have to do testing, but also because they want to do specific marketing. Pick 1, probably paying most attention to side affects, and try it. But also, talk to your doctor about how long you should stay on it. Few docs help you prapare an exit plan, and it's good to think about.

Exercise and time outside both help quite a bit. I can't wait for warmer weather.
posted by theora55 at 12:26 PM on March 21, 2022 [2 favorites]

Zoloft worked nicely for my anxiety. Had about two weeks of nausea while ramping up, but as soon as the second week I felt it kicking in - I was able to appreciate stuff like nature without a constant fog of anxiety. Ended up at 15mg for a year, which let me get into therapy and unpack a lot of what was causing the anxiety. Been off it for nearly a year now, still regard it as a very good choice in my particular circumstances.
posted by I claim sanctuary at 12:35 PM on March 21, 2022 [1 favorite]

Lexapro saved my life, I'm pretty sure. I was a few years into menopause and a pandemic and *gestures around*, suffering severe burnout, I would say medium and worsening depression plus skyrocketing anxiety.

My side effects are extremely manageable. I need to take a little something to sleep at night or I just get really thin sleep, but I switch off between half a trazodone and half a doxylamine succinate, and take magnesium with both, and I sleep well enough now. I've never been a great sleeper so I wasn't expecting perfection. I've always had a cranky stomach as well so I don't know if I can attribute my periodic bathroom issues to the meds or just my life.

I just got through losing two dogs in eight days with an appropriate amount of sadness and a surprising amount of stress cleaning. No black holes, no depersonalization, lots of tissues and also some laughs. I don't know if I would have gotten through it a year ago. I had run out of any resilience, I had no buffer for any additional stress or challenge, my executive function was garbage. There was just nothing left over, and now I feel a lot more agile and my perspective is more sound and I feel like I can handle hard things.
posted by Lyn Never at 12:40 PM on March 21, 2022 [8 favorites]

Perimenopausal. I started taking Zoloft a year ago and it was one of the best decisions I ever made. I have a heart issue that made Lexapro the second choice, otherwise, my doc would have gone with that. When I first started taking it, I found this video helpful (and these caps that tell you how long its been since you last took a pill).
posted by 10ch at 1:07 PM on March 21, 2022 [1 favorite]

Zoloft has kept me alive for over 20 years. I can’t tolerate a lot of meds or there are weird side effects or they don’t work, but Zoloft is the real deal for me.
posted by mermaidcafe at 1:13 PM on March 21, 2022 [2 favorites]

I was on Zoloft for a bit in my 20s - it helped the anxiety/depression but gave me increasing insomnia, so I switched off it to something else (which had the opposite effect, unfortunately).

More recently I was on Lexapro for a few months. It was amazing for my anxiety, but I became increasingly more exhausted. I also gained weight quickly while on it. My psych switched me to Wellbutrin. Lexapro absolutely pulled me out of a hole when I was on it, though, so I have an irrational feeling of gratitude toward it.

YMMV extremely - I was reading another similar Ask some time ago in which some folks reported Zoloft made them tired. For me it's been really worth trying different ones out to see which has the most tolerable side effects.
posted by esker at 1:21 PM on March 21, 2022 [1 favorite]

46F here - on Zoloft (generic) for the last 3 years for anxiety and depression. It was the best out of all the other ones I tried (Wellbutrin made me manic and Prozac made me robotic). I’m on what is apparently a big dose of 100mg a day but it works well and I feel like I can be a normal human on it.

It does make me run hot, and I have exceptionally vivid/weird but non-scary dreams on it.
posted by some chick at 2:22 PM on March 21, 2022

You describe your depression as cyclical--so when you say "standard medical providers" do you mean a PCP or have you been evaluated by a psychiatrist with experience in mood disorders? I ask because Lexapro in particular is decidedly contraindicated if you are suspected of having bipolar depression versus major depressive disorder or "normal" depression, and even the Zoloft might be a bad idea. "Normal" depression and MDD have you suffering at a consistent depressed level that may just be getting worse. With bipolar depression you're seeing the depression come cyclically, sometimes worse, sometimes better. The "better" phase does not necessarily include mania (also note: mania can manifest as really bad anxiety!)--sometimes the "better" phase is just "depressed, but less depressed".

The idea that bipolar depression could occur independent of mania and that bipolar disorders exist along a spectrum is a relatively new one (like the past 15 years). So some PCPs and even some old-school psychiatrists and psychologists might immediately eliminate the possibility of some form of bipolar disorder if you have not ever had a stereotypical "I went on a spending spree and engaged in a lot of unprotected sex and planned on becoming a CEO" mania experience. If you haven't seen a mental health provider that you know is familiar with the latest mood disorder research then I would consider getting evaluated before going on either med.
posted by Anonymous at 2:23 PM on March 21, 2022

Perimenopausal. I started taking daily 10mg of a generic version of lexapro about two years ago after many years of being hesitant to try medication for anxiety and depression. I regret not trying sooner. After many years of trying CBT, meditation and other strategies to try and address my depression and anxiety, I finally feel like I can put the strategies I've learned to use and see them become effective. No more crying while running! I'm able to experience an anxious thought, recognize it as anxious, and get on with my day. I have spontaneous happy thoughts and am noticeably happier.

I experienced various side effects (tinnitus, dry mouth, sleepiness) during the first two weeks (and I was extremely anxious the first day, and very very sleepy the first week), but noting that lasted beyond the first two weeks; I did not experience any further side effects as I increased the dosage. I did feel like the drug became a bit less effective after about 18 months (coinciding with winter and a new lockdown). This feeling went away after I increased my cardio and decreased alcohol intake. Good luck!
posted by frau_grubach at 2:30 PM on March 21, 2022 [2 favorites]

I tried both, separately, for a few months each while in perimenopause. They both made me not care about anything, which was different but not an improvement over my unmedicated depression/ anxiety. Everyone seems to have different experiences with antidepressants though.
posted by metasarah at 2:59 PM on March 21, 2022 [1 favorite]

I’m 46, f, may or may not be in perimenopause. I started taking Lexapro a few years ago when my life exploded due to divorce, and it’s been great for getting through that and These Unprecedented Times. I haven’t had any weight or sleep side effects, and a lifelong needle phobia has disappeared. The biggest inconvenience at first was being banned from taking most cold medicines, and when I started it I noticed my feet getting sweaty at night all of a sudden. That said, at least one good friend had some gnarly anxiety side effects from it, so YMMV.
posted by centrifugal at 3:34 PM on March 21, 2022

I'm 36 and have been on Lexapro since my late 20s. It worked absolute wonders for my anxiety and I have not had any side effects either. (Aside from the first couple of weeks, which were rough.)
posted by thereader at 4:15 PM on March 21, 2022

PERSONALLY I had a not-great experience with Lexapro for anxiety. After about a month on it I realized I wasn’t really ever feeling joy anymore, I just always felt kind of blah. I stopped taking it and my joy came back within about 4-5 days.

I’m really glad I tried it though. It wasn’t a horrible experience, just “oh, this med doesn’t really work for me.” I recommend mood journaling to help you keep an eye on how either of these meds are affecting you.

I don’t take antidepressants anymore but I did start taking meds for ADHD, which have helped me a lot.
posted by mekily at 4:25 PM on March 21, 2022 [1 favorite]

I was on Zoloft on and off for years. It didn’t help my anxiety as much as I would have liked and after a period of time it seemed like it stopped working. I just started Lexapro about a month ago and other than making me dizzy (so I take it at night) it’s starting to work and I think it’s a better fit. I am definitely less anxious and agitated. 47/not menopausal per my doctor, yet.
posted by cabingirl at 5:12 PM on March 21, 2022

Lexapro in my early 40s: I don’t want to discourage you at all because everyone is so different and this is trial and error— and it’s so important to try.

But this medication sucked the life out of me. It did dull anxiety and the terrifying lows of suicidal depression somewhat—but I still felt and thought those bad things; I just didn’t care that I was thinking and feeling horrible things, which is why I quit. Side effects were exhaustion, tinnitus (which is still with me long after quitting), zero, LESS than zero, sex drive, insatiable carb cravings, dreams so vivid that sleep wasn’t restful.

I took Zoloft as a teen and it improved my mood but exacerbated anxiety.

Good luck, don’t give up, don’t assume my experience will be yours—but don’t feel you’re a failure or beyond hope if this drug fails you as it did me. Humans are chemically complex.
posted by kapers at 6:52 PM on March 21, 2022 [2 favorites]

Perimenopausal here. Was having awful sleep issues and anxiety. Started Lexapro 5mg in October and it was life changing. I feel so much better, like the edge is off. I’ll still get appropriate anxiety, though, so I’m happy about that. I don’t feel flat at all. I was so anxious (ha!) about going on Lexapro after a horrible experience with Paxil in my 20s.
posted by msladygrey at 8:05 PM on March 21, 2022 [1 favorite]

I'm a mental health professional (social worker) who works closely with a psychiatrist in the behavioral health department of a large urban clinic. We treat a lot of people with severe depression/anxiety. [usual IANY mental health professional disclaimer here]

She was mentioning to me the other day that a lot of times, if people have a family history of anxiety/depression then a med that works for one person is helpful for their relative. So you might check with your mom/uncle/whoever if you know someone has depression and see what they've taken that works, and then consult with your PCP to see if they could trial that first.

In my experience most PCPs will typically have one or two meds that are their go-to antidepressants and then they're not sure what to do after that if the meds don't help the patient feel better. So don't be hesitant to ask for a psychiatrist referral if you've tried a few things and they haven't helped. (I'm sure your PCP told you this but it often does take a month or so for the rx to kick in, so unfortunately you do have to be kind of patient.)

I also agree with the comments upthread about the importance of making a good diagnosis. Anxiety, severe depression, bipolar disorder (what used to be called manic depression) and ADD/ADHD can look very similar in terms of how the symptoms affect you, but they all have different pharmacological treatments.

Finally, I want to thank you for taking these steps to help yourself feel better. Depression and anxiety are treatable. It can take time, but we have lots of medications now and different medical and therapeutic interventions. You've already done the hard thing, which is picking up the phone and asking for help.
posted by tivalasvegas at 2:01 PM on March 22, 2022 [1 favorite]