Medical Review by Jennie Stanford, MD, FAAFP
Summary
- Zoloft®, Prozac®, and Lexapro® are SSRIs that all influence your serotonin levels, while Wellbutrin® focuses on dopamine and norepinephrine.
- All of these medications can help treat depression and anxiety, but they may be better suited for different conditions.
- Side effects and risk factors also vary between these medications, so your individual tolerance matters.
- Cost and accessibility can influence the decision, especially if insurance coverage is a factor.
- Always consult a healthcare provider for personalized guidance on medication and use any medication you have been prescribed only as directed.
Numerous medications can help treat depression & anxiety—but they aren’t all the same
Choosing the right antidepressant can feel overwhelming, especially with so many different options available. Zoloft®, Prozac®, Lexapro®, and Wellbutrin® are all commonly prescribed medications for treating depression and anxiety, but they work in different ways and may be better suited for certain conditions.
This guide from Lemonaid Health compares these medications based on their uses, effectiveness, side effects, cost, and accessibility. We’re here to help you make more informed decisions with your healthcare provider so you can make meaningful progress and enjoy better outcomes.
A brief overview of each medicine
Zoloft®, Prozac®, and Lexapro® all belong to a class of medications called selective serotonin reuptake inhibitors (SSRIs). These medications are often prescribed for depression and other mental health conditions because they are generally considered to be safe, effective, and well-tolerated.
Wellbutrin® belongs to a different group of medications called norepinephrine and dopamine reuptake inhibitors (NDRIs). These medications are typically used to help treat conditions like depression and seasonal affective disorder, as well as to help people stop smoking.
All of these medications also have generic versions, which have the same benefits and potential risks as their branded counterparts. The generic form of Zoloft® is called sertraline, the generic form of Prozac® is called fluoxetine, the generic form of Lexapro® is called escitalopram, and the generic form of Wellbutrin® is called bupropion.
Here is a comparison chart showing how each of these medications works at a glance:
| Drug Class | Medications | How It Works |
| SSRIs | Zoloft® (sertraline), Prozac® (fluoxetine), Lexapro® (escitalopram) | Prevents serotonin from being absorbed after it is produced. Higher serotonin levels improve mood and memory while making behavior easier to regulate. |
| NDRIs | Wellbutrin® (bupropion) | Prevents dopamine and norepinephrine from being absorbed after they are produced. Dopamine regulates your brain’s reward system while norepinephrine regulates arousal, attention, cognitive function, and stress. |
Comparison of uses
All of these medications can be used to help treat depression in clinically indicated cases, but some may be better suited for specific cases than others. Below is a chart showing what conditions each medication is FDA-approved for, as well as the ones for which it is sometimes prescribed off-label:
| Medication | FDA Approvals | Off-Label Uses |
| Zoloft® (sertraline) | Major depressive disorderObsessive-compulsive disorder (OCD)Panic disorderPost-traumatic stress disorder (PTSD)Premenstrual dysphoric disorderSocial anxiety disorder (SAD) | Binge eating disorderBody dysmorphic disorderBulimia nervosa (BN)Generalized anxiety disorder (GAD)Premature ejaculation |
| Prozac® (fluoxetine) | Major depressive disorderObsessive-compulsive disorder (OCD)Panic disorder (with or without agoraphobia)Bulimia nervosaDepressive episodes associated with Bipolar I disorder (as an adjunct with olanzapine)Treatment-resistant depression (when used with olanzapine) | Binge eating disorderSocial anxiety disorderPremenstrual dysphoric disorderBorderline personality disorderRaynaud phenomenonSelective mutism |
| Lexapro® (escitalopram) | Major depressive disorderGeneralized anxiety disorder | Social anxiety disorderObsessive-compulsive disorder (OCD)Panic disorderPost-traumatic stress disorder (PTSD)Premenstrual dysphoric disorderVasomotor symptoms of menopause |
| Wellbutrin® (bupropion) | Adult depressionSeasonal affective disorderSmoking cessation | Sexual dysfunction caused by antidepressantsAttention-deficit/hyperactivity disorder (ADHD)Depression associated with bipolar disorderObesity |
Effectiveness & results
Even if you are prescribed an antidepressant that is appropriate for your needs, it can take some time before you start to notice the effects. SSRIs like Zoloft®, Prozac®, and Lexapro® can each take up to 6 weeks before their benefits become noticeable.
As an NDRI, Wellbutrin® may take at least 4 weeks before the full effects of treatment can be felt. You may want to talk to your healthcare provider if you have taken any of these medications for more than 4-6 weeks and have not noticed any changes so they can adjust your dosage or switch your medication as needed.
Potential side effects & risks
Each of these medications comes with its own potential side effects, but some may be more tolerable than others depending on your individual sensitivity. Here is a chart showing some of the most common side effects for each drug, along with their possible severe health risks:
| Medication | Common Side Effects | Serious Risks & Contraindications |
| Zoloft® (sertraline) | Nausea, diarrhea, tremors | Serotonin syndrome |
| Prozac® (fluoxetine) | Nausea, insomnia, nervousness | Serotonin syndrome |
| Lexapro® (escitalopram) | Insomnia, sexual problems, nausea | Serotonin syndrome |
| Wellbutrin® (bupropion) | Agitation, dry mouth, insomnia | Increased seizure risk, not recommended for people with eating disorders |
Be advised that while serotonin syndrome is serious, most cases involve taking at least two different medications that change serotonin levels. This is part of why it’s so important to talk to your healthcare provider about any other medications you are taking before they prescribe any new medications to you.
Cost & accessibility
Medication costs can vary based on insurance coverage and the availability of generics. However, research suggests that the cost per day of different SSRIs can vary, due to the way each medication is taken. This research shows fluoxetine (Prozac®) to be slightly more expensive than sertraline (Zoloft®), although escitalopram (Lexapro®) and bupropion (Wellbutrin®) are not included in the comparison.
The best way to find out how much any medication will cost you is to consult your healthcare provider and insurance provider. They will be able to help you understand what you can expect to pay for any of these medications if they are prescribed to you.
Consulting a healthcare provider
Finding the right antidepressant medication depends on multiple factors, and your healthcare provider will most likely ask you a series of questions before prescribing a specific medication to you. This may include questions about:
- The symptoms you’re experiencing, and which ones bother you most
- Any other medications or supplements that you currently take or have taken recently
- Whether specific antidepressants were effective for close family members, as this may increase the likelihood that it will work for you as well
- Any other health conditions you have that could contraindicate certain medications
- Whether you are pregnant, breastfeeding, or planning to become pregnant in the foreseeable future
Working with a healthcare provider can help you weigh the benefits and risks of each option and determine the best fit for you. They can also adjust the dosage of your medication or switch you to something else if your current medication isn’t working as intended. You should only ever take medication as it has been prescribed to you by a qualified medical professional.
Learn more about different depression & anxiety medication with Lemonaid Health
If you’re considering antidepressant treatment, discussing your options with a healthcare professional is the best way to find the right fit for your needs.
Lemonaid Health can connect you with US-based medical professionals who can answer your questions about Zoloft®, Prozac®, Lexapro®, and Wellbutrin®. We can also help create a personalized treatment plan to help you with anxiety or depression, which may include one of these medications or a generic version if clinically indicated for your case. Get started today for expert support on your mental health journey.
Zoloft® is a registered trademark of Viatris Specialty LLC, a Viatris Company. Prozac® is a registered trademark of Eli Lilly and Company. Lexapro® is a registered trademark of H. Lundbeck A/S. Wellbutrin® is a registered trademark of GlaxoSmithKline LLC.
