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Prozac vs. Zoloft: Which is Better for Anxiety?

Occasionally feeling anxious or excessively worried is a normal part of life. These feelings are triggered by an upcoming event like a public performance, job interview, or test for most people, and these feelings usually go away after some time. However, when they persist, it may be due to an anxiety disorder. Anxiety, which is known as one of the most common mental health conditions, affects approximately 40 million Americans. According to the National Institute of Mental Health, anxiety is the most common mental health issue in the United States, and it affects women more often than men. Anxiety can affect anyone at any age, and there are many reasons that a person can develop it. These include:

  • Increased stress due to work, school, relationship, or financial problems 
  • Substance abuse
  • Depression or other mental health problems
  • Family history or genetic predisposition
  • Low self-esteem
  • Certain medical conditions such as heart problems, thyroid disease, or a side effect of taking some medications

Recently, it has been found that there are various forms of anxiety disorders that have specific symptoms. The most prominent types of anxiety disorders include generalized anxiety disorder, specific phobia, social anxiety disorder, bipolar disorder, separation anxiety disorder, post-traumatic stress disorder and obsessive-compulsive disorder. The most common type of anxiety disorder is called generalized anxiety disorder. This condition mainly has the following symptoms:

  • Restlessness or feeling on edge
  • Fatigue
  • Trouble focusing
  • Irritability
  • Feeling excessively worried without a specific cause
  • Trouble sleeping
  • Sweating
  • Inability to relax
  • Not handling uncertainty well
  • Viewing situations as threatening even if they are harmless
  • Diarrhea or nausea

Getting treatment for anxiety is essential because it helps the affected person start living normally again. Also, it is important to be aware that depression and anxiety are two different medical conditions. Still, they are often interrelated, and the development of one condition can lead to the other. A person can be both depressed and anxious at the same time with symptoms of both. Typical treatment of anxiety disorders combines both medication and psychological counseling or therapy. 

If diagnosed with some form of anxiety disorder, you may be given either Prozac or Zoloft for treatment. These medications are two of the most widely used and well-known names among drugs that improve mental health. What is the difference between the two drugs, and how do you select the right one for you? The information provided here will allow you to  make a comparison of the two drugs to help you choose. 

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What is Prozac?

What is Prozac? Prozac is also known as the generic drug fluoxetine. The SSRI antidepressant was first manufactured by Eli Lilly and Company's pharmaceutical company, and it has been in use since 1986. The World Health Organization has put the drug on its List of Essential Medicines. Prozac belongs to the class of drugs known as selective serotonin reuptake inhibitors (SSRIs). The function of these medications is to block the reuptake of the neurotransmitter, serotonin, into neurons. This allows levels of serotonin in the brain to increase, leading to more neurotransmission by serotonin. Overall, these events elevate mood and feelings of happiness that relieve anxiety's physical, mental and depressive symptoms. Prozac is used to treat the following conditions: 

  • Major depressive disorder
  • Obsessive-Compulsive Disorder (OCD)
  • Panic Disorder
  • Bulimia Nervosa
  • Premenstrual Dysphonic Syndrome

What is Zoloft? 

Some people may find that Prozac is not the drug that works for them and need to ask their doctors the question: “What is Zoloft?” Zoloft is another commonly prescribed antidepressant medication, which was originally developed by Pfizer and has been on the market since 1991. Generic versions of Zoloft are named sertraline. The drug also belongs to the SSRI class of drugs that work by elevating serotonin levels in the brain to restore energy levels, stabilize mood and relieve physical symptoms of depression, such as loss of appetite and decreased interest in everyday activities. Zoloft is used to treat the following conditions:

  • Major Depressive Disorder
  • Obsessive-Compulsive Disorder (OCD)
  • Panic Disorder
  • Post-Traumatic Stress Disorder
  • Social Anxiety Disorder
  • Premenstrual Dysphoric Syndrome

Zoloft and Prozac have many things in common, but the medications are not interchangeable. Understanding their differences can help you get the most benefit out of taking either drug. 

Similarities between the Prozac and Zoloft

  • They belong to the same class of drugs 

Both Prozac and Zoloft are SSRI inhibitors. They work in the same way to treat anxiety. Drugs that belong to the same class often have many similar side effects and risks associated with taking them. 

  • Both are equally effective

Research has found no difference in the ability of Prozac and Zoloft to treat anxiety. Both drugs were found to work equally well and improved symptoms of anxiety in patients. Like all SSRIs, both Prozac and Zoloft can take up to two weeks to start having noticeable effects, and it can take up to six weeks to feel the full effect of either drug. 

  • They have similar side effects 

Prozac and Zoloft are associated with mostly the same side effects. These include:

  • Nausea 
  • Vomiting
  • Diarrhea
  • Feeling nervous or anxious
  • Dizziness
  • Sexual problems like erectile dysfunction 
  • Insomnia 
  • Weight gain
  • Weight loss
  • Headache
  • Dry mouth

Out of these common side effects, Prozac has a higher likelihood of causing dry mouth and problems with sleep, while Zoloft is more likely to cause diarrhea. 

Serious side effects are also common to both medications and include:

  • Increased risk of suicidal thoughts, especially in adults younger than the age of 24
  • Changes to heart rhythm, called QT prolongation, especially in people that have a history of heart problems 
  • Drug interactions are the same 

Generally, other medications that can interact with either Zoloft or Prozac are similar. Some drugs that elevate serotonin levels can increase the risk of serotonin syndrome if taken with Prozac or Zoloft.  Other drugs may also interfere with how both medications work or cause adverse reactions to occur in the body. These drugs include the following:

  • Monoamine oxidase inhibitors 
  • Methylene blue injection
  • Linezolid
  • Pimozide
  • Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen, diclofenac, aspirin
  • Blood thinners like warfarin
  • They are not habit-forming

Prozac and Zoloft have a very low risk of abuse, so they are not controlled substances. However, a prescription is required to purchase either drug. 

  • They may cause problems during pregnancy or breastfeeding

Both drugs are pregnancy category C, meaning that they could cause complications during pregnancy and should only be taken if the benefits outweigh the risks. Consult your doctor to determine if it is safe for you to take either drug during pregnancy or breastfeeding. 

  • They can cause withdrawal symptoms

Prozac and Zoloft must not be stopped suddenly, or they can worsen symptoms and cause withdrawal symptoms such as headache, anxiety, sweating, problems with sleep and feelings of electric shock. Both medications must be stopped gradually under the supervision of your doctor.

  • Cost 

Both Prozac and Zoloft are about the same price. The brand name drugs are quite expensive and can cost more than $400. However, generic versions are relatively inexpensive. Currently, generic fluoxetine (Prozac) costs about $30, and generic sertraline (Zoloft) costs about $40 for 30 tablets. Most commercial health insurance plans and all Medicare Part D or Medicare Advantage plans cover the cost of generic versions of both Zoloft and Prozac. Without insurance, you can also save on either drug with a prescription drug discount card.

Differences between Prozac and Zoloft

  • Different chemical drugs 

Prozac and Zoloft have different chemical formulas. Prozac is fluoxetine, and Zoloft is sertraline. 

  • Used for different indications

While both medications are indicated to treat major depressive disorder, panic disorder, obsessive-compulsive disorder and premenstrual dysphoric syndrome, they are also used for additional conditions that are different for each drug. Prozac is also used to treat bulimia nervosa. Zoloft is also used to treat post-traumatic stress disorder and social anxiety disorder. 

  • Difference in age specifications

Prozac is the only FDA-approved medication treating depression in children above the age of eight, and it is also used to treat OCD in children above seven years of age. Zoloft is approved to treat OCD in children above six years old. 

  • Prozac is also available as a capsule 

Both medications are available as an oral tablet and oral solution formulations. Additionally, Prozac is available as capsules.  

How do I choose? 

Both Prozac and Zoloft are both antidepressant drugs that work well in treating anxiety disorders. They have similar side effects, associated risks, and they are taken essentially in the same way. Therefore, whether you choose Prozac or Zoloft comes down to your age, your personal medical history and the condition that you are treating. If you have social anxiety or post-traumatic stress disorder, then choosing Zoloft is a good option because it is approved for treating these conditions. If you have bulimia nervosa, Prozac is a better choice because it is approved for this use. Additionally, if you have heart problems or other health conditions that can increase your risk of severe side effects with either drug, your doctor can help you decide which medication is safer for you. 

Remember that treating anxiety and other mental health conditions requires regularly taking your medication exactly as prescribed and following the instructions given to you by your healthcare provider. Anxiety is a highly treatable condition with both Prozac and Zoloft, so you will be on your way to feeling better soon with either medication.  

Published September 25th, 2020 by Chris Riley
Fact Checked by Chris Riley

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