Drug Comparison
For educational purposes only — a decision-support tool, not a substitute for clinical judgment.
Side-by-side rubric across 96 psychiatric medications. Every rating traces to a verbatim primary-source quote — click any cell to see it.
How to read this tool ▾
Rating scale
– Favorable / lower than class baseline
± Minimal / equivocal
+ Low / uncommon
++ Moderate / common
+++ High / very common
++++ Very high / class-outlier
Frequency vs severity
F = frequency, S = severity. Each gets its own pill colored on the same traffic-light scale: green → blue → yellow → orange → red. Click any cell for incidence percentages and NNH.
Evidence tier
A Network meta-analysis / RCT / FDA label
B Cohort / registry / pooled label data
C Expert review / textbook / case series
Sourcing
Click any cell to see the verbatim source quote and citation. Missing data shows n/a.
Data depth
++ Graded — frequency + severity, primary-source traces
+ FDA label — §6 frequency only (dashed border). Click for sub-types.
Blank — not yet checked (not “absent”)
–±++++++++++ABCF = frequency · S = severity · Dashed border = FDA label only · Click cell for details
1 drug selected — Escitalopram(click to collapse)
1/4 selected
Escitalopram
Lexapro
Selective Serotonin Reuptake Inhibitor
FDA-approved indications
- Major depressive disorder — acute and maintenance (adults; adolescents 12–17 years)
- Generalized anxiety disorder — acute treatment (adults)
Off-label uses
- Panic disorder
- OCD
- PTSD
Half-life27 to 32 hours
Decision GuideWhen to pick each / when to consider an alternative
Escitalopram
Consider when
- First-line MDD where efficacy and tolerability both matter — only SSRI ranking top-tier on both axes in Cipriani 2018 NMA
- Generalized anxiety disorder — FDA-approved for both MDD and GAD; citalopram is MDD-only
- Adolescent depression (age 12+) — one of only two SSRIs with FDA-approved pediatric MDD indication (with fluoxetine)
- Polypharmacy with CYP2D6 or CYP3A4 substrates — minimal CYP inhibition; safest SSRI for drug interactions alongside citalopram
- +1 more
Consider an alternative when
- Sexual dysfunction is treatment-limiting — highest-SD SSRI in Reichenpfader 2014 NMA; significant vs bupropion, fluoxetine, mirtazapine
- QTc prolongation risk — dose-dependent QTc increase; max 10 mg in elderly, hepatic impairment, or CYP2C19 PM
- CYP2C19 poor metabolizer — 2× plasma levels in PMs; max 10 mg may limit therapeutic dose optimization
- Cost is primary constraint — marginally more expensive than citalopram or sertraline generics in some formularies
- +1 more
Efficacy & Acceptability (2 axes)— NMA efficacy & discontinuation data (not side effects)
| Axis | Escitalopram |
|---|---|
| 📊 Efficacy (response rates) | |
MDDEfficacy | |
| 🛡️ Acceptability (all-cause discontinuation) | |
MDDAcceptability | |
| Axis | Escitalopram SSRI |
|---|---|
| Boxed Warnings | |
Suicidality (boxed warning) | |
Mania / hypomania induction | |
| CNS | |
Sedation / somnolence | |
Activation / insomnia | |
Emotional blunting | |
Seizure risk | |
| Metabolic | |
Weight gain | |
| Autonomic | |
Anticholinergic burden | |
Sweating | |
Angle-closure glaucoma | |
| Cardiac | |
QTc prolongation | |
| GI | |
Nausea / GI (general) | |
| Electrolytes | |
Hyponatremia / SIADH | |
| Sexual | |
Sexual dysfunction | |
| Discontinuation | |
Withdrawal / discontinuation | |
| Interactions | |
Serotonin syndrome risk | |
CYP interactions / DDI profile | |
| Safety | |
Bleeding risk | |