Escitalopram vs. Alprazolam

Instructor: Artem Cheprasov

Artem has a doctor of veterinary medicine degree.

This lesson is going to compare and contrast many of the similarities and differences between escitalopram and alprazolam. You'll compare their indications, adverse effects, and much more.

Escitalopram and Alprazolam

You know how you can accomplish the same thing in more than one way? For example, you can hold two pieces of wood planks together with a nail, a screw, or adhesive. Same end result, different way of getting there. Well, we can do the same thing, pharmacologically speaking, in medicine. This lesson, which compares escitalopram and alprazolam, will showcase one example of this.

Brand Names & Dosage Forms

Alprazolam is the generic name for a very famous trade name drug, known as Xanax. Escitalopram is the generic term for the trade name Lexapro.


The dosage forms aren't exactly the same for these medications. By dosage forms, this means the different ways by which the medication can be administered.

Alprazolam comes in standard tablets, disintegrating tablets, and extended-release tablets. It also comes as an oral concentrate. Escitalopram comes as an oral solution and as a standard oral tablet.

Classification, Pharmacology & Indications

Alprazolam is classified as a benzodiazepine. It works by hyperpolarizing the brain's neurons. This means it makes them less excitable. On the other hand, escitalopram is classified as a selective serotonin reuptake inhibitor; it works by increasing the levels of a biochemical called serotonin in the brain, namely in the space outside the brain cells themselves.

Despite being classified differently and working in different ways, both drugs are indicated for the treatment of anxiety. It's like our intro. Both accomplish the same task, just by different means.

Of course, they do have their other indications, ones they don't share. For instance, escitalopram is also used to treat major depressive disorder while alprazolam is used to treat panic disorder.

Precautions & Adverse Effects


Because alprazolam is a benzodiazepine, it shouldn't be used with an opioid medication unless absolutely necessary and, even then, under strict supervision. This is because combining a benzodiazepine like alprazolam with an opioid can lead to profound respiratory depression, sedation, and even coma and death. Alprazolam shouldn't be given to anyone with a known allergy to it or any other component in a medication containing it. Individuals with acute narrow-angle glaucoma, a sudden and/or severe increase in the pressure within the eye, shouldn't be given alprazolam. Neither should individuals using medications such as ketoconazole, itraconazole, or any other such medications that inhibit an enzyme called CYP3A4.

Like alprazolam, escitalopram shouldn't be given to anyone with a known allergy to this medication or a component of the medication. It shouldn't be given to people taking medications called MAO inhibitors or those who have taken one or plan to take one within 14 days. Doing so will increase the chances of a potentially deadly condition known as serotonin syndrome. People being given linezolid, pimozide, or intravenous methylene blue shouldn't take escitalopram either.

Adverse Effects

When compared to one another:

  • Alprazolam is more likely to cause drowsiness than escitalopram.
  • Escitalopram is more likely to lead to insomnia than alprazolam.
  • Escitalopram is more likely to lead to diarrhea while alprazolam is more likely to lead to constipation.
  • Alprazolam may lead to increased appetite while escitalopram may lead to decreased appetite.
  • Both can lead to decreased libido, but alprazolam has a higher chance of doing so.

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