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Is ZOLOFT considered gold standard than PRISITIQ?

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Thanks for the insight. I have heard that Lexapro is a considered the "best" SSRI with the least amount of side effects. I also heard that Prisitiq is supposed to be more effective than Zoloft but when I tried Pristiq it didn't work for me and I ended up back on Zoloft. Just wanted to get your perspective, I have spoken with two doctors and they have told me they consider Zoloft the gold standard. just wanted your perspective.

Category: Family Physician-GP

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Welcome back.

Just to confirm, may I know the specific indication for the medication ? (Depression and Anxiety ?) The standing diagnosis by your Doctor.
(SSRIs can be used in many conditions)

Thank you

Patient replied :

Anxiety and Depression. Anxiety is a lot more prevalent and from time to time I suffer from panic attacks. So irritability, racing mind severe anxiety excessive worrying really bad Insomnia. Worrying and anticipation that bad things will happen. Feeling guilty or like I have always done something wrong or will do something wrong.

After being on Zoloft for over a year all these symptoms have gone down dramatically and my work and studying for the CPA exam has improved a great deal.

Thank you

Lexapro and Zolft , both are SSRIs with very similar profiles.
Many studies and meta analysis proved no statistically significant difference among all. But in general Lexapro and Zolft are found slightly superior to others like Fluoxetine, Fluvoxamine, Paroxetine. Side effect profiles are similar. Zolft is a better choice if you have a history arrhythmia's. (not a concern in your case anyway).

Prisitiq is slightly different class of medication. If Zolft is working for you should stick on to that. I would not say it is the gold standard, but Zolft is the most commonly used medication among all.

Thank you

(Cipriani A, Santilli C, Furukawa TA, et al. Escitalopram versus other antidepressive agents for depression. Cochrane Database Syst Rev 2009; :CD006532.
Cipriani A, La Ferla T, Furukawa TA, et al. Sertraline versus other antidepressive agents for depression. Cochrane Database Syst Rev 2010; :CD006117.)

Patient replied :

I like Sertraline and will stick with it for sure. My doctor was shocked that Pristiq wasn't helping so I was curious as to why he was shocked. I thought the SNRI's were suppose to be more effective than SSRI's due to the dual neurotransmitter affect. Just was curious thanks for all your help especially concerning the weight and confirming its mind over manner it has already started to help.

SSRIs are preferred especially when there is Depression + Anxiety. Do stick on with Sertraline.
Wish you good health
Feel free to get back to me anytime.

Thank you

Patient replied :

Sorry to pester you again but just for clarifications sake, is it true that Zoloft is the least likely SSRI to cause weight gain? I have read that Lexapro is but I think most of that was because it was new and only recently became generic.


Hello and thankyou for your query.
Lexapro and Zoloft are very similar in their profile. Which means that their efficacy as well as side effects are very similar. Both are SSRIs and both cause less weight gain. As I said earlier since Zoloft is working on you I would advise you to continue it. Some people feel that they have gained more or less weight with a particular drug, but that is a perspective feeling. Scientifically both Lexapro and and Zoloft are proved to have similar profiles. Except that Zoloft is preferred if a patient has history of arrythmias.

I hope this has helped.

Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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