Prozac vs Xanax: How do they compare?

Key Points

• Prozac (fluoxetine) is a selective serotonin reuptake inhibitor (SSRI), and Xanax (alprazolam) is a benzodiazepine.
• Both Prozac and Xanax may be prescribed to treat certain mental health conditions. Xanax is only FDA approved for use in adults, while Prozac can be used in children for some indications.
• Drowsiness is more common from taking Xanax, while Prozac tends to cause insomnia and nausea as side effects.

Prozac (fluoxetine) and Xanax (alprazolam) are both prescription medications used to treat mental health conditions, but they work in different ways. Below, we will review several differences between these two medications.

What are Prozac and Xanax used for?

Prozac (fluoxetine) and Xanax (alprazolam) are both used to treat some of the same and some different mental health conditions. Both medications require a prescription from a healthcare provider.

Prozac is FDA approved to treat:

• Major depressive disorder
• Obsessive-compulsive disorder
• Panic disorder
• Bulimia nervosa
• Depressive episodes associated with Bipolar I disorder
• Treatment-resistant depression

Xanax is FDA approved for adults to treat:

• Generalized anxiety disorder
• Panic disorder

It is important to note that certain forms of each medication treat specific conditions. In addition, Prozac is approved for children only for specific indications. Follow up with your healthcare provider to learn more.

How do Prozac and Xanax work?

Prozac and Xanax work in very different ways. Prozac belongs to a group of medications called selective serotonin reuptake inhibitors, or SSRIs. Xanax is a benzodiazepine.

Prozac is thought to work by increasing serotonin in the brain. Serotonin is a neurotransmitter that affects mood.

Xanax works by enhancing the effects of a chemical in the brain called gamma-aminobutyric acid (GABA). This neurotransmitter causes you to feel more calm and relaxed.

What dosage forms do Prozac and Xanax come in?

Both Prozac and Xanax are available in immediate-release and extended-release formulations.

Prozac comes as immediate-release capsules, tablets, and an oral solution. It also comes as a delayed-release capsule that is approved to treat major depressive disorder.

Xanax comes as immediate-release tablets, orally disintegrating tablets, and an oral solution. It also comes as an extended-release tablet that is approved for panic disorder.

How are Prozac and Xanax taken?

The immediate-release formulations of Prozac are usually taken by mouth once a day. However, the dose can vary depending on your age and the reason you are taking it. The typical dose of the delayed-release capsule is 90 mg taken by mouth once a week.

Xanax is usually taken by mouth three times a day, except for the extended-release tablet that is taken by mouth once a day. The typical starting dosages of Xanax are listed below.

Immediate-release formulations:

• Generalized anxiety disorder: 0.25 mg to 0.5 mg by mouth 3 times a day.
• Panic disorder: 0.5 mg by mouth 3 times a day.

Extended-release tablets:

• Panic disorder: 0.5 mg to 1 mg by mouth once a day.

Your healthcare provider may increase your dose based on how you respond to the medication.

Related questions

• What does Prozac feel like when it starts working?
• SSRIs vs SNRIs - What's the difference between them?
• Does Prozac cause weight gain or loss?

What are the side effects of Prozac and Xanax?

Prozac and Xanax have unique side effects. For example, common side effects of Prozac include sleeping problems, nausea and headache while Xanax more commonly causes drowsiness and memory problems.

The most common side effects reported by people taking Prozac in clinical trials include:

• Insomnia (up to 33%)
• Nausea (up to 29%)
• Headache (21%)
• Asthenia (weakness) (up to 21%)
• Diarrhea (up to 18%)
• Poor appetite (up to 17%)
• Drowsiness (up to 17%)
• Anxiety (up to 15%)

Everyone responds to medications differently. Side effects can vary depending on your age, dose, and medical conditions.

The most common side effects reported by people taking Xanax extended-release tablets in clinical trials include:

• Sedation (45% vs. 23% placebo)
• Drowsiness (23% vs. 6% placebo)
• Memory problems (15% vs. 7% placebo)
• Fatigue (14% vs. 9% placebo)
• Depression (12% vs. 9% placebo)
• Slurred speech (11% vs. 3% placebo)

The most common side effects reported by people taking immediate-release alprazolam in clinical trials include:

• Drowsiness (up to 77%)
• Tiredness (up to 49%)
• Difficulty with coordination (up to 40%)
• Irritability (up to 33%)
• Larger appetite (up to 33%)
• Memory problems (up to 33%)
• Trouble thinking (up to 29%)
• Smaller appetite (up to 28%)
• Weight gain (up to 27%)
• Constipation (up to 26%)
• Slurred speech (up to 23%)
• Weight loss (up to 23%)
• Light-headedness (up to 21%)

Prozac and Xanax should not be stopped abruptly to avoid withdrawal symptoms. If you need to stop taking one of these medications, speak to your healthcare provider about a safe way to do so.

What’s better for anxiety, Prozac or Xanax?

Both Prozac and Xanax may be prescribed to treat anxiety. However, SSRIs like Prozac are considered first-choice treatment for anxiety. Prozac is currently not FDA approved for treating anxiety, but other medications in the same class are approved for this use.

Benzodiazepines, like Xanax, are typically used for short-term treatment of anxiety. They may work faster to control anxiety symptoms compared to other treatment options. Your healthcare provider will regularly assess whether you need to continue to take Xanax for your anxiety symptoms, and will likely recommend a different long-term treatment option.

Studies have shown that benzodiazepines do not work better than antidepressants for treating anxiety. For panic disorder, benzodiazepines and SSRIs are comparable in how well they work. The choice of treatment is based on side effects, cost, drug interactions, and medical history.

Can you take Xanax and Prozac together?

It is possible your prescriber recommends taking Xanax and Prozac together. This may be helpful if you continue having symptoms after trying Prozac alone first. However, experts recommend taking benzodiazepines like Xanax only for short periods of time. Prozac is used for long-term treatment because it has less risks.

This is not all the information you need to know about Prozac (fluoxetine) and Xanax (alprazolam) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.