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Prozac still makes a lot of sense in several situations: Broader symptom clusters: depression plus OCD, panic, or bulimia Low-energy states: fatigue, hypersomnia, lethargy Patients who need more dosing forgiveness: because of its longer duration in the body Lexapro tends to rise to the top when the question is narrower and more common: I have depression, anxiety, or both, and I need a first-line medication that often feels calmer and more focused. Comparing Side Effects and Safety Profiles A common appointment scenario goes like this: one patient says, "I can tolerate some nausea, but I cannot afford to gain weight or feel flat." Another says, "I already feel wired and I am barely sleeping." That is the right way to approach Lexapro versus Prozac