What is Lexapro? Explore Uses, Side Effects, Interactions and Safety

Mental health disorders are silent and pervasive struggles affecting millions across the globe.

In the United States alone, in 2021, an estimated 14.5 million U.S. adults aged 18 or older (5.7% of all U.S. adults) had at least one major depressive episode with severe impairment at a given time. Yet, only roughly 61% received treatment.

Among the various treatment options available, Lexapro (Escitalopram) is a frequently prescribed medication for depression and other mental health conditions. This article aims to provide a professional overview of what is Lexapro, its clinical applications, potential drawbacks, and safety profile for effective use.

Table of Contents

• What is Escitalopram (Lexapro)?
• 7 Clinical Applications of Lexapro
• Lexapro Dosage and Forms
• Lexapro Side Effects
• Lexapro Safety Profile
• Lexapro Interactions
• What is Lexapro (Escitalopram)? Final Considerations
• People Also Ask

What is Escitalopram (Lexapro)?

Trade name: Lexapro®

Generic name: Escitalopram

Lexapro is an antidepressant drug belonging to the selective serotonin reuptake inhibitors (SSRIs) class, considered a first-choice medication for the treatment of major depressive disorder (MDD) and generalized anxiety disorder (GAD).

Escitalopram is the active enantiomer of Citalopram, meaning it’s the pharmacologically active component responsible for the drug’s therapeutic effects. Its mechanism of action inhibits serotonin reuptake in the synaptic cleft, increasing serotonin concentrations in the brain. Higher serotonin levels help regulate mood and alleviate depression and anxiety symptoms.

7 Clinical Applications of Lexapro

Lexapro is FDA-approved for specific conditions based on clinical trials, but physicians may prescribe Lexapro off-label for unapproved uses like other anxiety disorders and phobias. Some of the Lexapro clinical applications include:

Lexapro Approved Uses

• Major Depressive Disorder (MDD): Lexapro is primarily approved by regulatory bodies for treating major depressive episodes, characterized by persistent feelings of sadness, loss of interest and changes in sleep or appetite.

• Generalized Anxiety Disorder (GAD): It is approved for the treatment of generalized anxiety disorder, helping to alleviate excessive worry and anxiety that interfere with daily life.

Lexapro Off-Label Uses

• Panic Disorder: In some cases, Lexapro might be used for panic disorder, involving sudden and intense anxiety attacks with physical symptoms like chest pain and rapid heart rate.

• Social Anxiety Disorder (SAD): In cases of social anxiety disorder, Lexapro can be beneficial in reducing excessive fear and avoidance of social settings.

• Obsessive-Compulsive Disorder (OCD): While not a first-line treatment, Lexapro may be considered for individuals with obsessive-compulsive disorder when other medications have not been effective.

• Post-Traumatic Stress Disorder (PTSD): It might be prescribed off-label for some but not all PTSD, linked to distressing memories and symptoms following a traumatic event.

• Premenstrual Dysphoric Disorder (PMDD): In some cases, Lexapro is prescribed to manage the emotional and physical symptoms of PMDD in women.

Lexapro Dosage and Forms

Lexapro (Escitalopram) dosage depends on the patient’s diagnosis and various forms are available:

Lexapro Dosages

• The typical starting dose for adults is 10 mg per day, often taken orally.
• A healthcare provider may adjust the dosage based on individual response, with a maximum recommended dose of 20 mg per day for most indications.

Lexapro Forms

• Lexapro tablets have different strengths, including 5 mg, 10 mg, and 20 mg. Typically, each bottle contains 100 tablets with pill identifier imprint codes corresponding to each drug presentation.
• It may also be available as premixed as a 5mg per 5mL oral solution with peppermint flavor for patients with difficulty swallowing tablets.

Lexapro Side Effects

Lexapro may cause a spectrum of side effects, ranging from common to more serious reactions. Lexapro common side effects are often transient, but more severe side effects require immediate medical attention. Lexapro side effects include:

• Nausea
• Insomnia
• Fatigue

• Drowsiness
• Dry mouth
• Sweating
• Shakiness or tremors
• Constipation or diarrhea
• Change in libido, orgasm delay, erectile dysfunction

Serious side effects are rare but can include:

• Allergic reactions: Such as rash, itching, swelling, severe dizziness, or difficulty breathing.
• Serotonin syndrome: Symptoms may include fever, hallucinations, rapid heartbeat and severe nausea.

Lexapro Safety Profile

Pregnancy and Breastfeeding

Lexapro is classified as Pregnancy Category C, indicating that animal studies have shown adverse effects on the fetus, but there are limited well-controlled studies in humans. Small amounts of Lexapro can pass into breast milk, but no harmful effects were seen in breastfed babies.

Use during pregnancy is typically reserved for cases where the benefits outweigh potential risks.

Elderly Population

Older adults may be more susceptible to side effects, and lower starting doses are often recommended. Close monitoring for adverse effects, such as drowsiness or dizziness, is essential in the elderly population.

Children and Adolescents

In 2019, Lexapro was approved for adolescents aged 12 and older for MDD, starting with a 10 mg daily dose. Its safety and efficacy in younger children have not been established, and its use in this population is generally avoided.

Lexapro Interactions

Lexapro can interact with various medications. Some notable interactions include:

• Monoamine Oxidase Inhibitors (MAOIs): Phenelzine, Tranylcypromine
• Other SSRIs and SNRIs: Fluoxetine, Venlafaxine
• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Ibuprofen, Naproxen
• Anticoagulants (Warfarin): Warfarin
• Certain Antiarrhythmics: Flecainide
• Lithium: Lithium carbonate
• Triptans: Sumatriptan, Rizatriptan
• Tricyclic Antidepressants: Amitriptyline
• St. John’s Wort
• Cimetidine

What is Lexapro (Escitalopram)? Final Considerations

Lexapro, a selective serotonin reuptake inhibitor (SSRI), is effective for managing depression and anxiety, two mental health disorders diagnosable by specialists. If you are taking Lexapro, follow your doctor’s orders for safe and successful administration.

While Lexapro itself is not considered addictive, some patients have difficulty discontinuing the medication, presenting Lexapro withdrawal symptoms. It is highly advisable to start at the lowest effective dose, gradually increasing to manage the depression or anxiety symptoms, minimizing risks of potential substance abuse, addiction or overdose. If concerns arise, consult your doctor promptly.

People Also Ask

What does Lexapro do to a person?

Lexapro is a selective serotonin reuptake inhibitor (SSRI) that increases serotonin levels in the brain. It helps regulate mood and is prescribed to treat conditions such as major depressive disorder and generalized anxiety disorder.

Is Lexapro compared to Xanax?

No, Lexapro (escitalopram) and Xanax (alprazolam) are different medications. Lexapro is a selective serotonin reuptake inhibitor (SSRI) used for long-term treatment of conditions like depression and anxiety, while Xanax is a benzodiazepine prescribed for short-term relief of anxiety symptoms.

I am taking 30 mg of Lexapro is this a high dose for treating depression?

The short answer is yes. A dose of 30 mg of Lexapro (escitalopram) is considered a high dose for treating depression. The maximum recommended dose for Lexapro is 20 mg per day. If you are prescribed 30 mg, discussing this with your professional healthcare provider to understand the rationale behind this dosage is essential.

How long does it take for Lexapro to get out of your system?

Generally speaking, the time it takes for a drug to be out of your system depends on its half-life, which is the time it takes for the concentration of the drug in the blood to decrease by half. The Lexapro half-life is approximately 27 to 32 hours. Therefore, Lexapro should be out of your system within 7 to 8 days after your last dose, on average. However, this timeline can be variable for each individual.

Can you take Benadryl with Lexapro?

Yes, you can take Benadryl while on Lexapro, but caution is advised due to potential increased drowsiness. Consult your healthcare provider for personalized advice based on your medication regimen.

What is the biggest side effect of Lexapro?

The most common side effect of Lexapro is nausea, affecting approximately 18% of patients. Other common side effects include insomnia, drowsiness, and sexual dysfunction. Lexapro sexual side effects typically include decreased libido, erectile dysfunction, delayed ejaculation, and anorgasmia. Moreover, Lexapro side effects in women can also include reduced vaginal lubrication.

Page Sources

• Major Depression. (n.d.-b). National Institute of Mental Health (NIMH). https://www.nimh.nih.gov/health/statistics/major-depression
• Chen, F., Larsen, M. B., Sánchez, C., & Wiborg, O. (2005). The S-enantiomer of R, S-citalopram, increases inhibitor binding to the human serotonin transporter by an allosteric mechanism. Comparison with other serotonin transporter inhibitors. European Neuropsychopharmacology, 15(2), 193-198. https://doi.org/10.1016/j.euroneuro.2004.08.008
• Landy, K. (2023b, November 10). Escitalopram. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK557734/
• Kirino, E. (2012). Escitalopram for the management of major depressive disorder: A review of its efficacy, safety, and patient acceptability. Patient Preference and Adherence, 6, 853-861. https://doi.org/10.2147/PPA.S22495
• Davidson, J., Bose, A., Korotzer, A., & Zheng, H. (2004). Escitalopram in the treatment of generalized anxiety disorder: Double-blind, placebo controlled, flexible-dose study. Depression and Anxiety, 19(4), 234–240. https://doi.org/10.1002/da.10146
• Stahl, S. M., Gergel, I., & Li, D. (2003). Escitalopram in the treatment of panic disorder. The Journal of Clinical Psychiatry, 64(11), 1322–1327. https://doi.org/10.4088/jcp.v64n1107
• Pallanti, S., & Quercioli, L. (2006). Resistant social anxiety disorder response to Escitalopram. Clinical Practice and Epidemiology in Mental Health : CP & EMH, 2, 35. https://doi.org/10.1186/1745-0179-2-35
• Zutshi, A., Math, S. B., & Janardhan Reddy, Y. C. (2007). Escitalopram in Obsessive-Compulsive Disorder: A Case Series. Primary Care Companion to The Journal of Clinical Psychiatry, 9(6), 466-467. https://doi.org/10.4088/pcc.v09n0611c
• Qi, W., Gevonden, M., & Shalev, A. (2017). Efficacy and Tolerability of High-dose Escitalopram in Posttraumatic Stress Disorder. Journal of Clinical Psychopharmacology, 37(1), 89. https://doi.org/10.1097/JCP.0000000000000626
• Carlini, S. V., & Deligiannidis, K. M. (2020). Evidence-based treatment of Premenstrual Dysphoric Disorder: A concise review. The Journal of Clinical Psychiatry, 81(2). https://doi.org/10.4088/JCP.19ac13071
• Wade, A. G., Crawford, G. M., & Yellowlees, A. (2011). Efficacy, safety and tolerability of escitalopram in doses up to 50 mg in Major Depressive Disorder (MDD): An open-label, pilot study. BMC Psychiatry, 11, 42. https://doi.org/10.1186/1471-244X-11-42
• O’Connor, E. (2019, February 1). Antidepressant and FDA pregnancy categories. Interventions to Prevent Perinatal Depression: A Systematic Evidence Review for the U.S. Preventive Services Task Force - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK537817/
• Findling, R. L., Robb, A., & Bose, A. (2013). Escitalopram in the Treatment of Adolescent Depression: A Randomized, Double-Blind, Placebo-Controlled Extension Trial. Journal of Child and Adolescent Psychopharmacology, 23(7), 468-480. https://doi.org/10.1089/cap.2012.0023

Retrieved on February 26, 2024.