- What is Lexapro (escitalopram)? How does it work?
- What are the side effects of Lexapro (escitalopram)?
- What is the dosage for Lexapro (escitalopram)?
- Which drugs or supplements interact with Lexapro (escitalopram)?
- Is Lexapro (escitalopram) safe to use during pregnancy or while breastfeeding?
- What else should I know about Lexapro (escitalopram)?
What is Lexapro (escitalopram)? How does it work?
Chemically, escitalopram is similar to citalopram (Celexa). Both are in a class of drugs called selective serotonin reuptake inhibitors (SSRIs), a class that also includes fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft).
SSRIs work by affecting neurotransmitters in the brain, the chemical messengers that nerves use to communicate with one another. Neurotransmitters are made and released by nerves and then travel to other nearby nerves where they attach to receptors on the nerves. Not all of the neurotransmitter that is released binds to receptors and, instead, is taken up by the nerves that produced them. This is referred to as "reuptake." Many experts believe that an imbalance of neurotransmitters is the cause of depression.
Escitalopram prevents the reuptake of serotonin (a neurotransmitter), which results in more serotonin in the brain to attach to receptors. Drugs in the SSRI class also are used for treating obsessive compulsive disorders and panic disorders, although Lexapro is not approved for these purposes.
What are the side effects of Lexapro (escitalopram)?
WARNING: Side Effects Warning
Some patients experience withdrawal reactions upon stopping SSRI therapy. Symptoms may include
In order to avoid these symptoms, the dose of SSRI can be slowly reduced instead of abruptly stopped.
Common side effects associated with Lexapro include:
- agitation or restlessness,
- blurred vision,
- difficulty sleeping,
- dry mouth,
- frequent urination,
- increased or decreased appetite,
- increased sweating,
- sexual difficulties (decreased sexual ability or desire, ejaculatory delay),
- taste alterations, tremor (shaking), and
- weight changes.
Antidepressants increased the risk of suicidal thinking and behavior (suicidality) in short-term studies in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of Lexapro or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared with placebo in adults beyond 24 years of age. There was a reduction in risk of suicidality with antidepressants compared with placebo in adults 65 years of age and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients who are started on therapy with antidepressants should be closely observed for clinical worsening, suicidality, or unusual changes in behavior.
Although changes in sexual desire, sexual performance, and sexual satisfaction often occur as a result of depression itself, they also may be a consequence of the drugs used to treat depression. In particular, about one in 11 men given Lexapro report difficulties ejaculating.
Possible serious side effects of Lexapro include:
What is the dosage for Lexapro (escitalopram)?
- The usual starting dose of Lexapro for treating depression in adults or adolescents is 10 mg once daily in the morning or evening. The dose may be increased to 20 mg once daily after 3 weeks.
- Benefit may not be seen until treatment has been given for up to 4 weeks. A daily dose of 20 mg may not be more effective than 10 mg daily for treatment of depression.
- The dose for treating generalized anxiety disorder is 10 mg once daily.
- Lexapro can be taken with or without food.
Which drugs or supplements interact with Lexapro (escitalopram)?
- All SSRIs, including Lexapro, should not be combined with drugs in the monoamine oxidase (MAO) inhibitor class of antidepressants such as:
- Such combinations may lead to confusion, high blood pressure, high fevers, tremor or muscle rigidity, and increased activity. At least 14 days should elapse after discontinuing Lexapro before starting an MAO inhibitor. Conversely, at least 14 days should elapse after discontinuing an MAO inhibitor before starting Lexapro.
- Similar reactions occur when SSRIs are combined with other drugs that increase serotonin in the brain, for example
- Use of selective serotonin inhibitors may increase the risk of gastrointestinal bleeding in patients taking warfarin (Jantoven, Coumadin), aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and other drugs that cause bleeding.
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Is Lexapro (escitalopram) safe to use during pregnancy or while breastfeeding?
- The safety of Lexapro during pregnancy and breastfeeding has not been established. Therefore, Lexapro should not be used during pregnancy unless, in the opinion of the physician, the expected benefits to a patient outweigh unknown hazards to the fetus.
- Lexapro is excreted in human milk. Lexapro should not be given to nursing mothers unless, in the opinion of the physician, the expected benefits to the patient outweigh the possible hazards to the child.
What else should I know about Lexapro (escitalopram)?
- Lexapro is available as Tablets: 5, 10, and 20 mg and oral solution: 1 mg/ml
- Escitalopram should be stored at room temperature, 15 C to 30 C (59 F to 86 F).
- Escitalopram is available in generic form. You need a prescription to obtain this medication.
- The FDA approved escitalopram in August 2002.
Lexapro (escitalopram) is a medication used for treating depression and general anxiety disorder. Lexapro is in the drug class called selective serotonin reuptake inhibitors (SSRIs). Some of the side effects of Lexapro include agitation or restlessness, blurred vision, diarrhea, drowsiness, difficulty sleeping, dry mouth, frequent urination, headache, indigestion, nausea, sweating, and sexual difficulties.
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Related Disease Conditions
Paraphilias are characterized by sexual fantasies, urges, and behaviors involving unusual objects or activities. Exhibitionism, fetishism, frotteurism, pedophilia, sadism, transvestitism, voyeurism, and sexual masochism are examples of paraphilias. Counseling, therapy, and medications are used in the treatment of paraphilias.
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
The term sex addiction describes the behavior of someone who has an unusually strong sex drive or sexual obsession. Sex and thoughts of sex dominate a sex addict's thinking, making it difficult to work or engage in healthy personal relationships. Sex addicts may engage in exhibitionism, voyeurism, prostitution, compulsive masturbation, or cybersex. Treatment for sex addiction includes individual counseling, marital and/or family therapy, support groups, 12-step recovery programs, and in some cases, medications.
Anxiety is a feeling of apprehension and fear characterized by symptoms such as trouble concentrating, headaches, sleep problems, and irritability. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults. Treatment for anxiety may incorporate medications and psychotherapy.
Suicide is the process of intentionally ending one's own life. Approximately 1 million people worldwide commit suicide each year, and 10 million to 20 million attempt suicide annually.
Misophonia is defined as the hatred of sound. Symptoms of this condition include a negative emotional response to certain trigger sounds, such as slurping, snoring, yawning, or throat clearing. Other symptoms include distancing oneself from the trigger, and acting out at the sound's source. Treatment may involve medications, cognitive behavioral therapy, or tinnitus retraining therapy.
Panic attacks are sudden feelings of terror that strike without warning. These episodes can occur at any time, even during sleep. A person experiencing a panic attack may believe that he or she is having a heart attack or that death is imminent. The fear and terror that a person experiences during a panic attack are not in proportion to the true situation and may be unrelated to what is happening around them. Most people with panic attacks experience several of the following symptoms: racing heartbeat, faintness, dizziness, numbness or tingling in the hands and fingers, chills, chest pains, difficulty breathing, and a feeling of loss or control. There are several treatments for panic attacks.
Obsessive Compulsive Disorder (OCD)
Obsessive-compulsive disorder (OCD) is an anxiety disorder that causes a person to suffer repeated obsessions and compulsions. Symptoms include irresistible impulses despite a person's realization that the thoughts are irrational, excessive hand washing, skin picking, lock checking, or repeatedly rearranging items. People with OCD are more likely to develop trichotillomania, muscle or vocal tics, or an eating disorder. Treatment for OCD includes psychotherapy, behavioral therapy, and medication.
What Is Compulsive Overeating vs. Binge Eating Disorder?
Compulsive overeating is eating more than needed. Binge eating disorder involves recurrent episodes of compulsive eating, even when not hungry. Symptoms of bingeing include rapid eating, secret eating, and feeling guilty following a binge. Vyvanse is the only medication approved in the United States for the treatment of binge eating disorder.
Childhood ADD or ADHD (Attention Deficit Hyperactivity Disorder in Children)
Attention deficit hyperactivity disorder (ADHD) causes the following symptoms in children: excessive activity, problems concentrating, and difficulty controlling impulses. There are three types of ADHD: the predominantly inattentive type, the predominantly hyperactive/impulsive type, and the combined (inattentive, hyperactive, and impulsive) type. Stimulant medications are the most common medication used to treat ADHD.
Phobias are unrelenting fears of activities (social phobias), situations (agoraphobia), and specific items (arachnophobia). There is thought to be a hereditary component to phobias, though there may be a cultural influence or they may be triggered by life events. Symptoms and signs of phobias include having a panic attack, shaking, breathing troubles, rapid heartbeat, and a strong desire to escape the situation. Treatment of phobias typically involves desensitization, cognitive behavioral therapy, and medications such as selective serotonin reuptake inhibitors and beta-blockers.
Bipolar Disorder vs. Schizophrenia
Bipolar disorder and schizophrenia are mental illnesses that share some risk factors and treatments. Symptoms of bipolar disorder include mood changes and manic and depressive episodes. Symptoms of schizophrenia include unusual behavior, delusions, and hallucinations.
Anorexia is an eating disorder characterized by markedly reduced appetite or total aversion to food. Anorexia is a serious psychological disorder and is a condition that goes well beyond out-of-control dieting. With anorexia, the drive to become thinner is actually secondary to concerns about control and/or fears relating to one's body. There are psychological and behavioral symptoms as well as physical symptoms of anorexia including: depression, social withdrawal, fatigue, food obsession, heart and gastrointestinal complications, kidney function, flaky skin, brittle nails, and tooth loss (this list is not exhaustive).
Bipolar disorder (or manic depression) is a mental illness characterized by depression, mania, and severe mood swings. Treatment may incorporate mood-stabilizer medications, antidepressants, and psychotherapy.
Emotional eating can be detrimental to one's efforts at weight loss. Learning to identify the situations and emotions that trigger overeating can help to break the habit and prevent future instances of compulsive eating.
Depression in teenagers may be caused by many factors. Symptoms of teen depression include apathy, irresponsible behavior, sadness, sudden drop in grades, withdrawal from friends, and alcohol and drug use. Treatment of depression in adolescents may involve psychotherapy and medications.
Schizotypal Personality Disorder
Schizotypal personality disorder is characterized by odd behaviors, feelings, perceptions, and ways of relating to others that interfere with one's ability to function. Medication and psychotherapy can help the sufferer to manage their symptoms.
Psychotic disorders are a group of serious illnesses that affect the mind. Different types of psychotic disorders include schizophrenia, schizoaffective disorder, schizophreniform disorder, brief psychotic disorder, shared psychotic disorder, delusional disorder, substance-induced psychotic disorder, paraphrenia, and psychotic disorders due to medical conditions.
Separation anxiety disorder is a common childhood anxiety disorder that has many causes. Infants, children, older kids and adults can suffer from symptoms of separation anxiety disorder. Common separation anxiety treatment methods include therapy and medications. Factors that contribute to how quickly or successfully a child moves past separation anxiety by preschool age include how well the parent and child reunite, the skills the child and adult have at coping with the separation, and how well the adult responds to the infant's separation issues. For example, children of anxious parents tend to be anxious children.
Depression in Children
Childhood depression can interfere with social activities, interests, schoolwork and family life. Symptoms and signs include anger, social withdrawal, vocal outbursts, fatigue, physical complaints, and thoughts of suicide. Treatment may involve psychotherapy and medication.
Dysthymia is a less severe form of chronic depression. Symptoms and signs include insomnia, suicidal thoughts, guilt, empty feeling, loss of energy, helplessness, sluggishness, and persistent aches and pains. Treatment may involve psychotherapy, electroconvulsive therapy, and antidepressants.
People with bulimia nervosa, an eating disorder that involves episodes of bingeing and purging, experience symptoms and signs such as deteriorating teeth, sore throat, constipation, thinning hair, and dehydration. Treatment of bulimia may involve cognitive behavior therapy, family therapy, nutritional counseling, and medication.
Agoraphobia is a fear of being outside or of being in a situation from which escape would be impossible. Symptoms include anxiety, fear, disorientation, rapid heartbeat, diarrhea, or dizziness. Treatment may incorporate psychotherapy, self-exposure to the anxiety-causing situation, and medications such as SSRIs, benzodiazepines, and beta-blockers.
Postpartum depression is a form of depression that occurs within a year after delivery. It is thought that rapid hormone changes after childbirth may lead to depression. Symptoms of postpartum depression include crying a lot, headaches, chest pains, eating too little or too much, sleeping too little or too much, withdrawal from friends and family, and feeling irritable, sad, hopeless, worthless, guilty, and overwhelmed. Treatment typically involves talk therapy and medication.
Depression in the Elderly
Depression in the elderly is very common. That doesn't mean, though, it's normal. Treatment may involve antidepressants, psychotherapy, or electroconvulsive therapy.
Treatment & Diagnosis
- Mood Swings
- Poor Hygiene
- Unusual Behavior
- Social Isolation
- Inability to Regulate Emotions
- Antisocial Personality Disorder
- Anorexia Nervosa
- Bipolar Disorder
- Obsessive-Compulsive Disorder (OCD)
- Borderline Personality Disorder
- Panic Attack
- Generalized Anxiety Disorder
- Illness Anxiety Disorder (Hypochondria)
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Medications & Supplements
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- Zoloft (sertraline)
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- Citalopram (Celexa)
- fluoxetine (Prozac, Sarafem, Prozac Weekly)
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- paroxetine (Paxil, Pexeva)
- Monoamine Oxidase Inhibitors (MAOIs) vs. Selective Serotonin Reuptake Inhibitors (SSRIs)
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Prevention & Wellness
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- Prenatal Antidepressant Use Not Linked to Infant Heart Defects: Study
- Certain Antidepressants May Be Linked to Bipolar Disorder: Study
- Antidepressants in Pregnancy May Raise Autism Risk, Study Suggests
- Antidepressants During Pregnancy Have Benefits, Risks: Study
- Common Antidepressants Linked to Higher Fracture Odds in Menopausal Women
- Risk to Baby From Antidepressant Use in Pregnancy Is Small, Study Says
- One Dose of Antidepressant Changes Brain Connections, Study Says
- Weight Gain From Antidepressants Is Minimal, Study Suggests
- For Many Women, Hot Flashes Last 10 Years or More After Menopause
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