What is Lexapro (escitalopram)?
Lexapro (escitalopram) is a selective serotonin reuptake inhibitor (SSRI) antidepressant used to treat depression and generalized anxiety disorder.
Drug interactions of Lexapro include monoamine oxidase inhibitors (MAOIs), tryptophan, St. John's wort, meperidine, lithium, triptans, tramadol, warfarin, aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and other drugs that cause bleeding.
The safety of Lexapro during pregnancy and breastfeeding has not been established. Lexapro should not be used during pregnancy unless 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 the expected benefits to the patient outweigh the possible hazards to the child.
What are the side effects of Lexapro?
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.
What are the common side effects of Lexapro?
Common side effects associated with Lexapro include:
- agitation or restlessness,
- blurred vision,
- diarrhea,
- difficulty sleeping,
- drowsiness,
- dry mouth,
- fever,
- frequent urination,
- headache,
- indigestion,
- nausea,
- 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 the 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.
Other side effects include influenza-like symptoms and pain in the neck or shoulders.
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.
What are the serious side effects of Lexapro?
Possible serious side effects of Lexapro include:
- Serotonin syndrome
- Suicidal thinking and behavior
- Abnormal bleeding
- Seizures
- Manic episodes
- Confusion
- High fever
- Slurred speech
- Muscle rigidity
- Low sodium
- Angle-closure glaucoma.
What drugs interact with Lexapro?
Monoamine Oxidase Inhibitors (MAOIs)
Serotonergic Drugs
Triptans
There have been rare postmarketing reports of serotonin syndrome with use of an SSRI and a triptan. If concomitant treatment of Lexapro with a triptan is clinically warranted, careful observation of the patient is advised, particularly during treatment initiation and dose increases.
CNS Drugs
Given the primary CNS effects of escitalopram, caution should be used when it is taken in combination with other centrally acting drugs.
Alcohol
Although Lexapro did not potentiate the cognitive and motor effects of alcohol in a clinical trial, as with other psychotropic medications, the use of alcohol by patients taking Lexapro is not recommended.
Drugs That Interfere With Hemostasis (NSAIDs, Aspirin, Warfarin, etc.)
Serotonin release by platelets plays an important role in hemostasis. Epidemiological studies of the case-control and cohort design that have demonstrated an association between use of psychotropic drugs that interfere with serotonin reuptake and the occurrence of upper gastrointestinal bleeding have also shown that concurrent use of an NSAID or aspirin may potentiate the risk of bleeding. Altered anticoagulant effects, including increased bleeding, have been reported when SSRIs and SNRIs are coadministered with warfarin. Patients receiving warfarin therapy should be carefully monitored when Lexapro is initiated or discontinued.
Cimetidine
In subjects who had received 21 days of 40 mg/day racemic citalopram, combined administration of 400 mg twice a day cimetidine for 8 days resulted in an increase in citalopram AUC and Cmax of 43% and 39%, respectively. The clinical significance of these findings is unknown.
Digoxin
In subjects who had received 21 days of 40 mg/day racemic citalopram, combined administration of citalopram and digoxin (single dose of 1 mg) did not significantly affect the pharmacokinetics of either citalopram or digoxin.
Lithium
Coadministration of racemic citalopram (40 mg/day for 10 days) and lithium (30 mmol/day for 5 days) had no significant effect on the pharmacokinetics of citalopram or lithium. Nevertheless, plasma lithium levels should be monitored with appropriate adjustment to the lithium dose in accordance with standard clinical practice. Because lithium may enhance the serotonergic effects of escitalopram, caution should be exercised when Lexapro and lithium are coadministered.
Pimozide And Celexa
In a controlled study, a single dose of pimozide 2 mg co-administered with racemic citalopram 40 mg given once daily for 11 days was associated with a mean increase in QTc values of approximately 10 msec compared to pimozide given alone. Racemic citalopram did not alter the mean AUC or Cmax of pimozide. The mechanism of this pharmacodynamic interaction is not known.
Sumatriptan
There have been rare postmarketing reports describing patients with weakness, hyperreflexia, and incoordination following the use of an SSRI and sumatriptan. If concomitant treatment with sumatriptan and an SSRI (e.g., fluoxetine, fluvoxamine, paroxetine, sertraline, citalopram, escitalopram) is clinically warranted, appropriate observation of the patient is advised.
Theophylline
Combined administration of racemic citalopram (40 mg/day for 21 days) and the CYP1A2 substrate theophylline (single dose of 300 mg) did not affect the pharmacokinetics of theophylline. The effect of theophylline on the pharmacokinetics of citalopram was not evaluated.
Warfarin
Administration of 40 mg/day racemic citalopram for 21 days did not affect the pharmacokinetics of warfarin, a CYP3A4 substrate. Prothrombin time was increased by 5%, the clinical significance of which is unknown.
Carbamazepine
Combined administration of racemic citalopram (40 mg/day for 14 days) and carbamazepine (titrated to 400 mg/day for 35 days) did not significantly affect the pharmacokinetics of carbamazepine, a CYP3A4 substrate. Although trough citalopram plasma levels were unaffected, given the enzyme-inducing properties of carbamazepine, the possibility that carbamazepine might increase the clearance of escitalopram should be considered if the two drugs are coadministered.
Triazolam
Combined administration of racemic citalopram (titrated to 40 mg/day for 28 days) and the CYP3A4 substrate triazolam (single dose of 0.25 mg) did not significantly affect the pharmacokinetics of either citalopram or triazolam.
Ketoconazole
Combined administration of racemic citalopram (40 mg) and ketoconazole (200 mg), a potent CYP3A4 inhibitor, decreased the Cmax and AUC of ketoconazole by 21% and 10%, respectively, and did not significantly affect the pharmacokinetics of citalopram.
Ritonavir
Combined administration of a single dose of ritonavir (600 mg), both a CYP3A4 substrate and a potent inhibitor of CYP3A4, and escitalopram (20 mg) did not affect the pharmacokinetics of either ritonavir or escitalopram.
CYP3A4 And -2C19 Inhibitors
In vitro studies indicated that CYP3A4 and -2C19 are the primary enzymes involved in the metabolism of escitalopram. However, coadministration of escitalopram (20 mg) and ritonavir (600 mg), a potent inhibitor of CYP3A4, did not significantly affect the pharmacokinetics of escitalopram. Because escitalopram is metabolized by multiple enzyme systems, inhibition of a single enzyme may not appreciably decrease escitalopram clearance.
Drugs Metabolized By Cytochrome P4502D6
In vitro studies did not reveal an inhibitory effect of escitalopram on CYP2D6. In addition, steady state levels of racemic citalopram were not significantly different in poor metabolizers and extensive CYP2D6 metabolizers after multiple-dose administration of citalopram, suggesting that coadministration, with escitalopram, of a drug that inhibits CYP2D6, is unlikely to have clinically significant effects on escitalopram metabolism. However, there are limited in vivo data suggesting a modest CYP2D6 inhibitory effect for escitalopram, i.e., coadministration of escitalopram (20 mg/day for 21 days) with the tricyclic antidepressant desipramine (single dose of 50 mg), a substrate for CYP2D6, resulted in a 40% increase in Cmax and a 100% increase in AUC of desipramine. The clinical significance of this finding is unknown. Nevertheless, caution is indicated in the coadministration of escitalopram and drugs metabolized by CYP2D6.
Metoprolol
Administration of 20 mg/day Lexapro for 21 days in healthy volunteers resulted in a 50% increase in Cmax and 82% increase in AUC of the beta-adrenergic blocker metoprolol (given in a single dose of 100 mg). Increased metoprolol plasma levels have been associated with decreased cardioselectivity. Coadministration of Lexapro and metoprolol had no clinically significant effects on blood pressure or heart rate.
Electroconvulsive Therapy (ECT)
There are no clinical studies of the combined use of ECT and escitalopram.
Lexapro side effects list for healthcare professionals
Clinical Trials Experience
Because clinical studies are conducted under widely varying conditions, adverse reaction rates observed in the clinical studies of a drug cannot be directly compared to rates in the clinical studies of another drug and may not reflect the rates observed in practice.
Clinical Trial Data Sources
Pediatrics (6 -17 Years)
Adverse events were collected in 576 pediatric patients (286 Lexapro, 290 placebo) with major depressive disorder in double-blind placebo-controlled studies. Safety and effectiveness of Lexapro in pediatric patients less than 12 years of age has not been established.
Adults
Adverse events information for Lexapro was collected from 715 patients with major depressive disorder who were exposed to escitalopram and from 592 patients who were exposed to placebo in double-blind, placebo-controlled trials. An additional 284 patients with major depressive disorder were newly exposed to escitalopram in open-label trials. The adverse event information for Lexapro in patients with GAD was collected from 429 patients exposed to escitalopram and from 427 patients exposed to placebo in double-blind, placebo-controlled trials.
Adverse events during exposure were obtained primarily by general inquiry and recorded by clinical investigators using terminology of their own choosing. Consequently, it is not possible to provide a meaningful estimate of the proportion of individuals experiencing adverse events without first grouping similar types of events into a smaller number of standardized event categories. In the tables and tabulations that follow, standard World Health Organization (WHO) terminology has been used to classify reported adverse events.
The stated frequencies of adverse reactions represent the proportion of individuals who experienced, at least once, a treatment emergent adverse event of the type listed. An event was considered treatment-emergent if it occurred for the first time or worsened while receiving therapy following baseline evaluation.
Adverse Events Associated With Discontinuation Of Treatment
Major Depressive Disorder
Pediatrics (6 -17 years)
Adverse events were associated with discontinuation of 3.5% of 286 patients receiving Lexapro and 1% of 290 patients receiving placebo. The most common adverse event (incidence at least 1% for Lexapro and greater than placebo) associated with discontinuation was insomnia (1% Lexapro, 0% placebo).
Adults
Among the 715 depressed patients who received Lexapro in placebo-controlled trials, 6% discontinued treatment due to an adverse event, as compared to 2% of 592 patients receiving placebo. In two fixed-dose studies, the rate of discontinuation for adverse events in patients receiving 10 mg/day Lexapro was not significantly different from the rate of discontinuation for adverse events in patients receiving placebo. The rate of discontinuation for adverse events in patients assigned to a fixed dose of 20 mg/day Lexapro was 10%, which was significantly different from the rate of discontinuation for adverse events in patients receiving 10 mg/day Lexapro (4%) and placebo (3%). Adverse events that were associated with the discontinuation of at least 1% of patients treated with Lexapro, and for which the rate was at least twice that of placebo, were nausea (2%) and ejaculation disorder (2% of male patients).
Generalized Anxiety Disorder
Adults
Among the 429 GAD patients who received Lexapro 10-20 mg/day in placebo-controlled trials, 8% discontinued treatment due to an adverse event, as compared to 4% of 427 patients receiving placebo. Adverse events that were associated with the discontinuation of at least 1% of patients treated with Lexapro, and for which the rate was at least twice the placebo rate, were nausea (2%), insomnia (1%), and fatigue (1%).
Incidence Of Adverse Reactions In Placebo-Controlled Clinical Trials
Major Depressive Disorder
Pediatrics (6 -17 years)
The overall profile of adverse reactions in pediatric patients was generally similar to that seen in adult studies, as shown in Table 2. However, the following adverse reactions (excluding those which appear in Table 2 and those for which the coded terms were uninformative or misleading) were reported at an incidence of at least 2% for Lexapro and greater than placebo: back pain, urinary tract infection, vomiting, and nasal congestion.
Adults
The most commonly observed adverse reactions in Lexapro patients (incidence of approximately 5% or greater and approximately twice the incidence in placebo patients) were insomnia, ejaculation disorder (primarily ejaculatory delay), nausea, sweating increased, fatigue, and somnolence.
Table 2 enumerates the incidence, rounded to the nearest percent, of treatment-emergent adverse events that occurred among 715 depressed patients who received Lexapro at doses ranging from 10 to 20 mg/day in placebo-controlled trials. Events included are those occurring in 2% or more of patients treated with Lexapro and for which the incidence in patients treated with Lexapro was greater than the incidence in placebo-treated patients.
TABLE 2: Treatment-Emergent Adverse Reactions observed with a frequency of ≥ 2% and greater than placebo for Major Depressive Disorder
Adverse Reaction | Lexapro (N=715)% |
Placebo (N=592) % |
---|---|---|
Autonomic Nervous System Disorders | ||
Dry Mouth | 6% | 5% |
Sweating Increased | 5% | 2% |
Central & Peripheral Nervous System Disorders | ||
Dizziness | 5% | 3% |
Gastrointestinal Disorders | ||
Nausea | 15% | 7% |
Diarrhea | 8% | 5% |
Constipation | 3% | 1% |
Indigestion | 3% | 1% |
Abdominal Pain | 2% | 1% |
General | ||
Influenza-like Symptoms | 5% | 4% |
Fatigue | 5% | 2% |
Psychiatric Disorders | ||
Insomnia | 9% | 4% |
Somnolence | 6% | 2% |
Appetite Decreased | 3% | 1% |
Libido Decreased | 3% | 1% |
Respiratory System Disorders | ||
Rhinitis | 5% | 4% |
Sinusitis | 3% | 2% |
Urogenital | ||
Ejaculation Disorder1,2 | 9% | <1% |
Impotence2 | 3% | <1% |
Anorgasmia3 | 2% | <1% |
1Primarily ejaculatory delay. 2Denominator used was for males only (N=225 Lexapro; N=188 placebo). 3Denominator used was for females only (N=490 Lexapro; N=404 placebo). |
Generalized Anxiety Disorder
Adults
The most commonly observed adverse reactions in Lexapro patients (incidence of approximately 5% or greater and approximately twice the incidence in placebo patients) were nausea, ejaculation disorder (primarily ejaculatory delay), insomnia, fatigue, decreased libido, and anorgasmia.
Table 3 enumerates the incidence, rounded to the nearest percent of treatment-emergent adverse events that occurred among 429 GAD patients who received Lexapro 10 to 20 mg/day in placebo-controlled trials. Events included are those occurring in 2% or more of patients treated with Lexapro and for which the incidence in patients treated with Lexapro was greater than the incidence in placebo-treated patients.
TABLE 3 : Treatment-Emergent Adverse Reactions observed with a frequency of ≥ 2% and greater than placebo for Generalized Anxiety Disorder
Adverse Reactions | Lexapro (N=429)% |
Placebo (N=427)% |
---|---|---|
Autonomic Nervous System Disorders | ||
Dry Mouth | 9% | 5% |
Sweating Increased | 4% | 1% |
Central & Peripheral Nervous System Disorders | ||
Headache | 24% | 17% |
Paresthesia | 2% | 1% |
Gastrointestinal Disorders | ||
Nausea | 18% | 8% |
Diarrhea | 8% | 6% |
Constipation | 5% | 4% |
Indigestion | 3% | 2% |
Vomiting | 3% | 1% |
Abdominal Pain | 2% | 1% |
Flatulence | 2% | 1% |
Toothache | 2% | 0% |
General | ||
Fatigue | 8% | 2% |
Influenza-like Symptoms | 5% | 4% |
Musculoskeletal System Disorder | ||
Neck/Shoulder Pain | 3% | 1% |
Psychiatric Disorders | ||
Somnolence | 13% | 7% |
Insomnia | 12% | 6% |
Libido Decreased | 7% | 2% |
Dreaming Abnormal | 3% | 2% |
Appetite Decreased | 3% | 1% |
Lethargy | 3% | 1% |
Respiratory System Disorders | ||
Yawning | 2% | 1% |
Urogenital | ||
Ejaculation Disorder1,2 | 14% | 2% |
Anorgasmia3 | 6% | <1% |
Menstrual Disorder | 2% | 1% |
1Primarily ejaculatory delay. 2Denominator used was for males only (N=182 Lexapro; N=195 placebo). 3Denominator used was for females only (N=247 Lexapro; N=232 placebo). |
Dose Dependency Of Adverse Reactions
The potential dose dependency of common adverse reactions (defined as an incidence rate of ≥5% in either the 10 mg or 20 mg Lexapro groups) was examined on the basis of the combined incidence of adverse reactions in two fixed-dose trials. The overall incidence rates of adverse events in 10 mg Lexapro-treated patients (66%) was similar to that of the placebo-treated patients (61%), while the incidence rate in 20 mg/day Lexapro-treated patients was greater (86%). Table 4 shows common adverse reactions that occurred in the 20 mg/day Lexapro group with an incidence that was approximately twice that of the 10 mg/day Lexapro group and approximately twice that of the placebo group.
TABLE 4: Incidence of Common Adverse Reactions in Patients with Major
Adverse Reaction | Placebo (N=311) |
10 mg/day Lexapro (N=310) |
20 mg/day Lexapro (N=125) |
---|---|---|---|
Insomnia | 4% | 7% | 14% |
Diarrhea | 5% | 6% | 14% |
Dry Mouth | 3% | 4% | 9% |
Somnolence | 1% | 4% | 9% |
Dizziness | 2% | 4% | 7% |
Sweating Increased | <1% | 3% | 8% |
Constipation | 1% | 3% | 6% |
Fatigue | 2% | 2% | 6% |
Indigestion | 1% | 2% | 6% |
Male And Female Sexual Dysfunction With SSRIs
Although changes in sexual desire, sexual performance, and sexual satisfaction often occur as manifestations of a psychiatric disorder, they may also be a consequence of pharmacologic treatment. In particular, some evidence suggests that SSRIs can cause such untoward sexual experiences.
Reliable estimates of the incidence and severity of untoward experiences involving sexual desire, performance, and satisfaction are difficult to obtain, however, in part because patients and physicians may be reluctant to discuss them. Accordingly, estimates of the incidence of untoward sexual experience and performance cited in product labeling are likely to underestimate their actual incidence.
TABLE 5: Incidence of Sexual Side Effects in Placebo-Controlled Clinical Trials
Adverse Event | Lexapro | Placebo |
---|---|---|
In Males Only | (N=407) | (N=383) |
Ejaculation Disorder (primarily ejaculatory delay) | 12% | 1% |
Libido Decreased | 6% | 2% |
Impotence | 2% | <1% |
In Females Only | (N=737) | (N=636) |
Libido Decreased | 3% | 1% |
Anorgasmia | 3% | <1% |
There are no adequately designed studies examining sexual dysfunction with escitalopram treatment.
Priapism has been reported with all SSRIs.
While it is difficult to know the precise risk of sexual dysfunction associated with the use of SSRIs, physicians should routinely inquire about such possible side effects.
Vital Sign Changes
Lexapro and placebo groups were compared with respect to (1) mean change from baseline in vital signs (pulse, systolic blood pressure, and diastolic blood pressure) and (2) the incidence of patients meeting criteria for potentially clinically significant changes from baseline in these variables. These analyses did not reveal any clinically important changes in vital signs associated with Lexapro treatment. In addition, a comparison of supine and standing vital sign measures in subjects receiving Lexapro indicated that Lexapro treatment is not associated with orthostatic changes.
Weight Changes
Patients treated with Lexapro in controlled trials did not differ from placebo-treated patients with regard to clinically important change in body weight.
Laboratory Changes
Lexapro and placebo groups were compared with respect to (1) mean change from baseline in various serum chemistry, hematology, and urinalysis variables, and (2) the incidence of patients meeting criteria for potentially clinically significant changes from baseline in these variables. These analyses revealed no clinically important changes in laboratory test parameters associated with Lexapro treatment.
ECG Changes
Electrocardiograms from Lexapro (N=625) and placebo (N=527) groups were compared with respect to outliers defined as subjects with QTc changes over 60 msec from baseline or absolute values over 500 msec post-dose, and subjects with heart rate increases to over 100 bpm or decreases to less than 50 bpm with a 25% change from baseline (tachycardic or bradycardic outliers, respectively). None of the patients in the Lexapro group had a QTcF interval >500 msec or a prolongation >60 msec compared to 0.2% of patients in the placebo group. The incidence of tachycardic outliers was 0.2% in the Lexapro and the placebo group. The incidence of bradycardic outliers was 0.5% in the Lexapro group and 0.2% in the placebo group.
QTcF interval was evaluated in a randomized, placebo and active (moxifloxacin 400 mg) controlled cross-over, escalating multipledose study in 113 healthy subjects. The maximum mean (95% upper confidence bound) difference from placebo arm were 4.5 (6.4) and 10.7 (12.7) msec for 10 mg and supratherapeutic 30 mg escitalopram given once daily, respectively. Based on the established exposure-response relationship, the predicted QTcF change from placebo arm (95% confidence interval) under the Cmax for the dose of 20 mg is 6.6 (7.9) msec. Escitalopram 30 mg given once daily resulted in mean Cmax of 1.7-fold higher than the mean Cmax for the maximum recommended therapeutic dose at steady state (20 mg). The exposure under supratherapeutic 30 mg dose is similar to the steady state concentrations expected in CYP2C19 poor metabolizers following a therapeutic dose of 20 mg.
Other Reactions Observed During The Premarketing Evaluation Of Lexapro
Following is a list of treatment-emergent adverse events, as defined in the introduction to the ADVERSE REACTIONS section, reported by the 1428 patients treated with Lexapro for periods of up to one year in double-blind or open-label clinical trials during its premarketing evaluation. The listing does not include those events already listed in Tables 2 & 3, those events for which a drug cause was remote and at a rate less than 1% or lower than placebo, those events which were so general as to be uninformative, and those events reported only once which did not have a substantial probability of being acutely life threatening. Events are categorized by body system. Events of major clinical importance are described in the Warnings and Precautions section (5).
Cardiovascular - hypertension, palpitation.
Central and Peripheral Nervous System Disorders - light-headed feeling, migraine.
Gastrointestinal Disorders - abdominal cramp, heartburn, gastroenteritis.
General - allergy, chest pain, fever, hot flushes, pain in limb.
Metabolic and Nutritional Disorders - increased weight.
Musculoskeletal System Disorders - arthralgia, myalgia jaw stiffness.
Psychiatric Disorders - appetite increased, concentration impaired, irritability.
Reproductive Disorders/Female - menstrual cramps, menstrual disorder.
Respiratory System Disorders - bronchitis, coughing, nasal congestion, sinus congestion, sinus headache.
Skin and Appendages Disorders - rash.
Special Senses - vision blurred, tinnitus.
Urinary System Disorders - urinary frequency, urinary tract infection.
Post-Marketing Experience
Adverse Reactions Reported Subsequent To The Marketing Of Escitalopram
The following additional adverse reactions have been identified from spontaneous reports of escitalopram received worldwide. These adverse reactions have been chosen for inclusion because of a combination of seriousness, frequency of reporting, or potential causal connection to escitalopram and have not been listed elsewhere in labeling. However, because these adverse reactions were reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. These events include:
Blood and Lymphatic System Disorders: anemia, agranulocytis, aplastic anemia, hemolytic anemia, idiopathic thrombocytopenia purpura, leukopenia, thrombocytopenia.
Cardiac Disorders: atrial fibrillation, bradycardia, cardiac failure, myocardial infarction, tachycardia, torsade de pointes, ventricular arrhythmia, ventricular tachycardia.
Ear and labyrinth disorders: vertigo
Endocrine Disorders: diabetes mellitus, hyperprolactinemia, SIADH.
Eye Disorders: angle closure glaucoma, diplopia, mydriasis, visual disturbance.
Gastrointestinal Disorder: dysphagia, gastrointestinal hemorrhage, gastroesophageal reflux, pancreatitis, rectal hemorrhage.
General Disorders and Administration Site Conditions: abnormal gait, asthenia, edema, fall, feeling abnormal, malaise.
Hepatobiliary Disorders: fulminant hepatitis, hepatic failure, hepatic necrosis, hepatitis.
Immune System Disorders: allergic reaction, anaphylaxis.
Investigations: bilirubin increased, decreased weight, electrocardiogram QT prolongation, hepatic enzymes increased, hypercholesterolemia, INR increased, prothrombin decreased.
Metabolism and Nutrition Disorders: hyperglycemia, hypoglycemia, hypokalemia, hyponatremia.
Musculoskeletal and Connective Tissue Disorders: muscle cramp, muscle stiffness, muscle weakness, rhabdomyolysis.
Nervous System Disorders: akathisia, amnesia, ataxia, choreoathetosis, cerebrovascular accident, dysarthria, dyskinesia, dystonia, extrapyramidal disorders, grand mal seizures (or convulsions), hypoaesthesia, myoclonus, nystagmus, Parkinsonism, restless legs, seizures, syncope, tardive dyskinesia, tremor.
Pregnancy, Puerperium and Perinatal Conditions: spontaneous abortion.
Psychiatric Disorders: acute psychosis, aggression, agitation, anger, anxiety, apathy, completed suicide, confusion, depersonalization, depression aggravated, delirium, delusion, disorientation, feeling unreal, hallucinations (visual and auditory), mood swings, nervousness, nightmare, panic reaction, paranoia, restlessness, self-harm or thoughts of self-harm, suicide attempt, suicidal ideation, suicidal tendency.
Renal and Urinary Disorders: acute renal failure, dysuria, urinary retention.
Reproductive System and Breast Disorders: menorrhagia, priapism.
Respiratory, Thoracic and Mediastinal Disorders: dyspnea, epistaxis, pulmonary embolism, pulmonary hypertension of the newborn.
Skin and Subcutaneous Tissue Disorders: alopecia, angioedema, dermatitis, ecchymosis, erythema multiforme, photosensitivity reaction, Stevens Johnson Syndrome, toxic epidermal necrolysis, urticaria.
Vascular Disorders: deep vein thrombosis, flushing, hypertensive crisis, hypotension, orthostatic hypotension, phlebitis, thrombosis.
Summary
Lexapro (escitalopram) is a selective serotonin reuptake inhibitor (SSRI) antidepressant used to treat depression and generalized anxiety disorder. Common side effects of Lexapro include agitation or restlessness, blurred vision, diarrhea, difficulty sleeping (insomnia), drowsiness, dry mouth, fever, frequent urination, headache, indigestion, nausea, changes in appetite, increased sweating, sexual difficulties, and others.
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Anxiety
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.
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Depression
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).
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What Color Light Is Best for Depression?
Light therapy, also known as phototherapy, involves the use of artificial bright light or blue light to improve mood and reduce depression symptoms. Research indicates that blue light is superior to other lights in the spectrum for treating depression.
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Teen Depression
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.
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What Is Major Depression Disorder?
The American Psychiatric Association defines major depressive disorder (depression) as a common, but serious, medical illness that negatively affects how one feels, thinks and acts. Depression causes sadness and/or a loss of interest in activities once enjoyed. Depression can lead to a variety of emotional and physical problems and decrease a person’s ability to function at work and home.
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What Happens During an Anxiety Attack?
Anxiety can occur during everyday life, it could be fleeting or it could persist and build. But if you have an anxiety disorder, you may feel your anxiety or panic overwhelm you with intense anxiety and fear.
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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.
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Postpartum Depression
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.
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Which Color Light Helps Anxiety?
Chromotherapy is an alternative medicine technique that claims to cure various physical or mental disorders by using colors. Most practitioners of modern medicine believe that this technique lacks scientific evidence.
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Is Melancholy the Same as Depression?
Melancholy or melancholia is a severe form of depression and it is now termed "melancholic depression." The word “melancholia” is a Greek word to describe the feeling of intense sadness and hopelessness. Melancholic depression makes people lose interest in almost all activities.
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What Is a Nervous Breakdown?
A nervous or mental breakdown is a general term used to describe a period of overwhelming mental distress. This term is usually used to refer to an intense set of emotions a person experiences in a wide variety of mental illnesses, including depression, stress disorder, and anxiety.
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What Are the Six Types of Anxiety Disorders?
Anxiety disorders cause worry, fear and panic as an irrational response to mundane situations. The six main types are generalized anxiety disorder, panic disorder, social anxiety, separation anxiety, trauma-related disorders and phobias.
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What Is the Difference Between a Panic Attack and an Anxiety Attack?
What is the difference between a panic attack and an anxiety attack? Learn about the differences between these common occurrences.
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Holiday Depression, Anxiety, and Stress
Though the holidays are a fun time for most, for others, they're a sad, lonely and anxiety-filled time. Get tips on how to avoid depression and stress during the holiday season.
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What Does Anxiety Do to Your Body?
It increases a person’s chances of suffering from other medical conditions, such as heart diseases, raised blood pressure, high cholesterol obesity, depression and diabetes. In short term, anxiety may cause sleep disturbances and poor work performance.
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Is Valerian Root Good for Anxiety?
Valerian is an herb that has been used for many centuries to help relieve anxiety and as a sleep aid in traditional medicine. The studies for proving the effectiveness of valerian root for sleep and anxiety have not been conclusive. More studies are required to prove its effectiveness and find the optimal dose.
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Depression and Suicide
Depression is a psychiatric illness that affects one in six people in the United States. Nearly two-thirds of people with depression do not realize that they have a treatable illness and do not seek treatment. Depression could happen when there is a decrease in the functional balance of the brain chemicals e.g., serotonin and norepinephrine.
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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.
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Is Trichotillomania an Anxiety Disorder?
Trichotillomania, also known as hair-pulling, is an impulse control disorder. It could be caused by anxiety and stress. It can coexist with an anxiety disorder. However, psychiatrists consider it as a separate illness and not an anxiety disorder.
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What Are 6 Signs and Symptoms of Anxiety Disorders?
Anxiety disorders have an impact on one's behavior, thoughts, emotions, and physical health. The six major symptoms of anxiety disorders include worrying incessantly and excessively for no apparent reason; fear of any social or performance-related situations in which one may be subjected to scrutiny from others; irrational fear of an object or location; flashbacks, nightmares, and subsequent anxiety due to exposure to a highly traumatic event in the past; cleaning and rearranging things and objects around excessively and repetitively; and repeated panic attacks.
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Can Blue Light Cause Depression?
Yes, in humans, there is evidence that supports that blue light disrupts the normal circadian rhythms (biological clock), resulting in mood disorders such as depression.
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What Age Group Has the Highest Rate of Depression?
American Psychiatric Association defines major depressive disorder (depression) as a common and serious medical illness that negatively affects how one feels, thinks and acts. Depression causes feelings of sadness and/or a loss of interest in activities once enjoyed. It can lead to a variety of emotional and physical problems and decrease a person’s ability to function at work and home. Depression can occur at any age.
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What Triggers Social Anxiety?
Social anxiety disorder, also known as social phobia, is a mental health condition that is characterized by extreme anxiety and fear of social settings. People with social anxiety disorder have a constant, intense, persistent fear of being watched, judged, negatively evaluated, or rejected in a social situation.
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What Symptoms Are Caused by Anxiety?
It's normal to feel stressed or worried about things that happen in our everyday lives. However, people who experience anxiety disorders often feel heightened fear or worry about common situations.
Treatment & Diagnosis
- Anxiety
- Depression
- Postpartum Depression
- Postpartum Depression: Behind the Smile
- Illness Anxiety Disorder (Hypochondria)
- Teen Depression
- Generalized Anxiety Disorder
- Depression
- Anxiety Treatment with Virtual Reality Exposure
- Anxiety, Panic, and Phobias: Seeking Help
- Depression: Beating the Holiday Blues
- Anxiety: Facing Fear and Anxiety -- Jonathan Davidson, MD
- Depression Drug Warning: Signs of Suicide
- Depression FAQs
- Does Depression Cause Obesity or Does Obesity Cause Depression?
- Depression - St. John's Wort
- Miscarriage - Depression Risk Increased
- Accutane (isotretinoin) for Acne linked to birth defects, depression and suicide
- Depression and Women
- Hot Flashes: Anxiety Worsens Hot Flashes
- Is Depression a Side Effect of Celebrex?
- Do Statins Cause Depression?
- What Is CNS Depression?
- 11 Common Depression Symptoms
- Diet and Depression: How Food Can Help with Depression Symptoms
Medications & Supplements
Prevention & Wellness

Report Problems to the Food and Drug Administration
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Professional side effects list and drug interactions section courtesy of the U.S. Food and Drug Administration.