What is Lexapro (Escitalopram)?
Lexapro (escitalopram) is one in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). It is prescribed for adults and adolescents at least 12 years of age to treat major depressive disorders.
How does Lexapro work?
Lexapro affects the brain, altering certain chemical levels in people who may be suffering from depression or generalized anxiety disorder. On a chemical level, Lexapro is similar to Celexa (escitalopram), and both are SSRIs, along with Prozac (fluoxetine), Paxil (paroxetine), and Zoloft (sertraline).
SSRIs affect neurotransmitters that communicate in the brain to send and receive information. Neurotransmitters are created by the nerves in the brain and are sent on to become attached to other nerves. In some cases, the neurotransmitters do not attach to their intended receptors and end up returning to the nerves that originally created them. This imbalance of neurotransmitters is known as “reuptake,” and experts believe this to be the cause of depression.
Lexapro stops serotonin from returning to its original nerve, resulting in higher serotonin levels available in the brain to bind to receptors.
Lexapro Dosing Information
The amount you are prescribed will depend upon a variety of factors, including your age and medical condition. Generally, adults will begin with a daily dose of 10 mg. If necessary, this may be increased after a minimum of one week.
Typical dose for adults with generalized anxiety disorder:
Initially, 10 mg orally daily, increasing, if necessary, after a minimum of one week to 20 mg to be taken once each day.
Maintenance dose: 10 mg to 20 mg to be taken orally once each day
Maximum dose: 20 mg orally to be taken once each day
Please note:
- Treatment should be re-evaluated regularly to assess its effectiveness. Clinical trials for generalized anxiety disorder have primarily evaluated Lexapro for up to 8 weeks; long-term efficacy should be assessed periodically.
Typical dose for adults with major depressive disorder
Initially, 10 mg to be taken orally once each day, to be increased after a minimum of one week, if necessary, to 20 mg once each day
Maintenance dose: 10 mg to 20 mg to be taken orally once each day
Maximum dose: 20 mg orally to be taken once each day
Please note:
- Several months of sustained pharmacological therapy, or even longer, may be needed to address acute episodes.
- Treatment should be regularly re-evaluated to assess the necessity for maintenance treatment.
Typical geriatric dose for major depressive disorder
The recommended dose is 10 mg, which will be taken orally once daily.
Typical pediatric dose for major depressive disorder
For adolescents aged 12 and older, the initial dose is 10 mg, which is to be taken orally once daily. This may be increased after a minimum of 3 weeks of treatment, if necessary, to 20 mg to be taken once each day
Maintenance dose: 10 mg to 20 mg to be taken orally once each day
Maximum dose: 20 mg orally to be taken once each day
Please note:
- Sustained pharmacological therapy may need to continue for several months or longer beyond the initial response to an acute episode.
- The treatment should be re-evaluated regularly to assess the need for maintenance treatment.
How should you take Lexapro (Escitalopram)?
Lexapro should be used precisely as instructed on the label, or as your doctor has prescribed. Do not increase or decrease the amounts or use Lexapro for longer than has been recommended to you. Be sure to read all the information and instructions and follow the advice on the prescription label.
Try to take Lexapro at the same time each day. It can be taken with or without food.
Use a dosing syringe or a medicine dosing device to measure out a liquid dose, but do not use a normal kitchen spoon.
Make your doctor aware of any changes in your sexual activities after commencing your Lexapro treatment. Changes such as loss of sex drive and difficulty achieving an orgasm should be reported to your doctor. For men, trouble achieving an erection and ejaculation issues should also be reported to their doctor. Some sexual issues can be addressed with treatment.
Your treatment should be regularly re-evaluated so progress can be assessed. Children taking Lexapro should have their height and weight gain evaluated.
Do not stop taking Lexapro suddenly without medical guidance. If you do, you might experience unpleasant withdrawal symptoms. Instead, take your doctor’s advice and gradually taper your dose.
How to store Lexapro
Be sure to store Lexapro away from moisture and heat, at room temperature.
Side Effects
Patients generally tolerate SSRIs, such as Lexapro, well, compared to other kinds of antidepressants. Generally, a higher dosage of Lexapro will make it more likely that a patient will have more side effects. Gastrointestinal side effects, such as diarrhea, are more likely with a high dosage of Lexapro.
Common side effects
Lexapro side effects appear to be the same for men and women, but they are slightly different between adults and children.
Among adults, the side effects may include:
- nausea
- sleepiness
- weakness
- dizziness
- anxiety
- sleeping trouble
- sexual problems, such as decreased sex drive and erectile dysfunction
- sweating
- shaking
- loss of appetite
- dry mouth
- constipation
- infection
- yawning
Among children and adolescents, the side effects may include the above, but also the following:
- increased thirst
- abnormal increase in muscle movement or agitation
- nosebleeds
- trouble urinating
- heavy menstrual periods
- slowed growth and weight change
There have been reports of Lexapro use in children and adolescents resulting in a loss of appetite and a decrease in weight. Your child’s doctor should monitor their height and weight throughout treatment.
Depression tends to leave patients with a decreased appetite and weight loss. However, there have been some cases of Lexapro causing adults to put on a little bit of weight. It is important to bear in mind that weight gain may reflect improved appetite and nutrition as depressive symptoms improve. With better-managed depression comes a better appetite. Some patients find they lose weight while on Lexapro. In this case, it could be that the increase in serotonin is resulting in a loss of appetite.
Most of the above side effects are negligible and should dissipate without any need for additional treatment. If they turn severe or do not dissipate, the patient should inform their doctor.
Serious Side Effects
Lexapro has been known to increase thoughts of suicide and suicidal actions, particularly amongst children, teenagers, and young adults. This is more probable during changes in dosage or within the first 2 or 3 months of being treated with Lexapro. The patient should immediately contact their doctor after they notice any of the following symptoms.
- suicide attempts
- carrying out dangerous impulses
- aggressive or violent actions
- thoughts about suicide or dying
- new or worse depression
- new or worse anxiety or panic attacks
- feeling restless, angry, or irritable
- having trouble sleeping
- increased activity (doing more than what is normal for you)
- other unusual changes in your behavior or mood
The patient should contact local emergency services if these symptoms are new, worsening, or upsetting.
Other side effects
Allergies
Do not take Lexapro if you are allergic to it or any of its ingredients. Allergy symptoms can include:
- having trouble breathing
- swelling of your face, tongue, eyes, or mouth
- severe rash, hives (itchy welts), or blisters with fever or joint pain
Seizures or convulsions
There have been cases of patients on Lexapro having seizures, so individuals with a history of seizures are more vulnerable.
Serotonin syndrome
Serotonin syndrome occurs when there is too much serotonin in the body. It is a serious condition that is more likely to happen if the patient is also taking other medications that may increase serotonin. These include antidepressants or lithium. The symptoms can include:
- agitation
- hallucinations
- coma
- coordination problems, overactive reflexes, or muscle twitching
- racing heart rate
- high or low blood pressure
- sweating or fever
- nausea, vomiting, or diarrhea
- muscle stiffness
Low salt levels
Lexapro can result in low salt levels, but this is more likely in senior patients, those who take water pills, or patients who are dehydrated. The side effects can cause the following:
- headache
- confusion
- trouble concentrating
- thinking or memory problems
- weakness
- unsteadiness that can lead to falls
- seizures
Manic episodes
Lexapro may cause a patient to have manic episodes if they have bipolar disorder. Being treated with Lexapro without taking other drugs for bipolar disorder may trigger a manic episode. The symptoms may include the following:
- big increase in energy
- much difficulty sleeping
- racing thoughts
- irresponsible behavior
- unusually grand ideas
- excessive happiness or irritability
- talking quickly or more than normal
Trouble with vision
Your pupils may become dilated due to using Lexapro, leading to a glaucoma attack, even if the patient does not have a background of eye trouble. The symptoms may include the following:
- eye pain
- changes in your vision
- swelling or redness in or around your eye
Warnings & Interactions
Do not use Lexapro if you are already taking pimozide or citalopram (Celexa).
Do not use Lexapro 14 days before or 14 days after using an MAO inhibitor. This includes but is not limited to:
- Isocarboxazid
- Linezolid
- Methylene blue injection
- Phenelzine
- Rasagiline
- Selegiline
- Tranylcypromine
Younger patients sometimes have suicidal thoughts when first taking antidepressants, so it is important to monitor mood changes and changes in symptoms. Make the doctor aware of any new or worsening symptoms. Children under the age of 12 should not take Lexapro.
A patient should inform their doctor of all over-the-counter and prescription medications, supplements, and herbs they are taking.
Frequently Asked Questions
Disclaimer
Pharma Giant provides medical information to help you better understand medications and medical conditions.This content is for informational use only and does not replace advice from a licensed medical practitioner. Consult your doctor or pharmacist before starting or changing any medication. All our partners follow strict safety standards set by their country’s health authorities to make sure you receive safe and high-quality medications.
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