Lexapro: Restore Balance with Effective SSRI Therapy
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Synonyms | |||
Lexapro (escitalopram oxalate) is a selective serotonin reuptake inhibitor (SSRI) approved by the FDA for the treatment of major depressive disorder (MDD) and generalized anxiety disorder (GAD) in adults and adolescents. As one of the most widely prescribed antidepressants globally, it works by increasing serotonin levels in the brain, which helps improve mood, reduce anxiety, and restore emotional stability. Its favorable side effect profile and demonstrated efficacy in clinical studies make it a first-line option for healthcare providers managing these conditions. Lexapro offers a well-tolerated pathway to sustained mental wellness under professional supervision.
Features
- Active ingredient: Escitalopram oxalate
- Drug class: Selective serotonin reuptake inhibitor (SSRI)
- Available forms: Oral tablets (5 mg, 10 mg, 20 mg) and oral solution (5 mg/5 mL)
- FDA-approved for: Major depressive disorder (MDD) and generalized anxiety disorder (GAD)
- Half-life: Approximately 27–32 hours
- Metabolism: Primarily hepatic via CYP450 enzymes (CYP2C19, CYP3A4, CYP2D6)
Benefits
- Effectively reduces symptoms of depression, including low mood, loss of interest, and fatigue
- Alleviates excessive worry, tension, and physical symptoms associated with anxiety
- Improves overall daily functioning and quality of life
- Generally well-tolerated with a lower incidence of certain side effects compared to older antidepressants
- Once-daily dosing supports treatment adherence
- Non-sedating for most patients, allowing for daytime use without significant drowsiness
Common use
Lexapro is commonly prescribed for the management of major depressive disorder and generalized anxiety disorder in adults and adolescents aged 12 years and older. It may also be used off-label for other anxiety-related conditions, such as panic disorder, social anxiety disorder, and obsessive-compulsive disorder, based on clinical judgment. Treatment is typically initiated after a thorough diagnostic evaluation, and response is usually observed within 2–4 weeks, with full therapeutic effects often achieved after 6–8 weeks of consistent use.
Dosage and direction
Adults (MDD and GAD):
The recommended starting dose is 10 mg once daily, which may be increased to 20 mg daily after a minimum of one week, based on individual response and tolerability.
Adolescents (12–17 years, MDD only):
Start with 10 mg once daily. Dose may be maintained or adjusted based on clinical response; the maximum recommended dose is 20 mg daily.
Elderly or hepatically impaired patients:
A starting dose of 5 mg daily is recommended. Dose escalation should be cautious.
Lexapro may be taken with or without food. Tablets should be swallowed whole; the oral solution must be measured using the provided dosing device. Do not abruptly discontinue treatment; taper gradually under medical supervision to avoid withdrawal symptoms.
Precautions
- Monitor for worsening depression, suicidal thoughts, or unusual changes in behavior, especially during the first few months of therapy or after dose changes. This is particularly important in children, adolescents, and young adults.
- Use with caution in patients with a history of mania/hypomania or bipolar disorder; may precipitate a manic episode.
- May increase the risk of bleeding, especially when used with NSAIDs, aspirin, or other anticoagulants.
- Caution advised in patients with seizures, hyponatremia, or angle-closure glaucoma.
- SSRI use may impact bone density; periodic monitoring may be considered in long-term users.
- Avoid alcohol during treatment.
Contraindications
- Hypersensitivity to escitalopram, citalopram, or any component of the formulation.
- Use of monoamine oxidase inhibitors (MAOIs) concurrently or within 14 days of discontinuing Lexapro. Similarly, do not initiate Lexapro within 14 days of stopping an MAOI.
- Known congenital long QT syndrome or conditions predisposing to QT prolongation.
- Severe hepatic impairment.
- Not recommended during pregnancy unless potential benefits justify potential risks. Discuss with a healthcare provider.
Possible side effect
Common side effects (may affect up to 1 in 10 people):
- Nausea
- Insomnia or somnolence
- Increased sweating
- Fatigue
- Dry mouth
- Constipation
- Ejaculation disorder
Less common but serious side effects (seek medical attention if experienced):
- Suicidal thoughts or behavior
- Serotonin syndrome (agitation, hallucinations, fever, tachycardia, nausea)
- Abnormal bleeding
- Hyponatremia
- Seizures
- Manic episodes
- Angle-closure glaucoma
- QT prolongation
Drug interaction
- MAOIs: Risk of serotonin syndrome; contraindicated.
- Other serotonergic drugs (e.g., tramadol, linezolid, triptans, other SSRIs/SNRIs): Increased risk of serotonin syndrome.
- Drugs that prolong QT interval (e.g., antipsychotics, antiarrhythmics): Additive QT prolongation possible.
- CNS depressants (e.g., benzodiazepines, alcohol): May enhance sedative effects.
- NSAIDs, aspirin, warfarin: Increased bleeding risk.
- CYP2C19 inhibitors (e.g., omeprazole, fluconazole): May increase escitalopram levels.
- CYP3A4 inducers (e.g., carbamazepine, rifampin): May decrease escitalopram efficacy.
Missed dose
If a dose is missed, take it as soon as remembered unless it is almost time for the next scheduled dose. In that case, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed one.
Overdose
Symptoms of overdose may include dizziness, sweating, nausea, vomiting, tremor, somnolence, and sinus tachycardia. In severe cases, seizures, coma, or ECG changes (including QT prolongation) may occur. There is no specific antidote; provide supportive care and monitor cardiac and vital signs. Gastric lavage or activated charcoal may be considered if presented early. Contact a poison control center or seek emergency medical attention immediately.
Storage
Store at room temperature (20–25°C or 68–77°F), away from light, moisture, and heat. Keep the bottle tightly closed. Do not freeze the oral solution. Keep out of reach of children and pets. Discard any unused medication after the expiration date or as directed.
Disclaimer
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or medication. Do not disregard professional medical advice or delay in seeking it because of something you have read here.
Reviews
Clinical studies and patient reports consistently note Lexapro’s efficacy in reducing symptoms of depression and anxiety. Many users report improved mood, reduced nervousness, and better daily functioning after several weeks of use. Side effects such as initial nausea or sleep disturbances are common but often subside. Individual experiences may vary; always follow your prescriber’s guidance.
