Lexapro

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, Lexapro works by increasing serotonin levels in the brain, which helps improve mood, reduce anxiety, and restore emotional balance. Its favorable side effect profile and demonstrated efficacy in clinical trials make it a first-line pharmacological option for managing these common mental health conditions.

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)
• Bioavailability: Approximately 80%
• Half-life: 27–32 hours
• Metabolism: Primarily hepatic via CYP2C19, CYP3A4, and CYP2D6 enzymes

Benefits

• Effectively reduces symptoms of depression, including low mood, loss of interest, and fatigue
• Significantly decreases anxiety and worry associated with generalized anxiety disorder
• Generally well-tolerated with a lower incidence of side effects compared to older antidepressants
• Once-daily dosing convenience supports treatment adherence
• Non-sedating profile allows for daytime use without significant drowsiness
• Improves overall quality of life and social functioning

Common use

Lexapro is primarily prescribed for the treatment of major depressive disorder in adults and adolescents aged 12–17 years. It is also indicated for generalized anxiety disorder in adults. Off-label uses may include other anxiety disorders, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD), though these applications should be carefully evaluated by a healthcare provider. Treatment duration varies from several months to years depending on individual response and recurrence risk.

Dosage and direction

Adults (MDD and GAD):
Initial dose: 10 mg once daily
May increase to 20 mg daily after at least one week based on clinical response

Geriatric patients:
Recommended maximum dose: 10 mg daily

Adolescents (12–17 years for MDD):
Initial dose: 10 mg once daily
May increase to 20 mg daily after at least three weeks

Administration:
Take with or without food, preferably at the same time each day
Tablets should be swallowed whole; oral solution should be measured with provided dosing device

Therapeutic effect may take 2–4 weeks to become apparent. Do not abruptly discontinue treatment.

Precautions

• Monitor for worsening depression, suicidal thoughts, or unusual behavior changes, particularly during initial treatment or dosage adjustments
• Use caution in patients with history of mania/hypomania or seizure disorders
• May cause hyponatremia, especially in elderly patients or those taking diuretics
• Use with caution in patients with hepatic impairment; consider dosage reduction
• May increase risk of bleeding, particularly when used with NSAIDs, aspirin, or other anticoagulants
• Inform healthcare provider of pregnancy or plans to become pregnant
• Avoid alcohol consumption during treatment

Contraindications

• Hypersensitivity to escitalopram, citalopram, or any component of the formulation
• Concurrent use with monoamine oxidase inhibitors (MAOIs) or within 14 days of discontinuing MAOI therapy
• Concurrent use with pimozide
• Patients with congenital long QT syndrome or known QT prolongation

Possible side effects

Common (≥5%):

• Nausea
• Insomnia
• Ejaculation disorder
• Fatigue
• Somnolence
• Increased sweating

Less common (1–5%):

• Diarrhea
• Constipation
• Decreased libido
• Anxiety
• Anorexia
• Rhinitis
• Sinusitis
• Yawning

Rare (<1%):

• Serotonin syndrome
• Angle-closure glaucoma
• Hyponatremia
• Abnormal bleeding
• QT prolongation
• Withdrawal symptoms upon discontinuation

Drug interaction

• MAOIs: Risk of serotonin syndrome; contraindicated
• Serotonergic drugs (tramadol, triptans, other SSRIs/SNRIs): Increased serotonin syndrome risk
• Drugs that prolong QT interval (antiarrhythmics, antipsychotics): Additive QT prolongation possible
• CNS depressants (alcohol, benzodiazepines): Enhanced sedative effects
• NSAIDs/anticoagulants: Increased bleeding risk
• CYP2C19 inhibitors (omeprazole, cimetidine): May increase escitalopram levels
• CYP2C19 inducers (rifampin): May decrease escitalopram levels

Missed dose

If a dose is missed, take it as soon as remembered unless it is close to the 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 may include dizziness, sweating, nausea, vomiting, tremor, somnolence, sinus tachycardia, amnesia, confusion, coma, and seizures. ECG changes including QT prolongation may occur. There is no specific antidote; provide supportive care and symptomatic treatment. Gastric lavage with airway protection may be considered if presented early. Contact poison control center (1-800-222-1222) or emergency services immediately.

Storage

Store at 25°C (77°F); excursions permitted to 15–30°C (59–86°F). Keep in original container, tightly closed, and protect from light and moisture. Keep out of reach of children and pets. Properly dispose of unused medication through take-back programs or according to FDA guidelines.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Lexapro is a prescription medication that should be used only under the supervision of a qualified healthcare provider. Individual response to treatment may vary. Always consult with a healthcare professional before starting, changing, or discontinuing any medication.

Reviews

Clinical studies demonstrate Lexapro’s efficacy with response rates of 60–70% in major depressive disorder and significant anxiety reduction in generalized anxiety disorder. Patient reviews frequently note improved mood stability and reduced anxiety within 4–6 weeks of treatment. Common positive aspects include minimal weight gain compared to other antidepressants and generally manageable side effects. Some users report initial nausea and sleep disturbances that typically subside with continued use. Overall satisfaction rates remain high among appropriately selected patients.