What is Lexapro (escitalopram)?
Lexapro is an antidepressant from selective serotonin reuptake inhibitors group of drugs. Its active ingredient is escitalopram, which slows down the recycling of serotonin in brain structures. As a result, serotonin stays longer in receptors and causes inherent pharmacological effects - improves mood, increases interest in life, and reduce overall relief of pathological emotional state and mood.
Deficiency of serotonin in the brain is one of the most important factors of depression, panic disorders and phobias. That is why increasing its concentration will help to eliminate these mental disorders. Lexapro and other serotonin reuptake selective inhibitors do not increase the number of neurotransmitters in the brain structures but extend the duration of existing endogenous serotonin. This increased time of serotonin activity in brain provides gradual migration of brain functioning from depressive focus to normal, and people can be cured of depression and panic disorders.
Lexapro (escitalopram ) is by far the best antidepressant to treat depressions of mild to moderate severity, as well as to treat panic attacks (PA). This statement is based on substantial medical statistics of treatment with various antidepressants.
Escitalopram (the active ingredient of Lexapro) has the best selective effect of all SSRI antidepressants (selective serotonin reuptake inhibitors).
Why is this so important? Because, the better selective effect the drug has (ie only affects certain receptors), the fewer the side effects it causes.
SSRI group is named so because it only acts on the serotonin metabolism (there are antidepressants that affect the exchange of other mediators - such as norepinephrine or melatonin or several at once). However, this selectivity is not only substances that are participating in the regulation of mood. SSRIs may affect other receptors that do not participate in the formation of emotions, which causes such side effects as headaches, fatigue, sexual dysfunction, nausea, constipation and so on.
Despite the fact that Lexapro generic can also cause side effects, it happens much less frequently than when taking other antidepressants. I would say that this happens very rarely. In addition, most side effects go away after 5-7 days of regular drug intake.
An antidepressant effect usually develops within 2-4 weeks after the beginning of treatment. The maximum therapeutic effect in a treatment of panic disorder is reached after about 3 months.
What should I know when taking Lexapro?
You can experience anxiety exacerbation during the first days of treatment with Lexapro. This is not Lexapro feature only — this side effect is common for all SSRIs. It is easy to prevent anxiety attacks, you just need to know several things:
- Start taking Lexapro (escitalopram) with lowest possible dosage and gradually increase it. It is especially important for those, who suffer from panic disorder. Usually, the initial dosage is Lexapro 5 mg, with a consequent increase in dosage up to 10-20mg a day (in most cases 10 mg of Lexapro a day is enough).
- Take sedative drugs along with Lexapro from the first day of treatment and up to 10-20 days. Sedative medications do not cure depression or panic disorder, but they wonderfully relieve anxiety – exactly what we need in the first days of treatment until antidepressant starts to work.
- Take the entire daily dosage of Lexapro generic at once any time of a day. Clinical practice shows that it is better to take Lexapro in the morning because it has an activating effect. But there is a small number of people who experience drowsiness after Lexapro intake. In this case, it is recommended to take the drug in the evening for a week, and then switch the drug intake into the first half of a day.
Generic Lexapro can be prescribed to treat depressions after heart failure and strokes because it has minimal impact on a body.
Taking into an account, that average time to treat depression is 6-12 months, Lexapro is the best drug of the first choice in terms of its minimal side effects, impact on the internal bodies and high effectiveness in a treatment of depression. Patients who usually take Escitalopram say they do not feel they are using it, ie, there is a feeling that it feels better by itself, without medications.
Of course, treatment with Lexapro has its disadvantages:
- the drug is not powerful enough to treat severe depression;
- the cost of Lexapro is rather high, especially considering the duration of treatment. However, you can buy Lexapro generic instead of the brand drug, which would be much cheaper.
What is Lexapro (escitalopram) used for?
Lexapro (escitalopram) is used to treat the following mental disorders:
- Various depressions;
- Panic disorder with agoraphobia (fear of open spaces) or without it;
- Social disorder (fear of performing any act in public, fear of attention to his/her own person by other people, etc.);
- Generalized anxiety disorder (constant anxiety about normal daily activities or events);
- Obsessive-compulsive disorder (fear any far-fetched events, which people constantly try to overcome).
Avoid using Lexapro (escitalopram) in case of:
- Simultaneous treatment with MAO inhibitors;
- Childhood and adolescence up to 15 years old;
- Pregnancy and breastfeeding;
- Hypersensitivity to escitalopram.
Lexapro (Escitalopram) dosage
Take Lexapro generic tablets by mouth swallowing the whole tablet without chewing or crushing it, washing it down with a glass of water. Take Lexapro once a day with or without your meals. The best time to take Lexapro is in the morning.
Duration of therapy is determined by the type of a disease and the speed of achieving clinical effect. Lexapro dosage is established individually, based on your tolerance to the drug and clinical effect.
Depending on the indication, the usual single dosage is Lexapro 10-20 mg a day. The maximum daily dosage is 20 mg of Lexapro. The duration of treatment is a few months. The dosage should be gradually reduced over 1-2 weeks at the end of treatment in order to avoid withdrawal symptoms.
The recommended dosage for elderly people (over 65 years) is 5 mg a day, maximum daily dosage - 10 mg.
In case of liver function disorders, it is recommended start treatment taking 5 mg of Lexapro a day for 2 weeks. The dosage may be increased up to 10 mg a day depending on your body reaction.
For people with a weak activity of CYP2C19 isoenzyme, the recommended starting dosage of Lexapro (escitalopram) for the first 2 weeks of treatment is 5 mg a day. The dosage may be increased up to 10 mg a day depending on your reactions.
Lexapro (escitalopram) interaction
Avoid simultaneous intake of Lexapro with MAO inhibitors. It is also recommended to wait for 2 weeks after you finished to take MAO inhibitors in order to start taking generic Lexapro. MAO inhibitors treatment should start no earlier than 7 days after Lexapro (escitalopram) cancelation.
The combination of escitalopram with a moclobemide type A MAO inhibitor is not recommended due to the possible risk of serotonin syndrome. If the necessity of this combination is clinically proven, take minimally recommended dosages under close medical supervision.
The simultaneous use of serotonergic medication (eg tramadol, sumatriptan) may lead to serotonin syndrome.
Take Lexapro together with lithium drugs with caution, because lithium drugs can enhance the action of SSRIs.
There is no clinical data about a interaction of escitalopram and alcohol. Therefore, like with most drugs, it is not recommended to take alcohol during treatment with Lexapro generic.
Can I take Lexapro (escitalopram) during pregnancy and breastfeeding?
There is a limited information about using Escitalopram during pregnancy. Pregnant women should avoid taking the drug except for cases, where there is a clear medical need to take the drug after careful consideration of all the advantages and disadvantages. It recommended taking a thorough examination of newborns, whose mothers took escitalopram during pregnancy, especially in the III trimester.
Use of the drug during pregnancy should not be stopped abruptly. If a woman takes Lexapro during the third trimester and cancels it shortly before having a baby, a newborn baby may experience withdrawal symptoms, such as:
Respiratory depression; Cyanosis; Apnea; Convulsions; Temperature leaps; Difficulties with feeding a baby; Vomiting; Reduced blood glucose level; High blood pressure; Muscles hypotension; Increased reflexes; Tremor; Neuro-reflex excitability; Irritability; Constant crying; Drowsiness; Sleep disorders.
The most common of the above symptoms develop in the newborn during the first days after birth.
Avoid taking Lexapro during pregnancy, because of the possible adverse effects on a fetus. However, since the drug provides no teratogenic and mutagenic effect, then it can be theoretically used during pregnancy if the expected benefits outweigh the possible risks. Consult with your doctor before taking Lexapro during pregnancy.
Escitalopram penetrates into breast milk, that is why breastfeeding is not recommended during treatment.
Lexapro (escitalopram) side effects
Central and peripheral nervous system: dizziness, weakness, insomnia or drowsiness, seizures, tremor, movement disorders, serotonin syndrome (agitation, tremor, myoclonus, hyperthermia), hallucinations, delusions, confusion, agitation, anxiety, depersonalization, panic attacks, increased irritability, and visual disturbances.
Digestive system: nausea, vomiting, dry mouth, impaired sense of taste, decreased appetite, diarrhea, constipation, liver disorders.
Cardiovascular system: orthostatic hypotension.
Endocrine system: reduction of ADH secretion, galactorrhea.
Reproductive system: decreased libido, erectile dysfunction, ejaculation disorder, anorgasmia (in women).
Urinary system: urinary retention.
Dermatological reactions: skin rash, pruritus, ecchymosis, purpura, sweating.
Allergic reactions: angioedema, anaphylactic reactions.
Metabolism: hyponatremia, hyperthermia.
Musculoskeletal system: arthralgia, myalgia.
Other: sinusitis, withdrawal symptoms (dizziness, headache and nausea).
Take Lexapro (escitalopram) if you suffer from renal insufficiency, hypomania, mania, pharmacologically uncontrolled epilepsy, depression with suicidal attempts, diabetes, a tendency to bleeding.
Elderly patients with liver cirrhosis should have individual dosage adjustment.
You should be cautious taking Lexapro simultaneously with drugs that reduce seizure threshold, causing hyponatremia, with alcohol.
Start taking escitalopram only after 2 weeks after canceling irreversible MAO inhibitors intake, and 24 hours after finishing reversible MAO inhibitors intake. Non-selective MAO inhibitors may be administered no earlier than 7 days after canceling escitalopram treatment.
Some people with panic disorder may experience increased anxiety at the beginning of treatment with escitalopram, which typically disappears within the next 2 weeks of treatment. It is recommended to use a low initial dosage of Lexapro to reduce a risk of an anxiety attack.
Stop taking Lexapro in case of seizures or increased rates of pharmacologically uncontrolled epilepsy.
Lexapro intake should be canceled with the development of mania.
Escitalopram is able to increase glucose concentration in blood in case of diabetes, which may require hypoglycemic drugs dose adjustment.
Clinical experience of using escitalopram indicates a possible increase in a risk of suicide attempts during the first week of therapy. Therefore, it is very important to be under constant medical supervision during this period.
Stop taking Lexapro immediately in case of serotonin syndrome.
Avoid driving a car and be involved in other activities, which require high concentration and speed of psychomotor reactions during treatment with Lexapro.
Using Lexapro (escitalopram) for children
The drug is not prescribed to children until 15 years old since the clinical trials revealed a higher rate of suicidal behavior (suicide attempts and thoughts), hostility (with a predominance of aggression, propensity for confrontation and irritability). If the clinical situation still requires prescribing such treatment, a patient should be carefully observed for the early detection of suicidal symptoms.
Although escitalopram has a minor or moderate influence on the ability to drive a car, but, as in the case of other psychotropic drugs, patients should be warned about the potential risk of negative effects on the ability to drive and to operate mechanical equipment.
Lexapro (escitalopram) overdose
There is a limited data about Lexapro overdose. In most cases of overdose, the symptoms were absent or very mild.
There have not been lethal outcomes recorded after an overdose with Lexapro.
Escitalopram dosages (without other drugs) of 400-800 mg did not cause severe symptoms.
Symptoms that have been reported after overdose with escitalopram included: dizziness, tremor, agitation, seizures, sinus tachycardia, vomiting, metabolic acidosis, hypokalemia.
You can find many discussions about the effectiveness of various antidepressants on health forums. As for the Lexapro reviews, its therapeutic effect is usually noted after several weeks of treatment.
Usually, this medication is prescribed to treat panic attacks. In such cases, the duration of treatment may last up to a few months. People also report, that some medical experts recommend taking only Lexapro brand tablets, which provide a significant improvement and long-lasting effect.
Most Lexapro reviews are positive, because of its efficiency, mild action, good tolerance and rather fast results comparing to other antidepressants. People who took the drug say that it has helped them to get rid of depression and it was relatively well tolerated in most cases, causing just a few side effects. People say the first several days of treatment, as well as several days after canceling the drug, were the most difficult periods, causing a variety of unpleasant symptoms such as blurred vision, dizziness and so on. Most people noted significantly improved mood, increased interest in life, the desire to do something in 1-2 weeks after the beginning of treatment. All disorders usually were cured after finishing treatment with Lexapro.
According to numerous reviews of Lexapro, drowsiness, and dizziness were the most common side effects during treatment. There are several reports of insomnia. In general, adverse reactions are usually noted at the beginning of the treatment and gradually disappear on their own.
There are few negative reviews of Lexapro due to cases of heavily tolerated side effects. The drug users tolerated escitalopram poorly and therefore did not feel the improvement of their mental state. Of cause, such negative impressions background leave people no chance, but to post negative feedback.
Anyway, thanks to timely treatment, many people were able to completely get rid of depression and panic attacks, which have a negative effect on the overall health and quality of life.
Doctors reviews of Lexapro (escitalopram)
According to doctors, who treat mental disorders, Lexapro is a modern and highly effective antidepressant. It is tolerated well, rarely causing side effects, and this quality is highly appreciated by physicians, psychiatrists, and therapists because it allows prescribing the drug at home without the mandatory hospitalization for 2 - 3 weeks to control human behavior at the beginning of treatment. However, doctors do not consider Lexapro an ideal drug, because it does not suit some people and is not powerful to treat severe depressions. Therefore, while prescribing generic Lexapro doctors know that it can be effective. However, they are ready to quickly replace it with another antidepressant in case of adverse reactions or absence of clinical effects.
What is a generic name for Lexapro?
You can buy Lexapro generic, which is called Escitalopram. Generic Lexapro is usually cheaper than brand and you can order it online without prescription. The cost of Lexapro generic may be different in pharmacies around the internet.
Does Lexapro cause weight gain?
Weight gain is a common side effect of many antidepressants. You can gain weight because of an increase in appetite or lack of physical activity. Lexapro belongs to antidepressants, which are less likely cause weight gain.
There even were some reports, when people experienced weight loss during treatment with Lexapro.
Paxil is on average the most unfavorable SSRIs drug for weight gain. It causes this unpleasant side effect almost for everyone. Fluoxetine, Sertraline, Venlafaxine are more likely to cause weight loss than weight gain.
There are also few reports about Trazodone and Bupropion to cause weight gain. Almost all tricyclic antidepressants increase appetite.
Atypical antipsychotics like Clozapine, Olanzapine and Risperidone are most likely to cause weight gain. Aripiprazole and Ziprasidone usually do not boost an appetite.
Weight gain often associated with taking antidepressants and antipsychotics. There are different mechanisms of weight gain: increased appetite (mirtazapine), impaired glucose metabolism, hyperprolactinemia (risperidone, amisulpride, sulpiride). Your mental disorder can also influence weight gain - there is data on the effect of depression and mania on the hypothalamus-pituitary-adrenal axis, cortisol, insulin sensitivity and sympathetic nervous system. Depressive disorders can affect insulin-glucose homeostasis, immunoinflammatory process, the mechanism of oxidative stress.
Also, the combination of sleepwalking and increase in appetite (eg, those taking quetiapine, zolpidem) can lead to uncontrolled food intake at night.
Lexapro withdrawal symptoms and side effects
Withdrawal symptoms may develop after canceling treatment because the brain structures need some time to migrate to the operation without constant external maintenance of serotonin level. The body is forced to use own resources without a help of Lexapro (escitalopram) to maintain the required amount of serotonin, adjusting its output and the reuptake of the brain structures. It takes some time (from 1 to 3 weeks) to settle down all brain functions, during which a person suffers from unpleasant symptoms and sensations, which are called withdrawal syndrome.
Lexapro withdrawal is tolerated rather well. You do not have to be afraid of it, as it has nothing to do with heavy drug abstinent syndrome. You should stop taking the drug gradually to reduce the severity of withdrawal symptoms, slowly reducing the dosage, thus giving the body a chance to adapt to changing conditions.
Lexapro withdrawal symptoms usually include
Dizziness; Headache; Violation of sensitivity (for example, the feeling of electric shock, feeling of "pins and needles", etc.); Sleep disorders (most often a person suffers from insomnia or vivid and intense dreams); Anxiety; Agitation (a strong nervous excitement); Nausea; Vomiting; Tremor; Confusion; Strong sweating; Diarrhea; Heartbeat (tachycardia); Instability emotional background; Irritability; Blurred vision (most often double vision and blurred outlines of objects).
The above symptoms may have different degrees of severity, but generally, they are weak or moderate. The more expressed are withdrawal symptoms, the longer it will take reduce the dosage in order to cancel the drug intake.
Therefore, you have to gradually cancel Lexapro intake in order to minimize withdrawal symptoms. Typically, the dosage is reduced by 5 mg a week, bringing it to 5 mg of the drug a day. For example, Lexapro 20 mg dosage in the first week is reduced to 15 mg a day, during the second week a dosage is reduced to 10 mg a day, and the third - 5 mg a day. Then it is recommended to take 5 mg of Lexapro daily for the next 1 - 2 weeks and stop its intake after that. If you start experiencing withdrawal symptoms during lowering your dosage, return to your previous dosage and proceed to take the drug for the next 2 - 3 weeks. Then start to reduce the dosage by 5 mg, but not every week - once every 2 - 3 weeks. Thus, gradually cancel the drug completely.
Lexapro and alcohol – can I take the drug with alcohol?
Lexapro and alcohol are incompatible with each other because the drug is aimed to eliminate depression and alcohol, on the other hand, is a factor that enhances or provoking attacks and depressive episodes. That is why Lexapro and alcohol has an opposite effect on a brain. The results of this experiment can be very frustrating or even fatal if escitalopram and alcohol are taken together. The maximum allowable amount of alcohol is 150 ml of beer or wine, or 30 - 50 ml of spirits (vodka, brandy, gin, rum, etc.) 1 time in 2-3 months. Avoid taking Lexapro and alcohol more often and in higher amounts.
Compare Lexapro vs Zoloft
Lexapro and Zoloft belong to the same pharmacological group of SSRIs drugs and therefore have similar therapeutic effects. According to doctors and patients, Zoloft vs Lexapro efficiency, tolerance, and severity of side effects are about the same. That is why the drugs are distinguished by an individual human body's reaction to them. This means that Zoloft would be more suitable for someone, another person is going to feel better using Lexapro. Unfortunately, it is impossible to predict, which drug is better suited for a particular person. The only way to determine, which drug is better, is to try them both. Doctors usually prescribe one of this drug. If it is poorly tolerated or a person does not feel better, this drugs can be replaced with each other.