Lexapro (Escitalopram): What you need to know

What is Lexapro?

Lexapro is the brand name of the generic drug escitalopram, which is a type of antidepressant medication. It belongs to a group of antidepressants called selective serotonin reuptake inhibitors (SSRIs) first introduced in the late 1980s.

Scientists do not know exactly how Lexapro works. However, they do know that this drug has an effect on serotonin, a neurotransmitter in the brain involved in mood, sleep and other bodily functions. One theory is that Lexapro helps balance serotonin levels in the brain, which can reduce anxiety and improve mood.

SSRIs are generally effective and have fewer side effects than some of the older antidepressants, such as monoamine oxidase inhibitors (MAOIs). Lexapro, which comes in pill or liquid form, is used today to treat a variety of mental disorders.

In the United Kingdom, escitalopram is sold under the brand name Cipralex.

uses of lexapro

Escitalopram, the generic form of Lexapro, is primarily used to treat depression and generalized anxiety disorder (GAD). Initially, it was only used to treat depression, but research has shown it to be effective in treating mood disorders4 and anxiety disorders.

A doctor may prescribe Lexapro for other uses if he or she thinks it will help. A doctor may prescribe Lexapro for other uses if he or she thinks it will help. For example, he or she might prescribe Lexapro for conditions such as obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), social anxiety disorder, and even migraines.

If Lexapro doesn’t work for you, your doctor will try to find another medication that may help, such as another SSRI or a class of antidepressants. Psychotherapy may also be helpful.

Before taking Lexapro
Lexapro is prescribed to treat anxiety disorders, depressive disorders, and other mood disorders, sometimes in combination with other medications. Therefore, a mental health diagnosis is usually needed before a doctor will prescribe Lexapro.

Your primary care physician can prescribe Lexapro. But a mental health professional can prescribe medications and manage other therapeutic needs, such as combining medications with psychotherapy.

Mental health professionals who can prescribe medications include psychiatrists, mental health nurses, and psychiatric pharmacists.

Before you start taking Lexapro to treat anxiety or depression, tell your doctor if you are allergic or hypersensitive to escitalopram, or if you are pregnant or breastfeeding. Also tell your doctor if you have a history of any of these medical conditions, which may be exacerbated by Lexapro:

Bipolar disorder
Low salt level (hyponatremia)
Suicidal thoughts or behavior
Tell your doctor about all medications, supplements and vitamins you are currently taking. While some medications have minor interaction risks, others may be downright harmful or give rise to other considerations about whether the benefits of treatment outweigh the harm in your case.

Lexapro Precautions and Contraindications
Taking Lexapro comes with many precautions.7 You can reduce your risk by knowing who should not take this medication and understanding the black box warning.

Who should not take Lexapro

Lexapro is not safe for everyone. Some people should definitely not take Lexapro or take it with caution, including:

People allergic to escitalopram: You should not take Lexapro if you are hypersensitive to escitalopram oxalate. This means you have a known allergy to this medicine and have symptoms of an allergic reaction when you take it, such as difficulty breathing or swelling of the face, mouth or tongue.
Children: The safety and effectiveness of Lexapro in children under 12 years of age have not been well established. Some smaller studies have found this drug to be beneficial for young children with anxiety disorders with minimal side effects, but more research is needed to be sure.

Pregnant or nursing: Use Lexapro with caution if you are pregnant or breastfeeding, as the drug may be passed on to your baby. The FDA also reports that SSRIs taken after the 20th week of pregnancy increase the risk of persistent pulmonary hypertension in children sixfold.9 Your doctor should discuss this with you; if not, be sure to ask about the potential risks.
Elderly: The side effects of this drug may be more severe in the elderly, for example, causing blood sodium levels to drop to dangerous levels.10 Your doctor should monitor your dose and adjust it as needed to reduce the severity of its effects.

Lexapro Black Box Warning

A boxed warning, also called a black box warning, is the strictest warning for prescription drugs. It is issued by the Food and Drug Administration (FDA) to draw consumers’ attention to the serious or potentially life-threatening risks of taking this medication.

Lexapro has a black box warning because taking it may increase the risk of suicidal thoughts and behaviors, especially in children, adolescents and young adults. Careful monitoring by your psychiatrist or doctor is important while taking Lexapro, especially if you are young.

lexapro dosage
Lexapro tablets are available in 5 milligram (mg), 10 mg and 20 mg strengths. The 10 mg and 20 mg tablets are scored and can be cut in half. The oral solution is dosed at 1 mg per milliliter (mL).

The usual recommended daily dose of Lexapro is 10 mg, but you can start with a lower dose and increase it slowly if necessary. The manufacturer’s recommended doses for Lexapro based on condition and age are as follows: 7

Major depressive disorder, ages 12 to 18 years: 10 mg daily; the dose can be increased to 20 mg daily after three weeks if needed.
Major depressive disorder, over 18 years of age: 10 mg daily; the dose can be increased to 20 mg daily after one week if necessary.
Generalized anxiety disorder, adults only: 10 mg daily; the dose may be increased to 20 mg daily after one week if needed.
If you are having your first episode of depression or anxiety, you can take Lexapro for a certain period of time, for example, six months to a year. People with a chronic mental disorder may need to take Lexapro for an extended period of time (over several years).

All dosages listed are those of the drug manufacturer. Check your prescription and talk to your doctor to make sure you are getting the right dose for you.

Dosage adjustments may be needed in people with severe kidney failure. Your doctor can advise you in these situations to help you take this medicine safely.

Taking and Storing Lexapro
Proper intake and storage of Lexapro helps maintain the safety and effectiveness of the drug. Lexapro is usually taken as a tablet or oral solution once a day, in the morning or evening, with or without food.

If you miss a dose, take the prescribed dose as soon as you remember, unless your next dose is very close. In this case, take your usual dose. Never take two or more doses of Lexapro at the same time.

Doses higher than 20 mg are not FDA approved. Adhering to the recommended dose helps reduce the risk of side effects or adverse reactions.

It is important to recognize that you will not experience immediate relief after taking Lexapro. It takes one to four weeks to feel better after starting this medication.

You may notice an improvement in sleep, energy levels and appetite within the first two weeks.12 But you may not experience the full benefits of the medication until you start following the recommended treatment plan for a few months.

But you may not feel the full benefits of the drug until you follow the recommended treatment plan for a few months. Consult your doctor or pharmacist if you have any questions about this medicine.

Lexapro should be stored at room temperature, protected from light and moisture. Do not store in the bathroom. If you are traveling with Lexapro, be sure to carry the medication in its original packaging in your carry-on luggage and have your prescription with you.

Side effects of lexapro
Lexapro is generally well tolerated and effective. As your body adjusts to using the medication, the side effects should gradually disappear.

If you notice side effects worsening or interfering with your quality of life, talk to your doctor. Side effects can be minimized by carefully following the dosing instructions given by your doctor and reporting any adverse effects.

The most common side effects of Lexapro or escitalopram are:

sleep disturbances
visual disturbances
Dry mouth
Stomach pain
Stomach pain
Dizziness and fainting
Irritability and nervousness
Changes in weight and appetite
Excessive sweating
flu symptoms
sexual side effects
Seek immediate help if you experience any of the following unusual but serious side effects of Lexapro:

Difficulty breathing or swallowing.
Swelling of the face, mouth or tongue
muscle stiffness
rapid heartbeat
Skin irritation
Suicidal thoughts or behavior

Lexapro Warnings and Interactions
Caution should be exercised when taking Lexapro with other medications. The following serotonergic medications should not be used at all or only with extreme caution and close monitoring when combined with Lexapro because of the increased risk of serotonergic syndrome: 7

Other SSRIs, such as Celexa (citalopram)
Monoamine oxidase inhibitors (MAOIs), which are used to treat psychiatric conditions (should not use MAOIs within 14 days of using escitalopram13).
Tricyclic antidepressants such as Pamelor (nortriptyline).
Triptans, used to treat migraines, such as sumatriptan.
St. John’s wort
Other medications that may interact negatively with Lexapro include blood thinners; taking NSAIDs, aspirin and warfarin may increase the risk of bleeding in people taking Lexapro. While rare, there have been reports of people developing a life-threatening reaction after combining escitalopram with linezolid, a drug used to treat infections such as pneumonia.

To avoid drug interactions, tell your doctor about any other prescription or over-the-counter medications you are currently taking. Also avoid drinking alcohol while taking Lexapro, as it may reduce the drug’s effectiveness and increase its toxicity.

Stopping Lexapro
You should only stop taking Lexapro under your doctor’s supervision at the appropriate time, for example, when your symptoms have been stable for some time. Your doctor will help you gradually taper off your medication to minimize withdrawal effects.

If you stop taking escitalopram suddenly, you may experience withdrawal symptoms, which include:

muscle tension
Goose bumps
Difficulty concentrating
Difficulty remembering things
If you stop taking Lexapro to try another SSRI, it is recommended that your dose be reduced for a period of 4 weeks at the time of the switch.
How long does it take to withdraw from Lexapro?
When is the best time to take Lexapro for anxiety?
The answer to this question depends, in part, on the side effects that occur. If the medication makes you drowsy, for example, it’s best to take it at night. On the other hand, if it makes you more alert, taking it in the morning may prevent you from having trouble sleeping. Check with your doctor to determine the best time of day to take Lexapro for you.

How does Lexapro feel in the first week?

You probably won’t notice any real improvement in your depression or anxiety during the first week of using Lexapro. However, some side effects may occur, such as headache, nausea, diarrhea, dry mouth, nervousness, restlessness, fatigue, insomnia, and increased blood pressure.

These side effects should go away in one to two weeks. Otherwise, talk to your doctor to determine if this medication is right for you or if the dose needs to be adjusted.

How long does it take for Lexapro to work?

While you may notice some improvements in the first few weeks, such as better sleep, more energy, or increased appetite, it may take up to eight weeks to feel the full benefits of this medication. Therefore, you may not notice significant improvements in your feelings of depression or anxiety for a few months.

What should you expect when you increase your dose of Lexapro?
If your doctor increases your dose of Lexapro, you may notice side effects similar to those seen when you initially took this medication for a day or two. Your doctor may also want to follow you closely to make sure that your condition does not worsen or that you do not experience any significant negative side effects.

How do you know if Lexapro is effective?
Lexapro is unlikely to create a monumental change overnight. So you can tell if it’s working by looking at how you’ve been feeling over the past few days. If you seem to feel less depressed or anxious than before, Lexapro is working. Mark on your calendar that you’ll see each other once a week and compare how you feel. If you don’t notice any change over time or if your condition begins to worsen, contact your doctor immediately to discuss the necessary changes.

Why does Lexapro cause weight gain?
There are several reasons why Lexapro may cause you to gain weight. One is that it affects serotonin levels, which affects appetite. Research also indicates that some people are more likely to gain weight when taking this drug, including those with a lower BMI at the start of Lexapro treatment, people with a low level of education, and people with a family history of obesity.

What happens if you overdose on Lexapro?
One of the most notable effects of a Lexapro overdose is the development of a heart rhythm problem where there are prolonged intervals between contraction and relaxation.

In such cases, a single dose of activated charcoal may be recommended. If you or someone you know has taken an overdose of Lexapro, seek immediate medical help or call emergency health services.

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