Lexapro Drug Profile

Lexapro - generic escitalopram - is an antidepressant in the SSRI class - a selective serotonin reuptake inhibitor. It is approved by the US Food and Drug Administration (FDA) to treat major depressive episodes and generalized anxiety disorder (GAD). Lexapro is not FDA approved for treating bipolar depression, but many doctors still prescribe it for this use.

Lexapro is related to another SSRI antidepressant, Celexa (citalopram). Celexa has two mirror-image halves called enantiomers. Researchers found that one of these enantiomers was far more active than the other, so Lexapro was developed and contains only that half of Celexa. One result is that a low dose of Lexapro is as potent as a higher dose of Celexa.

Lexapro Dosages

Lexapro is available in 5, 10 and 20 milligram strengths. The 10mg and 20mg tablets are scored for cutting.

A typical starting dose might be 5mg or 10mg, taken once daily. Your doctor will wait to increase the dose to see if you have side effects. Doses will be lower in the elderly and for those with liver problems. Lexapro is not approved for use in children under 12.

Lexapro Warnings

Lexapro carries the following warnings:

• The same black box warning as all other antidepressants.

• Like many other antidepressants, Lexapro should not be taken at the same time as any MAOI antidepressant.
  *MAOIs in brief
  *MAOIs in depth

• Lexapro should not be taken at the same time as the migraine medications known as triptans.

• Certain types of substances like tryptophan should not be taken with Lexapro. Talk to your pharmacist before taking an over-the-counter supplement.

• Caution and careful monitoring should be used when using Lexapro with antipsychotic medications.
  *Antipsychotics in brief
  *Antipsychotics in depth

Use of the above types of medications and supplements can lead to serotonin syndrome or symptoms resembling Neuroleptic Malignant Syndrome. These are potentially life-threatening conditions, and if you are taking, for example, Lexapro along with an antipsychotic, you should know the symptoms of these conditions in order to recognize them if they occur.

Lexapro Precautions

In addition to the warnings above, there are some precautions that are recommended when using Lexapro:

• Discontinuation: Reduce the dose of Lexapro gradually rather than stopping all at once unless that's not possible. Withdrawal effects from lower the dosage too quickly or stopping abruptly may be severe.

• Prescribe with care for a patient with a history of seizures.

• Use cautiously in a patient with a history of mania.

• When taking Lexapro, be cautious about using drugs that can cause bleeding such as aspirin, NSAIDs like ibuprofen and naproxen, or anticoagulations drugs like Warfarin (coumadin).

• Patients should be monitored for hyponatremia (low blood sodium).

Most Common Lexapro Side Effects

In clinical trials, these side effects occurred in more than 5% of patients:

• insomnia
• ejaculation disorder (primarily ejaculatory delay)
• nausea
• increased sweating
• fatigue
• sleepiness
• decreased sex drive
• inability to have an orgasm

For more, see Lexapro Side Effects.

Pregnancy and Nursing

Lexapro should be used during pregnancy only when the potential benefits outweigh the risks to the infant. Several complications are possible. Discuss Lexapro usage during pregnancy with both your prescribing doctor and your obstetrician.

Lexapro is excreted in breast milk. If taking Lexapro while nursing, the infant should be monitored for problems such as excessive sleepiness, decreased feeding and/or weight loss.

Disclaimer: This is not intended to be all-inclusive or to replace information provided by your doctor or with the prescription from the manufacturer.

References: Lexapro Full Prescribing Information. Drugs@FDA. 19 March 2009. US Food and Drug Administration, Web. 13 Nov 2009.