An Overview of Lexapro for Mental Health Conditions

Lexapro is the trademark name for the generic drug escitalopram, which is a type of antidepressant medication. It belongs to a group of antidepressants called selective serotonin reuptake inhibitors (SSRI) that were first introduced in the 1980s. These medications are generally effective and have fewer side effects than some other antidepressants such as monoamine oxidase inhibitors (MAOIs).

Use of Lexapro

Lexapro was initially used only to treat depression. However, research began to show that it was also effective for other mood disorders as well as anxiety disorders. While it is currently only approved by the Food and Drug Administration (FDA) for the treatment of depression and generalized anxiety disorder (GAD), it is prescribed for many other conditions.

Doctors sometimes prescribe Lexapro off-label for illnesses such as bipolar disorder, obsessive-compulsive disorder (OCD), panic disorder (with or without agoraphobia), post-traumatic stress disorder (PTSD), social anxiety disorder (SAD), migraines, and chronic pain.

How It Works

It is not known exactly how Lexapro works to reduce symptoms of depression and anxiety. However, we know that this medication has an effect on serotonin, which is a brain neurotransmitter involved in mood, sleep, and other bodily functions. It is thought that by taking Lexapro, serotonin levels in your brain become more balanced, which helps to reduce anxiety and enhance your mood.

Efficacy

Lexapro is an allosteric serotonin reuptake inhibitor, which differentiates it from other SSRIs. There is some evidence that it is more effective than a range of other antidepressants. It is often a first choice because of its efficacy and tolerability.

How to Take It

Dosage

You may take Lexapro as tablets or an oral solution once daily, in the morning or evening, with or without food. The usual recommended daily dosage of Lexapro is 10 mg, but your doctor may begin at a lower dose. The dosage can be increased slowly to 20 mg or higher if needed. Doses higher than 20 mg are not approved by the FDA. Staying within the recommended dose helps to reduce risk of side effects or adverse reactions.

If you are experiencing a first episode of depression or anxiety, you may take Lexapro for a defined period such as between six months and one year. However, for individuals experiencing a chronic mental health condition, it may be necessary to take Lexapro for an extended period over many years.

Missed Doses

Missed doses should be taken as soon as you remember, unless it is very close to your next dose, in which case you should take your regular dose instead. Never take two or more doses of Lexapro together at the same time. Taking your medication as prescribed will ensure that you experience its full effectiveness.

How Long it Takes to Work

It can take anywhere from one to four weeks to feel better once you start taking Lexapro, and you may not experience the full benefits of the medication until you've been following a recommended treatment plan for several months.

It's important to recognize that you will not experience immediate relief from taking Lexapro.

Side Effects

The most common side effects of taking Lexapro are listed below. As your body adjusts to taking the medication, you should gradually notice that the side effects go away. If you notice that side effects are getting worse or are interfering with your quality of life, talk to your doctor about your concerns. Side effects can be minimized by carefully following the dosage directions given by your doctor and reporting any negative effects.

  • Sleep disturbances
  • Nausea
  • Headaches
  • Blurred vision
  • Dry mouth
  • Diarrhea
  • Stomach pain
  • Constipation
  • Heartburn
  • Lightheaded and faintness
  • Irritability and nervousness
  • Dizziness
  • Changes in weight and appetite
  • Fatigue
  • Excessive sweating
  • Flu-like symptoms
  • Sexual side effects

Serious Side Effects/Allergic Reactions

Seek immediate help if you experience any of the following unusual side effects of Lexapro:

  • Difficulty breathing or swallowing
  • Swelling of the face, mouth, or tongue
  • Fever
  • Stiff muscles
  • Fast heartbeat
  • Vomiting
  • Seizures
  • Rash
  • Confusion
  • Hallucinations
  • Suicidal thoughts or behaviors 

Precautions

There are many precautions involved when taking Lexapro. You can reduce potential risks by becoming aware of who should not take this medication, potential medication interactions, and the black box warning.

Who Should Not Take Lexapro

  • You should not take Lexapro if you're hypersensitive to escitalopram oxalate, meaning that you have a known allergy to the medication and experience symptoms listed in the allergic reactions in the section above such as difficulty breathing or swelling of the face, mouth, or tongue.
  • The effectiveness of Lexapro for use with children younger than 18 years of age has not been established and it's not generally recommended for kids under the age of 12.
  • Use Lexapro with caution if you're pregnant or breastfeeding as the medication can be passed to your child. Your doctor should discuss this with you if you are pregnant or nursing a child; if not, be sure to ask about potential risks.
  • Finally, side effects of the medication can be more severe in older adults. In this case, your doctor should monitor your dose and adjust as necessary to reduce the severity of side effects.

Medication Interactions

Caution should be used when taking Lexapro along with other medications. To help avoid any possible drug interactions, let your doctor know about any other prescribed and over-the-counter medications you are currently taking.

Aspirin, warfarin, medication for seizures, anxiety, depression, or migraines, and nonsteroidal anti-inflammatory drugs (NSAIDs) such as Motrin (ibuprofen) or Aleve (naproxen) can interact with Lexapro and should be used with caution.

Lexapro should not be combined with monoamine oxidase inhibitors (MAOIs), and only used with tryptophan, other SSRIs, serotonin-norepinephrine reuptake inhibitors (SNRIs), and St. John's wort with significant caution and close monitoring due to the potential for serotonin syndrome.

Alcohol

Try to avoid drinking alcohol when you are taking Lexapro, as it can reduce the effectiveness of the medication and also may increase its toxicity.

Black Box Warning

According to a black box warning (the strictest warning for prescription drugs by the Food and Drug Administration (FDA) related to a serious hazard), taking Lexapro can result in increased risk of suicidal thoughts and behaviors, particularly in children, adolescents, and young adults. Close monitoring by your psychiatrist or doctor is important particularly if you are an adolescent or young adult taking Lexapro.

Stopping Lexapro

You should only discontinue taking Lexapro under the guidance of your doctor at an appropriate time (such as when symptoms have been stable for a certain period of time).

If you stop taking this medication all of a sudden, you may notice withdrawal symptoms such as headaches, dizziness, excessive nervousness, or flu-like symptoms. Instead, your doctor will help to taper you off the medication in a safe and gradual way so as to minimize any withdrawal effects.

If Lexapro is not effective for you, your doctor will work to find another medication that may help, such as another SSRI or a different class of antidepressant medication. You may also find psychotherapy helpful if that has not already been implemented.

A Word From Verywell

This article is meant to provide an overview of the use of Lexapro for mental health conditions and does not cover every possible outcome of taking this medication. If you have been prescribed this medication by your doctor, be sure to follow the instructions carefully. If you have additional questions, these are best answered by a medical professional.

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