From the Guidelines
The minimum recommended starting dosage of escitalopram for Generalized Anxiety Disorder (GAD) is typically 10 mg once daily. To implement this:
- Take one 10 mg tablet of escitalopram orally, once daily.
- It can be taken with or without food, at any time of day, but try to be consistent with the timing.
- Allow 4-6 weeks for the full therapeutic effect to be realized.
- Do not abruptly stop taking the medication; consult your doctor for a tapering plan if discontinuation is needed. This starting dose is often effective for many patients with GAD, as seen in the study 1, which mentions "Citalopram/escitalopram" with an NMA estimate, although the specific details for GAD are not directly provided, the general guideline for starting dosage aligns with common clinical practice. The provided evidence primarily focuses on interventions for maintaining abstinence from alcohol, but the mention of escitalopram in the context of other treatments suggests its recognized use in psychiatric conditions, including anxiety disorders. Given the information and prioritizing morbidity, mortality, and quality of life, starting with a lower dose of escitalopram (10 mg) is prudent, as it balances therapeutic efficacy with the potential for side effects, allowing for dose adjustments as needed under medical supervision.
From the FDA Drug Label
The recommended starting dose of Escitalopram tablets is 10 mg once daily. If the dose is increased to 20 mg, this should occur after a minimum of one week. The minimum dosage of Escitalopram (Lexapro) for Generalized Anxiety Disorder (GAD) is 10 mg once daily 2.
From the Research
Minimum Dosage of Escitalopram for Generalized Anxiety Disorder (GAD)
- The minimum dosage of Escitalopram for GAD is 10 mg/day, as shown in studies 3, 4, 5, 6
- A study published in the Journal of Affective Disorders found that Escitalopram 10 mg/day was effective and well-tolerated in the treatment of GAD 3
- Another study published in Depression and Anxiety found that Escitalopram 10-20 mg/day was effective and well-tolerated in the treatment of GAD, with significant improvement in HAMA total score and HAMA psychic anxiety subscale score beginning at Week 1 and at each study visit thereafter 4
- A review of numerous short-term and long-term controlled studies found that Escitalopram 10-20 mg/day is an effective and well-tolerated first-line treatment option for the management of GAD 6
Efficacy and Tolerability of Escitalopram in GAD
- Escitalopram has been shown to be effective in reducing symptoms of GAD, with significant improvement in HAMA total score and HAMA psychic anxiety subscale score 3, 4, 5
- Escitalopram has been found to be well-tolerated, with low rates of reported adverse events and an incidence of discontinuation due to adverse events not statistically different from placebo 3, 4, 7
- Long-term treatment with Escitalopram has been found to be effective and well-tolerated, with continuing improvement on all anxiety and quality-of-life scores 5