From the Guidelines
Lexapro is a brand name for escitalopram, a prescription medication that belongs to a class of drugs called selective serotonin reuptake inhibitors (SSRIs), primarily used to treat major depressive disorder and generalized anxiety disorder in adults and adolescents. It is essential to note that Lexapro works by increasing the levels of serotonin, a neurotransmitter in the brain that helps maintain mental balance, by preventing its reabsorption by nerve cells 1. The typical starting dose for adults is 10 mg once daily, which may be increased to 20 mg after at least one week if needed. Common side effects include nausea, drowsiness, insomnia, headache, and sexual dysfunction. Patients should be aware that Lexapro may take several weeks to reach its full therapeutic effect, and the medication should not be stopped abruptly as this can cause withdrawal symptoms.
Key Considerations
- It's crucial to take Lexapro exactly as prescribed and to inform your doctor about all other medications you're taking to avoid potential drug interactions, particularly with monoamine oxidase inhibitors (MAOIs) which can cause serious reactions when combined with SSRIs 1.
- The American College of Physicians recommends that when clinicians choose pharmacologic therapy to treat patients with acute major depression, they select second-generation antidepressants on the basis of adverse effect profiles, cost, and patient preferences 1.
- For treatment-naive patients, all second-generation antidepressants are equally effective, and medication choice should be based on patient preferences, with adverse effect profiles, cost, and dosing frequency taken into consideration 1.
Adverse Effects and Interactions
- Lexapro may cause adverse effects such as QT prolongation, which is dose-dependent, and patients should be aware of this potential risk, especially when taking other medications that may interact with Lexapro 1.
- The medication should be used with caution in older adults, as they may be more susceptible to adverse effects, and the American College of Physicians recommends that clinicians assess patient status, therapeutic response, and adverse effects of antidepressant therapy on a regular basis beginning within 1 to 2 weeks of initiation of therapy 1.
From the FDA Drug Label
Escitalopram tablets contains escitalopram oxalate, an orally administered selective serotonin reuptake inhibitor (SSRI). Escitalopram is the pure S-enantiomer (single isomer) of the racemic bicyclic phthalane derivative citalopram The drug Lexapro is escitalopram, which is a selective serotonin reuptake inhibitor (SSRI).
- It is the pure S-enantiomer of the racemic bicyclic phthalane derivative citalopram.
- Lexapro is available as tablets for oral administration 2.
From the Research
Definition of Lexapro
- Lexapro, also known as escitalopram, is a selective serotonin reuptake inhibitor (SSRI) used for the treatment of major depressive disorder (MDD) and anxiety disorder 3.
- It is the active S-enantiomer of the racemic selective serotonin reuptake inhibitor (SSRI) citalopram (RS-citalopram) 4.
Mechanism of Action
- Lexapro exerts a highly selective, potent, and dose-dependent inhibitory effect on the human serotonin transport, inhibiting the reuptake of serotonin into presynaptic nerve endings and thus increasing serotonergic activity in the central nervous system 3, 5.
- It also has allosteric activity and a low propensity for drug interactions 3, 5.
Efficacy and Safety
- Lexapro has been shown to be effective in the treatment of MDD, with a rapid onset of antidepressant action and a preventive effect on MDD relapse and recurrence 3, 5.
- It has a predictable tolerability profile with generally mild to moderate and transient adverse events, and a low propensity for drug interactions 5.
- Lexapro is also effective in treating accompanying anxiety, insomnia, and pain in patients with MDD, although the strength of the evidence is moderate or low 6.
Comparison to Other SSRIs
- Lexapro has been compared to other SSRIs, such as citalopram, paroxetine, fluoxetine, and sertraline, and has been found to be at least as effective, if not more effective, in the treatment of MDD 3, 5, 4.
- It has also been found to have a more favorable tolerability profile and a lower propensity for drug interactions compared to some other SSRIs 3, 5.