From the Guidelines
Lexapro (escitalopram) is an effective antidepressant medication with a relatively favorable side effect profile, commonly prescribed for depression and anxiety disorders, and should be started at a dose of 10mg once daily, with potential increases to 20mg daily if needed after at least one week, as supported by the most recent guideline update from 2023 1.
Effectiveness
The effectiveness of Lexapro in treating depression and anxiety disorders is well-established, with studies showing its benefits in improving symptoms and quality of life, as noted in a clinical practice guideline from the American College of Physicians in 2008 1.
- The medication works by increasing serotonin levels in the brain, which helps regulate mood.
- It usually takes 2-4 weeks to experience the full therapeutic benefits of Lexapro.
- Lexapro has been shown to be effective in treating major depressive disorder (MDD) and generalized anxiety disorder (GAD).
Side Effects
Common side effects of Lexapro include:
- Nausea
- Headache
- Insomnia
- Drowsiness
- Dry mouth
- Dizziness
- Sexual dysfunction Most side effects are temporary and diminish within the first few weeks of treatment, as reported in a study on the adverse events profile of second-generation antidepressants in 2008 1.
- Lexapro may cause discontinuation symptoms if stopped abruptly, so tapering is recommended when discontinuing.
- Patients should avoid alcohol while taking Lexapro and inform their doctor about all other medications they're taking to avoid potential interactions.
Special Considerations
- Lexapro is not recommended during pregnancy without careful consideration of risks and benefits with a healthcare provider.
- The medication should be used with caution in patients with a history of suicidal thoughts or behaviors, as noted in a study on the risk of suicidality with SSRIs in 2008 1.
- Regular monitoring for adherence, side effects, and adverse events is recommended when prescribing Lexapro, as suggested in a guideline update from 2023 1.
From the FDA Drug Label
Escitalopram tablets may cause serious side effects, including all of those described in the section entitled “What is the most important information I should know about Escitalopram tablets? ” Common possible side effects in people who take Escitalopram tablets include: • Nausea • Sleepiness • Weakness • Dizziness • Feeling anxious • Trouble sleeping • Sexual problems • Sweating • Shaking • Not feeling hungry • Dry mouth • Constipation • Infection • Yawning Other side effects in children and adolescents include: • increased thirst • abnormal increase in muscle movement or agitation • nose bleed • difficult urination • heavy menstrual periods • possible slowed growth rate and weight change.
The effectiveness of Lexapro (escitalopram) is not explicitly stated in the provided drug label. However, common possible side effects of Lexapro include:
- Gastrointestinal symptoms: nausea
- Neurological symptoms: sleepiness, weakness, dizziness, feeling anxious, trouble sleeping
- Other symptoms: sexual problems, sweating, shaking, not feeling hungry, dry mouth, constipation, infection, yawning Additionally, side effects in children and adolescents may include:
- Increased thirst
- Abnormal increase in muscle movement or agitation
- Nose bleed
- Difficult urination
- Heavy menstrual periods
- Possible slowed growth rate and weight change 2
From the Research
Effectiveness of Lexapro
- Lexapro (escitalopram) has been shown to be effective in the treatment of major depressive disorder (MDD) and anxiety disorder 3, 4, 5.
- Studies have demonstrated that escitalopram is superior to placebo and comparable to or more effective than other selective serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs) 3, 4.
- Escitalopram has also been found to be effective in preventing relapse and recurrence of MDD with long-term administration 3, 4.
- In patients with generalized anxiety disorder (GAD), escitalopram has been shown to improve anxiety symptoms and is well tolerated 6.
Side Effects of Lexapro
- The most common side effects of escitalopram include nausea, sleepiness/somnolence, weight gain, and dry mouth 7.
- Escitalopram has a predictable tolerability profile with generally mild to moderate and transient adverse events 4.
- Discontinuation symptoms with escitalopram are milder compared to paroxetine, another SSRI 3.
- Sexual dysfunction with escitalopram treatment appears to occur to a similar or lower extent compared to paroxetine and to a greater extent compared to bupropion 4.
Comparison to Other Treatments
- Escitalopram has been found to be at least as effective as citalopram, paroxetine, and duloxetine in long-term comparative trials 3, 4.
- Escitalopram is considered a cost-effective treatment option for MDD, dominating other SSRIs and venlafaxine extended release in several studies 4.
- Generic escitalopram has been shown to be safe and effective, with no significant differences in efficacy and safety compared to branded escitalopram 7.