Lexapro (escitalopram) is an SSRI antidepressant most commonly used to treat moderate to severe depression, as well as a range of anxiety disorders.

The medication stands out from similar SSRIs for the speed at which beneficial effects are noticeable and the milder adverse effects experienced by the majority of patients using it.

Lexapro is also known as Cipralex in some areas.

Grabbing Life by the Horns

Like all SSRIs, Lexapro increases serotonin levels in the brain, which is thought to strengthen communication in the areas of the brain which control mood. The end result, when treatment is successful, is elevated mood and decreased anxiety. It is a potent medication which should be used only when depression or anxiety is severe enough to prevent patients from participating in routine activities such as working, shopping, socializing, or attending classes. It is most often prescribed for:

• Major depressive disorder
• Social anxiety disorder
• Generalized anxiety disorder
• Obsessive-compulsive disorder
• Post-traumatic stress disorder
• Panic disorder

Many patients notice improvements within a week of starting treatment, particularly those suffering from severe anxiety. It may take two or three weeks of treatment for depression to improve. In all cases, full effects may not be felt until the medication has been used for at least four weeks.

Another benefit of Lexapro is how easy it is to use; treatment is identical in all conditions:

• Take 10 mg once per day.
• In rare cases dosage may be increased to 20 mg per day after several weeks.
• Tablets may be taken with or without food.
• Take tablets at the same time each day to maximize presence of the drug in the body.

Treatment can range from short-term, just a few months, to long-term, spanning years, depending on the condition. If Lexapro (or any SSRI) has been used for more than 4 weeks treatment should not stop abruptly. Doses should be gradually tapered down over time, usually in half-dose increments. For example, if 10 mg is being taken per day, 5 mg per day should be taken for 1 or 2 weeks (or longer, if the medication has been used for years) before stopping treatment entirely. Tapering off will help prevent physical and psychological withdrawal symptoms.

Because Lexapro can produce feelings of euphoria, there is a risk of addiction. Individuals with a history of drug addiction should use with caution.

Precautions & Side Effects

While Lexapro tends to produce milder side effects than many SSRIs, risk of serious adverse effects is greater when there is a history of:

• Liver disease
• Seizures
• Bleeding problems
• Low sodium, potassium or magnesium
• Heart rhythm abnormalities

The above conditions do not necessarily rule out Lexapro use, but patients should discuss risks and warning signs with a doctor before starting treatment.

Though usually mild and transient, some side effects are fairly common:

• Stomach upset (nausea, vomiting, gas, etc)
• Mild to moderate weight gain or loss
• Drowsiness
• Mild confusion
• Euphoria
• Loss of libido
• Impotence
• Anorgasmia
• Headache
• Insomnia
• Excessive yawning

Sexual side effects, loss of libido and impotence, are generally milder and less frequent with Lexapro; however, anorgasmia (inability to achieve orgasm) may be higher than experienced with other SSRIs. In all cases a doctor or pharmacist may be able to recommend additional treatments to reduce or eliminate these side effects.

Other side effects more likely to result from Lexapro use are tooth grinding and jaw tension, which may be severe enough to lead to temporomandibular joint syndrome (TMJ). These symptoms are very unusual, however.

Rarely dangerous side effects may develop. Discontinue treatment until speaking with a doctor if experiencing:

• High fever
• Excessive sweating
• Rapid or uneven heartbeats
• Difficulty breathing
• Rigid muscles
• Seizures
• Severe mood swings
• Worsening depression or anxiety
• Aggressive or erratic behavior

With prompt medical attention the above side effects are unlikely to be life-threatening.

Lexapro is known to interact with a wide range of other medications; speak with a doctor or pharmacist before mixing treatments.