Mental Podcast Show

Lexapro — or the generic version, Escitalopram — is a common prescription medication used to treat anxiety and depression. Lexapro is in the selective serotonin reuptake inhibitor (SSRI) class of drugs, which works by increasing levels of serotonin in the brain, which is a neurotransmitter that helps maintain mental balance.

While intended to treat depression and anxiety, Lexapro is also used off-label to treat conditions like obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD). 

Wondering if you can get Lexapro online? The answer is yes. Set up an online psychiatry appointment today with Talkspace. Keep reading as we explore Lexapro uses, side effects, dosage information, and more. We’ll even look at the pros & cons of using the drug.

What is Lexapro?

Lexapro is an oral medication known to help improve mood and reduce symptoms associated with depression or anxiety.

How does Lexapro work?

Lexapro works by blocking the reabsorption of serotonin in the brain. This increases serotonin levels available for use by other neurons, so it can regulate emotions and benefit people with depression or anxiety disorders.

How does Lexapro make you feel?

The effects of taking Lexapro can vary but generally include improved moods and reduced anxiousness. In addition, people who take this medication often report feeling more energized and better able to focus on tasks throughout the day. 

Some people may experience negative side effects like nausea, headache, insomnia, dry mouth, constipation, weight gain/loss, and sexual dysfunction. 

Lexapro Uses

Lexapro has been approved for use in treating major depressive disorder (MDD) and generalized anxiety disorder (GAD) with a positive overall response rate. Additionally, the drug has been found effective in treating multiple other conditions off-label (meaning it’s often prescribed for uses other than what it was initially intended for). 

“Lexapro is indicated for major depressive disorder and generalized anxiety disorder. It’s also used off-label for panic disorder, symptoms of depression in bipolar disorder, and certain premenstrual symptoms.”

Talkspace psychiatrist Dr. Muhammad Munir
Lexapro for anxiety 

Lexapro can be a successful treatment option for anxiety in many people. The Diagnostic and Statistical Manual of Mental Disorders (DSM-V) states that GAD manifests as excessive worry and other symptoms that lasts for more than six months.

At least 3 or more of the following symptoms are required for a GAD diagnosis to be made: 

Restlessness or feeling “keyed up” or on edge

Being easily fatigued

Difficulty concentrating 

Mind going blank

Irritability

Muscle tension

Sleep disturbances

Multiple studies show that Lexapro treatment can effectively improve symptoms of GAD, panic disorder, OCD, and social anxiety. Further, controlled studies focusing on relapse prevention show long-term efficacy.

Lexapro for depression

Adults and adolescents (ages 12 to 17) can use Lexapro as a treatment for major depressive disorder.

A major depressive episode is characterized by the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) as a prominent and persistent depressed mood lasting nearly every day for at least two weeks. 

At least 5 of the following 9 symptoms must be present for MDD to be diagnosed:

Depressed mood

Change in appetite

Loss of interest in usual activities

Significant change in weight 

Increased fatigue

Insomnia or hypersomnia

Slowed thinking or impaired concentration

Psychomotor agitation 

Feelings of guilt or worthlessness

Suicide attempt or suicidal ideation

Studies show that Lexapro can improve symptoms of depression in adolescents. In adults, it resulted in symptom improvement and effectively increased the time between relapses.

Off-label uses

Lexapro is used off-label to reduce symptoms associated with other mental health issues beyond anxiety and depression. For example, it might be beneficial in treating:

Obsessive-compulsive disorder (OCD)

Panic disorder

Post-traumatic stress disorder (PTSD)

Premenstrual dysphoric disorder (PMDD)

Social phobia

Finally, some studies suggest that taking Lexapro can improve sleep quality and duration, potentially due to increased melatonin levels, which helps regulate our sleep cycles.

Pros & Cons of Lexapro

Pros of Lexapro

Cons of Lexapro

Studies show is an effective antidepressant for treating depression and anxiety

A common side effect is drowsiness, which might interfere with daily activities

It works by increasing the levels of serotonin in the brain, helping to regulate mood

Potential for Lexapro withdrawal symptoms when stopped abruptly 

Relatively low risk of side effects compared to other antidepressants

Must be tapered off slowly under the guidance of a doctor if discontinuing use

Can be taken regularly 

May cause weight gain due to appetite-stimulating properties; however, it can usually be managed through diet and exercise modifications

Generally well-tolerated and easy to take with few drug interactions

Brand name can be more expensive than some generic antidepressants, but the generic version is widely available (and both are often covered by insurance)

“Lexapro is an SSRI and increases the serotonin levels in the brain that relieve the symptoms of depression and anxiety features. It is a slow build-up medication that takes about 4 to 6 weeks for it to work. The dose flexibility and lack of interaction with other medications makes Lexapro an easier medication to use, especially when combination treatment is required.”

Talkspace psychiatrist Dr. Muhammad Munir

Side Effects of Lexapro

Common side effects of Lexapro include nausea, dry mouth, drowsiness, insomnia, increased sweating, and sexual dysfunction. These symptoms are usually mild and often go away after a few weeks of taking the medication.

Less common but more severe side effects include:

Changes in appetite resulting in weight gain/loss

Agitation or restlessness

Difficulty concentrating

Thoughts of suicide or self-harm

Unusual behavior changes

Tremors or shaking

Confusion

Fever or chills

Fast heartbeat and seizures

If you experience these symptoms while taking Lexapro, contact your doctor or healthcare provider immediately for further evaluation and to discuss treatment options.

Lexapro Dosage

The most common form of Lexapro is an oral tablet taken once daily, with or without food. 

For anxiety: The recommended starting dose for adults is 10 mg daily. Some people may require higher doses of up to 20 mg per day. Dosage should only be increased after at least a 1-week trial of the minimum dose. Long-term use of Lexapro for GAD should be monitored by a doctor. 

For depression in adolescents: It’s recommended that adolescents start on a 10 mg dose of Lexapro daily for depression. After a minimum of 3 weeks, the dose may be increased to up to 20 mg. 

For depression in adults: Adults should take 10 mg of Lexapro each day for at least 1 week before potentially increasing to no more than 20 mg per day. For adults where Lexapro has been effective in treating depression, there can be long-term benefits to continuing the drug, but dosage and treatment should be reevaluated periodically by a medical professional. 

How to take Lexapro

Take Lexapro exactly as prescribed by your doctor. Swallow the tablet whole with water — do not crush, chew, or break it apart before swallowing it. 

If you miss a dose, take it as soon as possible unless it’s almost time for your next scheduled dose — then skip the missed one and continue taking Lexapro according to schedule. Do not double up doses if you forget to take Lexapro.

Additional Considerations

If you’re considering taking Lexapro, it’s critical that you’re aware of potential interactions with other medications and any warnings associated with the drug.

Interactions

Certain drugs can interact with Lexapro, increasing or decreasing its effectiveness. For example, if you take a monoamine oxidase inhibitor (MAOI) like phenelzine or tranylcypromine, do not take Lexapro without consulting your doctor first and getting accurate medical advice. 

Additionally, combining Lexapro with other drugs that affect serotonin levels in the body may lead to serious side effects, including an increased risk of serotonin syndrome.  

Warnings

Make sure to tell your doctor if you’ve been on an MAO inhibitor within 14 days of starting or stopping Lexapro. Do not use Lexapro if you’re allergic to escitalopram or if you already take Pimozide. 

Tell your doctor if you take any of the following:

Linezolid 

Isocarboxazid 

Rasagiline

Tranylcypromine

Selegiline 

Phenelzine 

Stimulants

Opioids

Herbal products

Migraine medication 

Medication for Parkinson’s disease  

There are safety considerations regarding Lexapro and pregnancy, so be sure to let your doctor know if you’re pregnant or nursing. Talk to your doctor if you have also ever had: 

Seizures

Liver/kidney disease

Heart disease

High blood pressure

Low sodium

Bleeding 

Bipolar disorder

Addiction

Suicidal thoughts 

Lexapro Alternatives

If Lexapro doesn’t sound like the right medication for you or you are interested in alternatives, the following may work depending on a doctor’s prescription.

Zoloft

One alternative to Lexapro for anxiety and depression is Zoloft (Sertraline), another SSRI medication. Like Lexapro, Zoloft increases serotonin levels in the brain. Some people find that Zoloft has fewer side effects than Lexapro or that they have better results when taking it instead of Lexapro. For more detailed information, check out our article on the differences of Lexapro vs. Zoloft.

Wellbutrin

Another option for treating depression is Wellbutrin (Bupropion). This drug does not belong to the same class as SSRIs and does not treat anxiety. It works by boosting dopamine and norepinephrine in the brain. As a result, Wellbutrin may relieve depressive symptoms without causing sexual dysfunction or weight gain like some antidepressants do. Additionally, Wellbutrin can benefit people who experience fatigue or lack motivation due to their condition.

Cymbalta

A third option for those looking for an alternative to Lexapro is Cymbalta (Duloxetine). This medication belongs to a different class than both SSRIs and Wellbutrin. It’s known as a serotonin-norepinephrine reuptake inhibitor (SNRI). Unlike other antidepressants, Cymbalta can also help relieve pain associated with certain medical conditions.

Effexor XR

Finally, Effexor XR (Venlafaxine) is yet another SNRI that may be prescribed instead of Lexapro to treat depression. It works similarly by increasing levels of norepinephrine and serotonin in the brain. Because Effexor may have more side effects than other medications, doctors usually start patients on lower doses before gradually increasing them over time if necessary.

Online Lexapro Prescription Through Talkspace Psychiatry

Talkspace Psychiatry can help determine if Lexapro might be right for your condition. Talkspace offers a secure platform that connects you with licensed psychiatrists to make getting help simple. You can get started quickly without waiting weeks or months for an appointment like in more traditional clinic settings. 

Connecting with one of Talkspace’s psychiatrists is easy and straightforward. After completing a brief assessment, we’ll match you with a skilled psychiatrist so you can start your healing journey and find out if Lexapro is something you should consider. 

Sources: 

Pelissolo A. Efficacy and tolerability of escitalopram in anxiety disorders: a review. L’Encéphale. 2008;34(4):400-408. doi:10.1016/j.encep.2008.04.004. https://pubmed.ncbi.nlm.nih.gov/18922243/. Accessed February 6, 2023. 

DailyMed – LEXAPRO- escitalopram tablet, film coated LEXAPRO- escitalopram solution. U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=13bb8267-1cab-43e5-acae-55a4d957630a. Accessed February 6, 2023. 

Ensrud KE, Joffe H, Guthrie KA, et al. Effect of escitalopram on insomnia symptoms and subjective sleep quality in healthy perimenopausal and postmenopausal women with hot flashes. Menopause. 2012;19(8):848-855. doi:10.1097/gme.0b013e3182476099. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3382013/. Accessed February 6, 2023. 

The post Lexapro (Escitalopram): Uses, Side Effects, Dosage appeared first on Talkspace.

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