Lexapro: Effective SSRI Treatment for Depression and Anxiety
| Product dosage: 10mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 10 | $4.52 | $45.22 (0%) | 🛒 Add to cart |
| 20 | $2.51 | $90.44 $50.25 (44%) | 🛒 Add to cart |
| 30 | $1.84 | $135.66 $55.27 (59%) | 🛒 Add to cart |
| 60 | $1.00 | $271.33 $60.29 (78%) | 🛒 Add to cart |
| 90 | $0.89 | $406.99 $80.39 (80%) | 🛒 Add to cart |
| 120 | $0.84 | $542.65 $100.49 (81%) | 🛒 Add to cart |
| 180 | $0.73 | $813.98 $130.64 (84%) | 🛒 Add to cart |
| 270 | $0.67 | $1220.97 $180.88 (85%) | 🛒 Add to cart |
| 360 | $0.60
Best per pill | $1627.96 $216.06 (87%) | 🛒 Add to cart |
| Product dosage: 20mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 10 | $5.02 | $50.25 (0%) | 🛒 Add to cart |
| 20 | $2.76 | $100.49 $55.27 (45%) | 🛒 Add to cart |
| 30 | $2.01 | $150.74 $60.29 (60%) | 🛒 Add to cart |
| 60 | $1.34 | $301.47 $80.39 (73%) | 🛒 Add to cart |
| 90 | $1.12 | $452.21 $100.49 (78%) | 🛒 Add to cart |
| 120 | $1.00 | $602.95 $120.59 (80%) | 🛒 Add to cart |
| 180 | $0.89 | $904.42 $160.79 (82%) | 🛒 Add to cart |
| 270 | $0.82 | $1356.64 $221.08 (84%) | 🛒 Add to cart |
| 360 | $0.74
Best per pill | $1808.85 $266.30 (85%) | 🛒 Add to cart |
| Product dosage: 5mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 10 | $4.02 | $40.20 (0%) | 🛒 Add to cart |
| 20 | $2.26 | $80.39 $45.22 (44%) | 🛒 Add to cart |
| 30 | $1.67 | $120.59 $50.25 (58%) | 🛒 Add to cart |
| 60 | $0.92 | $241.18 $55.27 (77%) | 🛒 Add to cart |
| 90 | $0.67 | $361.77 $60.29 (83%) | 🛒 Add to cart |
| 120 | $0.54 | $482.36 $65.32 (86%) | 🛒 Add to cart |
| 180 | $0.39 | $723.54 $70.34 (90%) | 🛒 Add to cart |
| 270 | $0.32 | $1085.31 $85.42 (92%) | 🛒 Add to cart |
| 360 | $0.27
Best per pill | $1447.08 $95.47 (93%) | 🛒 Add to cart |
Synonyms | |||
Lexapro (escitalopram oxalate) is a selective serotonin reuptake inhibitor (SSRI) approved by the FDA for the treatment of major depressive disorder (MDD) and generalized anxiety disorder (GAD) in adults and adolescents. As one of the most widely prescribed antidepressants globally, Lexapro demonstrates high selectivity for the serotonin transporter, resulting in efficacy with a generally favorable side effect profile compared to older antidepressants. Clinical studies have consistently shown significant improvement in depressive and anxiety symptoms, making it a first-line treatment option recommended by psychiatric guidelines worldwide. Proper medical supervision is essential throughout treatment to monitor therapeutic response and manage potential adverse effects.
Features
- Active ingredient: Escitalopram oxalate
- Drug class: Selective serotonin reuptake inhibitor (SSRI)
- Available formulations: 5 mg, 10 mg, and 20 mg oral tablets; 5 mg/5 mL oral solution
- FDA-approved indications: Major depressive disorder, generalized anxiety disorder
- Half-life: Approximately 27-32 hours
- Time to peak plasma concentration: 5 hours
- Bioavailability: 80% relative to oral solution
- Metabolism: Primarily hepatic via CYP2C19, CYP3A4, and CYP2D6 enzymes
Benefits
- Demonstrated efficacy in reducing symptoms of depression and anxiety across multiple clinical trials
- Generally favorable side effect profile with lower incidence of weight gain and sexual dysfunction compared to some other SSRIs
- Once-daily dosing regimen improves medication adherence and convenience
- Suitable for long-term maintenance therapy in chronic depressive and anxiety disorders
- Available in generic formulations, improving accessibility and affordability
- Established safety profile in adolescents (ages 12-17) for major depressive disorder
Common use
Lexapro is primarily prescribed for the management of major depressive disorder in adults and adolescents aged 12-17 years. It is also approved for the treatment of generalized anxiety disorder in adults. Off-label uses may include social anxiety disorder, panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder, though these applications require careful medical consideration. Treatment typically begins with a low initial dose that is gradually titrated upward based on therapeutic response and tolerability. The full antidepressant effect usually becomes apparent within 4-6 weeks of initiation, though some patients may experience earlier improvement in anxiety symptoms.
Dosage and direction
Initial dosage: For most adults with MDD or GAD, treatment begins with 10 mg once daily. After at least one week, the dosage may be increased to 20 mg daily based on clinical response and tolerability.
Maintenance therapy: The effective dosage range is 10-20 mg daily. Many patients maintain response at 10 mg daily, while others may require 20 mg for optimal effect.
Geriatric patients: Consider initiation at 5 mg daily due to potential increased sensitivity in elderly patients.
Hepatic impairment: Maximum recommended dose is 10 mg daily for patients with severe hepatic impairment.
Administration: May be taken with or without food. Tablets should be swallowed whole and not crushed or chewed. The oral solution should be measured with the provided calibrated device.
Treatment duration: Continue treatment for at least 6 months after symptom remission to prevent relapse. Some patients may require longer maintenance therapy.
Precautions
- Monitor for worsening depression, suicidal thoughts, or unusual changes in behavior, particularly during the first few months of therapy and during dosage adjustments
- Use with caution in patients with history of mania/hypomania or bipolar disorder, as antidepressants may precipitate manic episodes
- Exercise caution in patients with seizure disorders or conditions that potentially lower the seizure threshold
- Monitor sodium levels in elderly patients, those taking diuretics, or those who are volume-depleted due to risk of hyponatremia
- Use carefully in patients with angle-closure glaucoma due to potential mydriatic effects
- Consider reduced dosage in patients with hepatic impairment or poor metabolizers of CYP2C19
- Abrupt discontinuation may cause withdrawal symptoms; taper gradually when discontinuing treatment
Contraindications
- Concomitant use with monoamine oxidase inhibitors (MAOIs) or within 14 days of discontinuing MAOI therapy due to risk of serotonin syndrome
- Known hypersensitivity to escitalopram, citalopram, or any component of the formulation
- Patients taking pimozide due to risk of QT prolongation
- Concurrent use with linezolid or intravenous methylene blue
- Patients with congenital long QT syndrome or known QT prolongation
Possible side effects
Common (≥5% incidence):
- Nausea (15-18%)
- Insomnia (9-14%)
- Ejaculation disorder (9-14%)
- Fatigue (5-8%)
- Somnolence (6-8%)
- Increased sweating (5-8%)
Less common (1-5% incidence):
- Diarrhea
- Constipation
- Decreased libido
- Anxiety
- Dizziness
- Influenza-like symptoms
- Rhinitis
- Sinusitis
- Yawning
Rare (<1% incidence but clinically significant):
- Serotonin syndrome
- Hyponatremia
- Abnormal bleeding
- Angle-closure glaucoma
- QT interval prolongation
- Manic episodes
- Seizures
- Withdrawal symptoms upon discontinuation
Drug interaction
- MAOIs: Contraindicated due to risk of serious, sometimes fatal, serotonin syndrome
- Serotonergic drugs: Increased risk of serotonin syndrome when combined with tramadol, triptans, other antidepressants, tryptophan, or St. John’s Wort
- Drugs that prolong QT interval: Use with caution with antipsychotics, antiarrhythmics, antibiotics (macrolides, fluoroquinolones)
- CNS depressants: Enhanced sedative effects with alcohol, benzodiazepines, opioids
- Antiplatelets/anticoagulants: Increased risk of bleeding with NSAIDs, aspirin, warfarin
- CYP2C19 inhibitors: Reduced escitalopram metabolism with omeprazole, cimetidine
- CYP2C19 inducers: Increased metabolism with rifampin, potentially reducing efficacy
- CYP2D6 substrates: Escitalopram may increase levels of metoprolol, desipramine, and other CYP2D6 substrates
Missed dose
If a dose is missed, take it as soon as remembered unless it is close to the time for the next scheduled dose. In that case, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed dose. Maintain consistent daily dosing time to ensure stable plasma concentrations. Patients should contact their healthcare provider if multiple doses are missed, as this may require dosage adjustment or monitoring for discontinuation symptoms.
Overdose
Symptoms of overdose may include dizziness, sweating, nausea, vomiting, tremor, somnolence, sinus tachycardia, amnesia, confusion, coma, convulsions, and ECG changes including QT prolongation. In cases of massive overdose, serotonin syndrome may occur, characterized by mental status changes, autonomic instability, neuromuscular abnormalities, and gastrointestinal symptoms. There is no specific antidote for escitalopram overdose. Treatment is supportive and symptomatic, including gastric lavage if presented early, activated charcoal, and close monitoring of cardiac and vital signs. Dialysis is unlikely to be effective due to high protein binding.
Storage
Store at room temperature (20-25°C or 68-77°F) with excursions permitted between 15-30°C (59-86°F). Keep in the original container with the lid tightly closed to protect from moisture and light. Keep out of reach of children and pets. Do not use beyond the expiration date printed on the packaging. Properly discard any unused medication through medication take-back programs or according to FDA-recommended disposal methods. Do not flush medications down the toilet unless specifically instructed to do so.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. Lexapro is a prescription medication that should only be used under the supervision of a qualified healthcare professional. Individual response to medication may vary, and the prescribing physician will determine the appropriate treatment based on the patient’s specific medical condition, history, and concurrent medications. Patients should not adjust dosage or discontinue treatment without consulting their healthcare provider. Report any adverse effects or concerns to a medical professional promptly.
Reviews
Clinical studies demonstrate Lexapro’s efficacy with response rates of 60-70% in major depressive disorder and similar rates in generalized anxiety disorder. Meta-analyses show Lexapro has one of the highest efficacy rates among SSRIs with a favorable tolerability profile. Patient-reported outcomes indicate improvement in quality of life measures, including social functioning and work productivity. Long-term studies support maintenance of therapeutic effect with continued treatment. While individual experiences vary, the majority of clinical evidence supports Lexapro as an effective first-line treatment for depression and anxiety disorders when prescribed appropriately.