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Uses
Side effects
Interactions
Precautions
How Lexapro (escitalopram) works
Lexapro is a selective serotonin reuptake inhibitor (SSRI) indicated for:
- Acute and Maintenance Treatment of Major Depressive Disorder (MDD) in adults and adolescents aged 12-17 years
- Acute Treatment of Generalized Anxiety Disorder (GAD) in adults
Lexapro (escitalopram) Dosage Information
| Indication | Recommended Dose |
| MDD in Adolescents (2.1) | Initial: 10 mg once daily Recommended: 10 mg once daily Maximum: 20 mg once daily |
| GAD in Adults (2.2) | Initial: 10 mg once daily Recommended: 10 mg once daily |
- No additional benefits seen at 20 mg/day dose (2.1).
- 10 mg/day is the recommended dose for most elderly patients and patients with hepatic impairment (2.3)
- No dosage adjustment for patients with mild or moderate renal impairment. use caution in patients with severe renal impairment (2.3).
- Discontinuing Lexapro: A gradual dose reduction is recommended (2.4).
What are the side effects of Lexapro (Escitalopram)?
Most commonly observed adverse reactions (incidence ≥ 5% and at least twice the incidence of placebo patients) are:
- insomnia
- ejaculation disorder (primarily ejaculatory delay)
- nausea
- sweating increased
- fatigue and somnolence
- decreased libido,
- anorgasmia
- Concomitant use with SSRIs, SNRIs or Tryptophan is not recommended.
- Use caution when concomitant use with drugs that affect Hemostasis (NSAIDs, Aspirin, Warfarin).
- Clinical Worsening/Suicide Risk: Monitor for clinical worsening, suicidality and unusual change in behavior, especially, during the initial few months of therapy or at times of dose changes
- Serotonin Syndrome: Serotonin syndrome has been reported with SSRIs and SNRIs, including Lexapro, both when taken alone, but especially when co-administered with other serotonergic agents (including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, amphetamines, and St. John’s Wort). If such symptoms occur, discontinue Lexapro and initiate supportive treatment. If concomitant use of Lexapro with other serotonergic drugs is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases Discontinuation of Treatment with Lexapro: A gradual reduction in dose rather than abrupt cessation is recommended whenever possible
- Seizures: Prescribe with care in patients with a history of seizure
- Activation of Mania/Hypomania: Use cautiously in patients with a history of mania
- Hyponatremia: Can occur in association with SIADH
- Abnormal Bleeding: Use caution in concomitant use with NSAIDs, aspirin, warfarin or other drugs that affect coagulation
- Interference with Cognitive and Motor Performance: Use caution when operating machinery
- Angle Closure Glaucoma: Angle closure glaucoma has occurred in patients with untreated anatomically narrow angles treated with antidepressants.
- Use in Patients with Concomitant Illness: Use caution in patients with diseases or conditions that produce altered metabolism or hemodynamic responses.
