LEXAPRO FAQS: Side-Effects of LEXAPRO

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Details of Lexapro side-effects - how long they may last, Lexapro and sleep problems, Lexapro and weight gain, sexual side effects of Lexapro.

Below are the answers to frequently asked questions about the SSRI antidepressant LEXAPRO (escitalopram oxalate). The answers are provided by HealthyPlace.com Medical Director, Harry Croft, MD, a board-certified psychiatrist.

As you are reading these answers, please remember these are "general answers" and not meant to apply to your specific situation or condition. Keep in mind that editorial content is never a substitute for personal advice from your health care professional.

Common Lexapro Side-Effects

In clinical trials, LEXAPRO was shown to be well tolerated by most adult patients with many of the side effects disappearing in the first few weeks.

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The most common adverse events reported with LEXAPRO vs placebo (approximately 5% or greater and approximately 2X placebo) were nausea, insomnia, ejaculation disorder, somnolence, increased sweating, fatigue, decreased libido, and anorgasmia. LEXAPRO is contraindicated in patients taking monoamine oxidase inhibitors (MAOIs) or in patients with a hypersensitivity to escitalopram oxalate or any of the ingredients in LEXAPRO. Lexapro is contraindicated in patients taking pimozide (see DRUG INTERACTIONS - Pimozide and Celexa). As with other SSRIs, caution is indicated in the coadministration of tricyclic antidepressants (TCAs) with LEXAPRO. As with other psychotropic drugs that interfere with serotonin reuptake, patients should be cautioned regarding the risk of bleeding associated with the concomitant use of LEXAPRO with NSAIDs, aspirin, or other drugs that affect coagulation.

Patients with major depressive disorder, both adult and pediatric, may experience worsening of their depression and/or the emergence of suicidal ideation and behavior (suicidality), whether or not they are taking antidepressant medications, and this risk may persist until significant remission occurs. Although no causal role for antidepressants in inducing such behaviors has been established, patients being treated with antidepressants should be observed closely for clinical worsening and suicidality, especially at the beginning of a course of drug therapy, or at the time of dose changes, either increases or decreases.

Lexapro and Sleeping Problems

Q: Will LEXAPRO cause sleeping problems, insomnia, too much sleep, or frequent drowsiness?

A: In clinical trials for depression, 9% of patients taking Lexapro experienced insomnia and 6% experienced drowsiness, compared with 4% and 2%, respectively, of those taking placebo. In clinical trials for generalized anxiety disorder, 12% of Lexapro-treated patients experienced insomnia and 13% experienced drowsiness, compared with 6% and 7%, respectively, of patients taking placebo. Many of the side effects of Lexapro are transient or mild, and tend to go away with continued treatment.

Lexapro and Stomach Problems

Q: Will LEXAPRO cause an upset stomach or nausea?

A: Most antidepressant medications can cause gastrointestinal (GI) side effects in some people. This is because there are more serotonin receptors in the GI tract than anywhere else in the body. However, in clinical trials for depression, Lexapro showed a low incidence of gastrointestinal side effects vs placebo. In fact, the only GI adverse event to occur in more than 10% of depressed patients was nausea, and nausea symptoms were generally mild and resolved over time.

Sexual Side-Effects of Lexapro

Q. Will LEXAPRO affect my sex drive?

A: Although changes in sexual desire, sexual performance, and sexual satisfaction may occur during a depressive episode, they may also be a consequence of treatment with SSRI therapies. Reliable estimates of changes in sexual behavior related to medication are difficult to obtain, because patients and physicians are often reluctant to discuss them. In clinical trials, a low percentage of patients taking LEXAPRO have reported sexual side effects, primarily ejaculatory delay in men. Additionally, decreased libido has also been reported at a low rate in clinical trials. If you have questions about sexual dysfunction, speak with your healthcare professional.

Q: What about taking a break from the medication for a few days to relieve side effects such as sexual dysfunction?

A: I do not recommend taking a break for two reasons: First, it sends the message that it is okay not to take your antidepressant now and then, when in fact it is very important to stay with the medication to have its full effect; second, patients may experience serotonin discontinuation symptoms—flu-like symptoms, nightmares, muscle aches, and increasing anxiety or insomnia after 1 or 2 missed doses. For these reasons, I think a break from the medication is, in general, not a good idea.

Lexapro and Weight Gain

Q. Will LEXAPRO cause weight gain?

A: In studies, adult patients treated with LEXAPRO experienced no clinically important weight change as a result of therapy. If you have concerns about any side effects, you should talk with your healthcare professional or doctor.

Q. Will LEXAPRO cause anxiety symptoms such as racing/pounding heart, lightheadedness, agitation, restlessness, panic attacks?

A: An increase in anxiety and related symptoms may occur when taking SSRIs early within the first few days or weeks. LEXAPRO has been shown to improve anxiety symptoms associated with depression by week 2 of treatment. Occasionally, in very anxious patients, starting with a smaller dose for the first few weeks helps, but it is generally best to "wait it out." If the anxiety symptoms associated with depression cause too much suffering, the physician can prescribe medications to lessen the anxiety, and then stop these medications within a few weeks when the anxiety is gone.

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