Important Lexapro Information (escitalopram oxalate)

Easy to understand Lexapro information. Covers what Lexapro is prescribed for, side effects of Lexapro, recommended dosage, Lexapro during pregnancy and breastfeeding, and food and drug interactions.

Detailed Lexapro pharmacology info here

Lexapro (escitalopram oxalate) is prescribed for major depression--a persistently low mood that interferes with daily functioning. To be considered major, depression must occur nearly every day for at least two weeks, and must include at least five of the following symptoms: low mood, loss of interest in usual activities, significant change in weight or appetite, change in sleep patterns, agitation or lethargy, fatigue, feelings of guilt or worthlessness, slowed thinking or lack of concentration, and thoughts of suicide. Lexapro is also approved for treatment of generalized anxiety disorder (GAD).

Lexapro works by boosting levels of serotonin, one of the chief chemical messengers in the brain. The drug is a close chemical cousin of the antidepressant medication Celexa. Other antidepressants that work by raising serotonin levels include Paxil, Prozac, and Zoloft.

Important Lexapro Warning

Do not take Lexapro for 2 weeks before or after taking any drug classified as an MAO inhibitor. Drugs in this category include the antidepressants Marplan, Nardil, and Parnate. Combining these drugs with Lexapro can cause serious and even fatal reactions marked by such symptoms as fever, rigidity, twitching, and agitation leading to delirium and coma.

Important FDA Advisory

The US Food and Drug Administration (FDA) has issued an advisory to patients, families, and health care providers to closely monitor adults and children taking antidepressants for signs of suicide. This is especially important at the beginning of treatment or when doses are changed.

The FDA also advises that patients be observed for increases in anxiety, panic attacks, agitation, irritability, insomnia, impulsivity, hostility, and mania. It is most important to watch for these behaviors in children who may be less able to control their impulsivity as much as adults and therefore may be at greater risk for suicidal impulses. The FDA has not recommended that people stop using antidepressants, but simply to monitor those taking the medications and, if concerns arise, to contact a health professional.

How should you take Lexapro?

Take Lexapro exactly as prescribed, even after you begin to feel better. Although improvement usually begins within 1 to 4 weeks, treatment typically continues for several months and even years. Lexapro is available in tablet and liquid forms and can be taken with or without food.

If you miss a dose, take the forgotten dose as soon as you remember. However, if it is almost time for your next dose, skip the one you missed and return to your regular schedule. Do not take two doses at once.

Lexapro should be stored at room temperature.

What side effects of Lexapro may occur?

It's important to keep in mind that medicines can affect each person differently. Some may experience none or very minor side-effects, while the opposite can occur with others.

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe to continue using Lexapro.

  • More common side effects may include: Constipation, decreased appetite, decreased sex drive, diarrhea, dizziness, dry mouth, ejaculation disorder, fatigue, flu-like symptoms, impotence, indigestion, insomnia, nausea, runny nose, sinusitis, sleepiness, sweating

  • Less common side effects may include: Abdominal pain, abnormal dreaming, allergic reactions, blurred vision, bronchitis, chest pain, coughing, earache, fever, gas, heartburn, high blood pressure, hot flushes, increased appetite, irritability, joint pain, lack of concentration, lack of energy, lack of orgasm, light-headedness, menstrual cramps, migraine, muscle pain, nasal congestion, neck and shoulder pain, pain in arms or legs, palpitations, rash, ringing in the ears, sinus congestion, sinus headache, stomachache, tingling, toothache, tremors, urinary problems, vertigo, vomiting, weight changes, yawning

A variety of very rare side effects have also been reported. Check with your doctor if you develop any new or unusual symptoms.

Who should NOT take Lexapro?

You'll be unable to use Lexapro if it causes an allergic reaction, or if you've ever had an allergic reaction to the related drug Celexa. Remember, too, that you must never take Lexapro while taking an MAO inhibitor such as Marplan, Nardil, or Parnate.

Special warnings about Lexapro

Lexapro makes some people sleepy. Until you know how the drug affects you, use caution when driving a car or operating other hazardous machinery.

In rare cases, Lexapro can trigger mania (unreasonably high spirits and excess energy). If you've ever had this problem, be sure to let the doctor know.

Also make sure that the doctor knows if you have liver problems or severe kidney disease. Your dosage may need adjustment.

Possible food and drug interactions when taking Lexapro

Do not use Lexapro if you are taking the related drug Celexa. Be sure to avoid MAO inhibitors when taking Lexapro. Although Lexapro does not interact with alcohol, the manufacturer recommends avoiding alcoholic beverages.

If Lexapro is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Lexapro with the following:

Carbamazepine (Tegretol)
Cimetidine (Tagamet)
Desipramine (Norpramin)
Drugs that act on the brain, including antidepressants, painkillers, sedatives, and tranquilizers
Ketoconazole (Nizoral)
Lithium (Eskalith)
Metoprolol (Lopressor)
Narcotic painkillers
Sumatriptan (Imitrex)

Special Lexapro information if you are pregnant or breastfeeding

If you are pregnant or plan to become pregnant, inform your doctor immediately. Lexapro should be taken during pregnancy only if its benefits outweigh potential risk.

Lexapro appears in breast milk and can affect a nursing infant. If you decide to breastfeed, Lexapro is not recommended, but again, your doctor may prescribe it only if its benefits outweigh potential risk.

Recommended Lexapro dosage

Adults

The recommended dose of Lexapro tablets or oral solution is 10 milligrams once a day. If necessary, the doctor may increase the dose to 20 milligrams after a minimum of 1 week, but the higher dose is not recommended for most older adults and people with liver problems.

Adolescents

The recommended dose of Lexapro for adolescents (age 12 and over) is 10 milligrams once a day. The maximum recommended dose is 20 mg once a day.

Lexapro Overdosage

A massive overdose of Lexapro can be fatal. If you suspect an overdose, seek emergency treatment immediately.

  • Typical symptoms of Lexapro overdose include:
    Dizziness, sweating, nausea, vomiting, tremors, drowsiness, rapid heartbeat, seizures

In rare cases, an overdose may also cause memory loss, confusion, coma, breathing problems, muscle wasting, irregular heartbeat, and a bluish tinge to the skin.

next: Lexaproâ„¢ Pharmacology (escitalopram oxalate)

Last Updated: January 14, 2014

Reviewed by Harry Croft, MD