Using the Antidepressant Escitalopram (Lexapro, Cipralex)
There are numerous prescription medications used to treat depression. Depending on a patient’s individual symptoms and health conditions, one may be preferred over another.
In this article, you’ll learn all about escitalopram (Lexapro)—a commonly prescribed antidepressant.
What Is Escitalopram?
Escitalopram is the generic name of an FDA-approved antidepressant medication marketed under brand names like Lexapro and Cipralex.1,2
This prescription drug is a selective serotonin reuptake inhibitor (SSRI), which means that it affects how much of the neurotransmitter serotonin is available in the brain to help neurons communicate.1
What Is Escitalopram Prescribed For?
Escitalopram is prescribed for:1
- Other mood disorders.
What Is the Average Dose of Escitalopram (Lexapro)?
Doctors typically start with the lowest possible dose of escitalopram and work their way up as needed to effectively help the patient.
As prescribed, a person will typically take a dose of escitalopram once per day; however, it could take between 1-2 weeks for the dose to begin to take effect, so it is important to stay with the regular dose during that time.3
In tablet form, escitalopram doses can come in:3
- 5 mg.
- 10 mg.
- 20 mg.
The medication can also be prescribed as a liquid, with about 1 mg of escitalopram per mL.3
Most people begin their dose at 10 mg per day, although if there is no effect after a week, the overseeing physician or therapist can increase the dose to 20 mg. Maximum improvement is often seen within 6-8 weeks.3
It is important not to self-administer or quit escitalopram without medical supervision. Consult a doctor before changing the prescribed dose. Serious side effects can occur with too much, or sudden cessation of, escitalopram.2
How Does Escitalopram Help With Depression?
Escitalopram increases levels of the neurotransmitter serotonin in the brain by inhibiting the reuptake of serotonin.4 This important chemical is related to mood regulation. When a person’s brain does not produce enough serotonin, or it is absorbed too quickly by neurons, the individual can experience depression, anxiety, or both.
Because SSRIs work on serotonin, and do not affect other neurotransmitters, they have fewer side effects and are tolerated better by more people in the general population. This makes them a very effective tool in the treatment of mood disorders, especially depression.5
What Are the Side Effects of Escitalopram?
General side effects associated with escitalopram include:2
- Sleep difficulties.
- Sexual problems.
- Dry mouth.
- Loss of appetite.
One of the most serious side effects of escitalopram, like with other SSRI antidepressants, is the increased risk of suicidal thinking or actions.2 Although antidepressants should improve mood and reduce thoughts of death or worthlessness, the medications can have the opposite effect in some people, particularly adolescents or young adults.
Children and adults younger than 24 years old are especially at risk of this side effect.4 It is important for people taking SSRIs like escitalopram to inform their therapist or physician immediately if they begin to have thoughts about suicide.2
There are some serious side effects that can occur, and a person taking escitalopram should inform their doctor immediately if they begin experiencing them. These include the following:2
- Irritability for no reason
- Extreme restlessness or agitation
- Aggressive behavior
- Worsening depression or anxiety
- Rapid heartbeat
- Serious stiffness in muscles
- Difficulty sleeping
- Mania, characterized by increased activity and chattiness
- Other changes in behavior or mood
What Happens When You Stop Taking Escitalopram?
People who take SSRIs like escitalopram may experience withdrawal symptoms if they stop taking the medication suddenly.4 People who wish to stop taking escitalopram should consult their doctor first, to develop a taper that will successfully detox the body from the substance.
Withdrawal symptoms associated with escitalopram include:2
- Mood swings.
- Sensations like electric shocks.
- Feeling restless.
- Sleep changes.
Can You Accidentally Overdose on Escitalopram?
It is possible to overdose on escitalopram, although if the medication is taken as prescribed, overdose is unlikely.
However, when combined with other prescription or recreational drugs, the potential for overdose on escitalopram increases.
An overdose on any drug or medication is very serious, so it is important to call 911 to get the person emergency medical help as soon as possible.
Symptoms of overdose include:2
- An altered mental status such as coma.
- Serotonin syndrome.
- Cardiovascular toxicity.
Escitalopram’s Interaction with Other Medical Conditions
People who have or have had certain medical conditions in the past should speak with their doctor before beginning a prescription for escitalopram.
These conditions include the following:2
- Kidney or liver problems
- Heart problems
- Seizures or convulsions
- Bipolar disorder or mania
- Bleeding problems
- Low sodium levels in blood
- Pregnant or planning to become pregnant
Escitalopram could interfere with these conditions as well as medicines used to treat the conditions.
Escitalopram and Other Medications
It is important not to take multiple antidepressants at the same time. SSRIs like escitalopram interact strongly with MAO inhibitors, an earlier and very potent class of prescription antidepressants.2
Escitalopram and citalopram, another SSRI medication, are also very similar and should not be taken in combination.2
Mixing antidepressants can cause several side effects, including serotonin syndrome. Symptoms of serotonin syndrome include:4
- Rigid muscles.
Other medications that can interact with escitalopram include:2
- Herbal supplements such as St. John’s Wort or tryptophan.
It is recommended that a person does not drink alcohol while taking this medication.2 Escitalopram can cause fatigue or sleepiness. This could cause a person to pass out or alter body control and reflexes, making for unsafe walking or driving.2