Selective Serotonin Reuptake Inhibitor (SSRI)

Lexapro (Escitalopram)

Generic: Escitalopram

One of the most effective and well-tolerated SSRIs for depression and anxiety

Important: This information is for educational purposes only and is not a substitute for professional medical advice. Always consult your healthcare provider before starting, stopping, or changing any medication.

Overview

Lexapro (escitalopram) is a selective serotonin reuptake inhibitor (SSRI) that is widely considered one of the most effective and well-tolerated antidepressants available. It's FDA-approved for both major depressive disorder and generalized anxiety disorder. At Next Step Psychiatry, Lexapro is often a first-line treatment choice due to its favorable side effect profile and proven effectiveness.

How Lexapro Works

Lexapro works by selectively blocking the reuptake of serotonin in the brain, increasing serotonin availability in the synaptic space. This helps regulate mood, reduce anxiety, and improve emotional well-being. Escitalopram is the "S-enantiomer" of citalopram, meaning it's the most active form of the molecule, allowing for lower doses with similar effectiveness.

What Is Lexapro Used For?

Major Depressive Disorder (MDD)
Generalized Anxiety Disorder (GAD)
Off-label: Panic disorder
Off-label: Social anxiety disorder
Off-label: OCD
Off-label: PTSD

Dosage Information

Starting Dose

10 mg once daily

Typical Dose

10-20 mg once daily

Maximum Dose

20 mg per day

Important Notes:

  • Can be taken with or without food
  • Usually taken in the morning, but can be taken at night if it causes drowsiness
  • Lower doses (5 mg) may be used initially in elderly patients
  • Dose increases should be made after at least 1 week
  • Available in tablet and liquid forms

Side Effects

Common Side Effects

These may occur when starting the medication and often improve over time:

Nausea (usually temporary)
Headache
Drowsiness or fatigue
Insomnia
Dry mouth
Increased sweating
Sexual side effects (decreased libido, difficulty with orgasm)
Dizziness
Diarrhea or constipation

Serious Side Effects (Seek Medical Attention)

Serotonin syndrome (when combined with other serotonergic drugs)
Severe allergic reactions
Abnormal bleeding
Hyponatremia (low sodium)
Mania or hypomania
Suicidal thoughts (especially in young adults)
QT prolongation (heart rhythm issue) at high doses

Important Warnings

  • !Black box warning for suicidal thoughts in children, adolescents, and young adults
  • !Do not use with MAO inhibitors or within 14 days of stopping them
  • !Use caution with other serotonergic medications
  • !May increase bleeding risk, especially with blood thinners or NSAIDs
  • !Do not stop abruptly - taper gradually to avoid withdrawal
  • !QT prolongation risk at doses above 20 mg

When to Seek Immediate Medical Help

Contact your doctor immediately or go to the emergency room if you experience:

  • Thoughts of suicide or self-harm
  • Signs of serotonin syndrome (agitation, fast heartbeat, fever, muscle stiffness)
  • Severe allergic reaction
  • Unusual bleeding or bruising
  • Manic symptoms
  • Severe nausea or vomiting
  • Seizures
  • Confusion or memory problems

Drug Interactions

Tell your doctor about all medications, supplements, and herbal products you take. Important interactions include:

MAO inhibitors - dangerous interaction
Other serotonergic drugs (risk of serotonin syndrome)
Blood thinners and NSAIDs (increased bleeding risk)
Medications that prolong QT interval
Pimozide - contraindicated
CYP2C19 inhibitors may increase escitalopram levels

Frequently Asked Questions

Is Lexapro the same as Celexa?

Lexapro (escitalopram) is related to Celexa (citalopram) but is not identical. Escitalopram is the purified "active" form of citalopram, which means it works at lower doses and may have fewer side effects for some patients.

How long does Lexapro take to work?

Some people notice improvements in sleep, energy, or appetite within 1-2 weeks. However, full antidepressant and anti-anxiety effects typically take 4-6 weeks. Don't give up if you don't feel better immediately.

Can I drink alcohol while taking Lexapro?

It's generally recommended to avoid or limit alcohol while taking Lexapro. Alcohol can worsen depression and anxiety, and the combination may increase drowsiness and impair judgment.

Crisis Support

If you're experiencing a mental health crisis or thoughts of suicide, call 988 (Suicide & Crisis Lifeline) or go to your nearest emergency room. Help is available 24/7.

Questions About Lexapro?

Our psychiatrists provide expert medication management and can help determine if Lexapro is right for you.

4145 Lawrenceville Hwy NW, Suite 100, Lilburn, GA 30047

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