What is Lexapro?
Dr. Angel Rivera
Before diving into what Lexapro is and how its benefits can improve your life, one must understand what it helps to treat medically. Clinical depression affects approximately 17.3 million Americans annually, according to statistics collected in 2017 by the National Institute for Mental Health. Depression can affect anyone at any age, and the highest prevalence is in adults between the ages of 18 and 25. There are many types of depression. Clinical depression is also known as major depressive disorder, which is the most common type of depression that affects people. Symptoms of depression can be mild, or they can be so intense that they interfere with the ability to do normal daily activity. These symptoms include:
- Regularly feeling sad or anxious
- Losing interesting in formerly enjoyable activities
- Easily irritable or frustrated
- Trouble sleeping or staying asleep
- Trouble concentrating or making decisions
- Feeling tired even after sleeping
- Feelings of guilt or worthlessness
- Suicidal thoughts
Getting treatment for mental health issues like depression is crucial for an individual to live a normal and healthy life. A related, but separate mental health condition that is also common among adults in the country is anxiety, of which the most common type is called generalized anxiety disorder. Anxiety is the most prevalent mental health issue in Americans, and according to the Anxiety and Depression Association of America, the condition affects approximately 40 million American adults. This is about 18 percent of the country’s entire population. Symptoms of anxiety include:
- Excessive worrying about situations that are not proportionate to the impact of the event
- Overthinking situations and plans to worst-case outcomes
- Viewing situations as threatening even if they are not
- Not handling uncertainty well
- Fear of making wrong decisions
- Inability to relax
- Difficulty concentrating
- Trouble sleeping
- Feeling irritable
- Nausea or diarrhea
About one-half of all individuals diagnosed with depression are also diagnosed with anxiety. Most of the time, anxiety and depression are treated with both therapy and medication. The treatment methods for both of these conditions go hand-in-hand and are essential for taking care of your mental health. The doctor, or healthcare provider, you are working with will prescribe the medication that is best for your mental health problem based on your symptoms and medical history.
If you suffer from depression, anxiety, or both conditions, you may be prescribed Lexapro for treatment. This is a guide about what you need to know about the drug and what to expect when taking it.
Lexapro, sometimes confused with the drug Celexa, was chosen as the brand name for the drug escitalopram. So what is the difference between Celexa vs Lexapro? Lexapro is a prescription medication that is FDA-approved for the treatment of major depressive disorder and generalized anxiety disorder. While other antidepressants are often used ‘off-label’ to treat anxiety, Lexapro is one of the few drugs that are actually indicated for this use due to its proven efficacy in treating anxiety, as demonstrated through clinical trials. Lexapro was first approved to treat depression in 2002. The drug was developed in a relatively short time frame due to its structural similarity with another popular antidepressant, citalopram. Lexapro is also one of the few drugs that can be taken to treat major depressive disorder by children above the age of 12. One of the best features of Lexapro is that the risk of abuse in taking this drug is minimal.
How does Lexapro work?
Physically, depression is caused by low levels of the neurotransmitter, serotonin, in the brain. Lexapro belongs to the class of antidepressant drugs named selective serotonin reuptake inhibitors (SSRIs). Medicines in this SSRI drug class elevate serotonin levels in the brain to establish feelings of happiness in the individual. These medications can prevent serotonin's reabsorption into nerve cells, allowing it to accumulate in the brain instead. The SSRIs are one of the most commonly prescribed classes of antidepressants, and they are considered to be safe and effective.
How to take Lexapro
Lexapro is available in different dosages as 5 mg, 10 mg and 20 mg oral tablets, or as an oral solution. The dosage recommended to you will depend on the condition you are treating and how severe your symptoms are. Generally, Lexapro starts at 10 mg per day, and the dose is gradually adjusted after an understanding is gathered regarding how your body responds to the medication. A maximum of 20 mg can be taken in a day. It usually takes about two weeks after starting the medication to start noticing any difference. Furthermore, it can take up to six weeks to feel the full effect of taking the drug.
It is vital not to abruptly stop taking the drug even if you do not notice any changes at first. Stopping Lexapro suddenly can lead to withdrawal symptoms that include changes in sleep, mood swings, headache, vomiting, nausea, dizziness and feelings similar to an electric shock. If you plan to stop the medication, the dosage must be decreased gradually to avoid experiencing withdrawal symptoms.
Side effects of Lexapro
Like all medication, Lexapro can also cause unwanted side effects. Compared to other antidepressants, Lexapro is generally very well tolerated and has fewer overall side effects associated with taking it. The chances of experiencing Lexapro side effects are higher as the dosage amount is increased within the individual. The most common side effects are:
- Excessive sweating
- Dry mouth
- Loss of appetite
- Sexual dysfunction
- Trouble sleeping
- Feeling anxious
- Weight gain
- Trouble sleeping
More serious side effects include:
- Seizures or convulsions
- Low salt levels, especially in people who take water pills or diuretics for other conditions
- Manic episodes in people that have bipolar disorder
- Vision problems
- Serotonin Syndrome- this is a condition that can develop when levels of serotonin become too high in the body. It can occur if you take more than one antidepressant that elevates serotonin levels in the brain. Serotonin syndrome symptoms include: hallucinations, coma, racing heart, high blood pressure, sweating, fever, muscle stiffness and problems with coordination.
- FDA black box warning- the FDA has issued a black box warning that Lexapro can increase the risk of having suicidal thoughts or actions. This risk is higher in adolescents or young adults, in the initial phase of treatment and during dosage changes. Get emergency medical help immediately if you have any new symptoms such as dangerous and aggressive behavior or suicidal thoughts.
Lexapro interacts with very few drugs because its potential to inhibit hepatic enzymes in the liver where drug metabolism takes place is low. However, Lexapro can interact with some medicines. If you take any of the following drugs, you can consult your doctor to find out how to arrange your medication schedule or whether you should take Lexapro at all.
- Monoamine oxidase inhibitors (MAOIs)
- Blood thinners such as warfarin
- Non-steroidal anti-inflammatory drugs (NSAIDs) and aspirin
- Other drugs that elevate serotonin levels such as drugs used to treat anxiety, seizures or depression
- Drugs for heart problems
- Drugs that lower potassium or magnesium levels in the body
This is not an exhaustive list of drugs that can interact with Lexapro. You can find more information here.
Who should not take Lexapro
Lexapro belongs to the pregnancy category C drugs, which means that it is not safe for use during pregnancy. Other drugs are preferred to treat depression during pregnancy, but it is important not to stop taking Lexapro suddenly. Consult your doctor to continue or stop taking the medication during pregnancy safely. Lexapro can also pass through breast milk, so check with your doctor before using this drug while breastfeeding.
Your personal medical history can also affect whether taking Lexapro is right for you. Taking Lexapro if you have certain medical conditions can increase the risk of side effects or serious adverse effects. Some of these conditions include:
- Bipolar disorder
- Family history of suicidal attempts
- Low salt levels
- Heart problems
- Liver problems
Older adults are also at a higher risk of experiencing side effects, getting low blood sodium, losing coordination and an increased risk of bleeding. Talk to your doctor about your personal medical history and other factors you may be concerned about to decide whether taking Lexapro is safe and beneficial for you.
Cost of Lexapro and where to buy it
The cost of purchasing brand-name Lexapro can be on the higher end compared to buying generic escitalopram. The average cost of a 30-day supply of brand name Lexapro is between $100 to $350 depending on the tablet's strength, while the average price for the same amount of generic escitalopram is less than $15. Most health insurance plans and all Medicare plans cover the cost of the drug. Another great way to save even more on Lexapro or escitalopram, is through a prescription drug discount card, like the card available from USA Rx. This discount card is free and can be used at more than 90% of pharmacies across the nation to purchase escitalopram for potentially less than $10. Try out the card the next time you fill your prescription to start saving more on Lexapro.