Lexapro---the brand name for escitalopram oxalate---is a selective serotonin reuptake inhibitor, or SSRI. Lexapro is prescribed to treat depression and generalized anxiety disorder, a condition characterized by excessive worry and tension that disrupts daily life for six months or longer, according to Drugs.com. Selective serotonin reuptake inhibitors help to maintain mental balance by increasing the amount of serotonin in the brain. The medication is available in tablet or oral solution. The U.S. Food and Drug Administration lists three contraindications to prescribing Lexapro. Patients who are allergic to any of the ingredients, as well as those taking monoamine oxidase inhibitors or pimozide, cannot take Lexapro because they risk suffering serious and even life-threatening side effects.
Monoamine Oxidase Inhibitors
Taking Lexapro while also taking an MAOI---or within 14 days of each other-- is contraindicated, according to Drugs.com. MAOIs--phenelzine, tranylcypromine, isocarboxazid and selegiline---block the enzyme monoamine oxidase from metabolizing certain chemicals in the brain, according to MayoClinic.com. The levels of these chemicals---norepinephrine, serotonin and dopamine---remain high as a result, improving mood and relieving depression. MAOIs are generally prescribed only for people who do not respond to other antidepressants because MAOIs can cause serious side effects.
If an MAOI is taken with an SSRI, including Lexapro, the level of serotonin in the brain becomes dangerously high. The symptoms of this rare condition, known as serotonin syndrome, include confusion, restlessness, hallucinations, extreme agitation, blood pressure fluctuations, nausea, vomiting, increased heart rate, fever, seizures and coma.
Pimozide
Taking pimozide and Lexapro together is contraindicated by the FDA. Pimozide is in a class called conventional antipsychotics, which reduce abnormal excitement in the brain. It is prescribed for severe motor or verbal tics---uncontrollable movements or sounds---in patients with Tourette's syndrome. Lexapro increases the risk of the side effects of pimozide, which may include fast or irregular heartbeat; difficulty breathing or swallowing; and uncontrollable rhythmic face, mouth or jaw movements.
Hypersensitivity
Lexapro is contraindicated in patients with a hypersensitivity to escitalopram or citalopram or any of the inactive ingredients in Lexapro. Inactive ingredients in the tablets include talc, croscarmellose sodium, microcrystalline cellulose/colloidal silicon dioxide, and magnesium stearate. The film coating contains hypromellose, titanium dioxide and polyethylene glycol. The inactive ingredients in the oral solution include sorbitol, purified water, citric acid, sodium citrate, malic acid, glycerin, propylene glycol, methylparaben, propylparaben and natural peppermint flavor.
Symptoms of a severe allergic reaction may include rash, hives, itching, difficulty breathing, tightness in the chest or swelling of the mouth, face, lips or tongue, according to Drugs.com. Patients experiencing any of these symptoms after taking Lexapro should seek medical attention immediately.
