Lexapro is a drug prescribed for the treatment of generalized anxiety disorder and major depressive disorder. The United States Food and Drug Administration does not list Lexapro, known generically as escitalopram, as a medication that interacts adversely with grapefruit. The absence of an FDA warning doesn't guarantee that you can safely mix Lexapro and grapefruit. Grapefruit does interact negatively with many medications, including some antidepressants and anti-anxiety medications.
Lexapro received a newly approved FDA label on May 12, 2011, that did not warn against combining grapefruit with the medication. Additionally, no mainstream articles, periodicals, journals or magazines have published any information pertaining to side effects from combining Lexapro and grapefruit, according to a Lexis Nexus search conducted on June 20, 2011. But many drugs remain untested regarding their possible interactions with grapefruit, according to The People’s Pharmacy.
The FDA does warn against taking Lexapro with the drug citalopram, a medication similar to Lexapro in chemical makeup. Lexapro can also cause negative side effects if combined with blood thinners and some drugs to treat pain and migraines. In addition, the FDA warns against taking Lexapro with St. John’s wort and antidepressants such as amitriptyline and imipramine. To find out all the substances and medications that can cause side effects if combined with Lexapro, ask your doctor or pharmacist.
Grapefruit and Psychiatric Drug Interactions
Though Lexapro is not one of the psychiatric drugs known to cause side effects with grapefruit, many psychiatric drugs do interact dangerously with the citrus fruit. This is important to know, as your doctor may suggest you switch or combine medications. Some antidepressants, anti-anxiety and other psychiatric drugs known to cause side effects if consumed with grapefruit include sertraline, buspirone, diazepam, midazolam and triazolam, according to Harvard Medical School. The People’s Pharmacy notes that the sleeping medication zaleplon, as well as the antidepressants zaleplon and trazodon, may also cause side effects when combined with grapefruit. The drugs quetiapine, prescribed for schizophrenia, and clomipramine, prescribed for obsessive compulsive disorder, may also cause side effects if mixed with grapefruit.
Grapefruit and Metabolism
Grapefruit prevents your body’s CYP34A enzyme from metabolizing medication. This means that medication may remain in your system longer than intended and, if you keep taking the medication, it may build up to dangerous levels. If you combine Lexapro with grapefruit, you will end up with extra Lexapro in your system. This may not cause problems and so far, none has been documented. But, if you wish to err on the side of caution, do not consume grapefruit or grapefruit juice if you take Lexapro.
- US Food and Drug Administration: Label and Approval History – Lexapro; May 12 2011
- “The New York Times”; Experts Reveal the Secret Powers of Grapefruit Juice; Nicholas Bakalar; March 21 2006
- The Harvard Medical School Family Health Guide: Grapefruit and Medication: A Cautionary Note; Feb. 2006
- The People’s Pharmacy; Graedons’ Guide to Grapefruit Interactions; 2002