Lexapro, or escitalopram, is an antidepressant drug in the selective serotonin reuptake inhibitor, or SSRI, class that is FDA-approved as a treatment for depression and generalized anxiety disorder. Fish oil can improve symptoms of depression and anxiety, and it does not interact with Lexapro. It may be risky to take melatonin with Lexapro, as this combination could enhance the side effects of melatonin.
SSRIs
Low levels of the mood-enhancing neurotransmitter serotonin are strongly associated with anxiety and depression. Low levels of serotonin increase the activity in the amygdala, the brain’s main fear processing center. SSRI help alleviate the symptoms of depression and anxiety by preventing the serotonin transporter from transporting serotonin back into the cells. Once inside the cells, serotonin is inactive. When less serotonin is deactivated, more serotonin is available for enhancing the neuronal signal at the synapses, the junctions between neurons.
Fish Oil
SSRIs do not enhance the synthesis or function of existing serotonin in the brain. They just prevent existing serotonin from reentering the neurons. For this reason, SSRIs work only if the system for producing serotonin and optimizing its functionality is in place. Serotonin cannot function optimally without omega-3 fatty acids, the fats in fatty fish and fish oil. Taking a fish oil supplement or eating a diet high in fatty fish can help prevent an omega-3 deficiency. Fish oil in combination with an SSRI, such as Lexapro, may help Lexapro do its job.
Melatonin
Melatonin is a neurotransmitter that derives from serotonin. It helps regulate sleep and is commonly used to prevent jet lag and adjust sleep patterns for people working night shifts. Studies show that SSRIs can raise the brain’s levels of melatonin. The SSRI fluvoxamine triggers an immediate increase in the brain’s levels of melatonin. The SSRI fluoxetine leads to an immediate drop in melatonin levels. With long-term use, however, fluoxetine may lead to higher daytime levels of melatonin.
Lexapro and Melatonin
There are no studies of whether Lexapro affects the brain’s levels of melatonin. But given that other SSRIs can give rise to elevated melatonin levels, there is a real risk that Lexapro may have similar effects. Taking an SSRI that raises melatonin levels together with a melatonin supplement can enhance the side effects of melatonin. The side effects include stomach cramps, headaches, irritability, dizziness, short-term feelings of depression and daytime sleepiness.
References
- Mayo Clinic: Selective Serotonin Reuptake Inhibitors
- Science Today at the University of California: Myelin: The Insulation that Coats the Brain's Wiring System
- CBN; Omega 3 Fish Oils and Diet Help Alleviate Depression; Dr. Barry Sears
- "Journal of Psychiatry and Neuroscience"; How to Increase Serotonin in the Human Brain without Drugs; Simon N. Young; November 2007
- University of Maryland Medical Center: Melatonin
- "European Journal of Clinical Pharmacology"; Fluvoxamine but Not Citalopram Increases Serum Melatonin in Healthy Subjects -- An Indication that Cytochrome P450 CYP1A2 and CYP2C19 Hydroxylate Melatonin; C. von Bahr; May 2000
- "British Journal of Psychiatry"; Effect of Fluoxetine on Melatonin in Patients with Seasonal Affective Disorder and Matched Controls; P. A. Childs, et al.; February 1995
- "Clinical Pharmacology: Advances and Applications"; Chronic Fluoxetine Treatment Increases Daytime Melatonin Synthesis in the Rodent; G. W. Reierson, et al.; September 2009
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