Lexapro (escitalopram) is an antidepressant medication that belongs to a group of drugs called selective serotonin reuptake inhibitors. Lexapro is FDA-approved for the treatment of major depressive disorder or generalized anxiety disorder. Lexapro is generally well tolerated but, like most drugs, it has side effects. And, as with other SSRIs, you need to take precautions when using Lexapro.
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Common Side Effects
The most common side effects associated with Lexapro are nausea, insomnia, excessive sweating, fatigue, decreased interest in sex and impaired ejaculation, according to a 2012 review in "Patient Preference and Adherence." Less commonly, people report diarrhea, constipation, dry mouth, vomiting or a feeling the room is spinning. In most cases these side effects are mild and temporary. When compared to other SSRIs, such as paroxetine (Paxil) or fluoxetine (Prozac), Lexapro appears to have fewer and milder adverse effects.
SSRIs increase the concentration of serotonin within the junctions between your nerves. Serotonin is a neurotransmitter that regulates a number of processes, including mood, alertness, appetite, intestinal function and blood clotting. Serotonin syndrome is a rare but potentially deadly condition that occurs when serotonin levels within your nervous system climb too high. Symptoms of serotonin syndrome include confusion, agitation, rapid heart rate, sweating, fever, vomiting, diarrhea and muscle spasms.
Serotonin syndrome can occur while you are taking any SSRI, but it is more likely to occur in people who intentionally overdose on their SSRI, who take more than one SSRI at the same time or who combine their SSRI with something that interferes with its metabolism or enhances its actions. For example, a case report published in the May 2012 issue of "Clinical Medicine Insights" described a young man who developed serotonin syndrome when he combined an overdose of Lexapro with cocaine.
If you take Lexapro or any other SSRI for a long time, abruptly discontinuing your medication could trigger a type of withdrawal known as SSRI discontinuation syndrome. This condition is not caused by drug dependence or addiction. Rather, it is triggered by your body’s response to a sudden fall in serotonin levels.
Symptoms of serotonin discontinuation syndrome typically develop 1 to 3 days after stopping an SSRI and include dizziness, nausea, headache, poor concentration and sensations that feel like an electric shock in the upper body and thighs. Serotonin discontinuation syndrome is not life-threatening, and it can be avoided by gradually tapering your medication rather than stopping it suddenly.
One concern that has arisen from the use of antidepressants in children and adolescents is an increased risk for suicidal thoughts and attempted or completed suicide after starting the medications. While there is some controversy surrounding this issue, SSRIs should be avoided or used with caution in children and adolescents. Lexapro is not FDA-approved for use in children younger than age 12.
Research studies indicate that Lexapro is not associated with an increased risk for suicide in adults. Conversely, Lexapro usually reduces suicidal thoughts in adults shortly after they start treatment.
Lexapro is a safe and effective medication for most people. Your doctor will determine if Lexapro is appropriate for you.
- Neuropsychiatric Disease and Treatment: Escitalopram Tolerability as Mono- Versus Augmentative Therapy in Patients With Affective Disorders: A Naturalistic Study
- Patient Preference and Adherence: Escitalopram for the Management of Major Depressive Disorder: A Review of Its Efficacy, Safety and Patient Acceptability
- Clinical Medicine Insights: Case Reports: Serotonin Syndrome With Escitalopram and Concomitant Use of Cocaine: A Case Report
- Journal of the Canadian Academy of Child and Adolescent Psychiatry: SSRIs and SNRIs: A Review of the Discontinuation Syndrome in Children and Adolescents