Lexapro (Escitalopram Oxalate)

Lexapro Review

The antidepressant Lexapro is a member of the family of medications known as selective serotonin reuptake inhibitors (SSRIs). Lexapro offer advantages in the treatment of depression and generalized anxiety disorder.


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Lexapro Drug Class and Mechanism

Lexapro Uses

Escitalopram acts by increasing intrasynaptic levels of the neurotransmitter serotonin by blocking the reuptake of the neurotransmitter into the neuron. Of the SSRIs currently on the market escitalopram has the highest affinity for the human serotonin transporter (SERT). Remarkably, another enantiomer of citalopram (R-citalopram) counteracts to a certain degree the serotonin-enhancing action of escitalopram. As a result, escitalopram is a more potent antidepressant than citalopram, which is a mixture of escitalopram and R-citalopram. In order to explain this phenomenon, researchers from Lundbeck proposed that escitalopram enhances its own binding via an additional interaction with another allosteric site on the transporter.[11] Further research by the same group showed that R-citalopram also enhances binding of escitalopram,[12] and therefore the allosteric interaction cannot explain the observed counteracting effect. However, in the most recent paper the same authors again reversed their findings and reported that R-citalopram decreases binding of escitalopram to the transporter.[

Lexapro Side Effects

The side effect profile of escitalopram is close to that of other SSRIs, with nausea, somnolence, and gastrointestinal side effects reported as relatively common. Escitalopram, like other SSRIs, has been shown to cause sexual side effects in many patients.[14] Escitalopram is not associated with significant weight gain. For example, 0.6 kg mean weight change after 6 months of treatment with escitalopram for depression was insignificant and similar to that with placebo (0.2 kg).[15] 1.4-1.8 kg mean weight gain was reported in 8-month trials of escitalopram for depression,[16] and generalized anxiety disorder.[17] A 52-week trial of escitalopram for the long-term treatment of depression in elderly also found insignificant 0.6 kg mean weight gain.[18] Escitalopram may help reduce weight in those treated for binge eating associated obesity.[19] It may also cause dizziness after exercise in children.[citation needed]

A meta-analysis of clinical trials database conducted by the escitalopram manufacturer Lundbeck found no indication that escitalopram would provoke suicidal behaviour compared with placebo in patients with major depressive disorder and anxiety disorders, on the contrary, suicidal thoughts in the escitalopram group were significantly decreased.[20] An analysis conducted by the FDA found a statistically insignificant 1.5 to 2.4-fold, depending on the statistical technique used, increase of suicidality among the adults treated with escitalopram for psychiatric indications.[21][22][23] Similarly, the UK MHRA data indicate an 80% increase of suicide-related events, not reaching statistical significance, in the escitalopram vs placebo patients.[24] The authors of a related study note the general problem with statistical approaches—due to the rarity of suicidal events in clinical trials, it is hard to draw firm conclusions with a sample smaller than two million patients.[25] A single case report described a patient developing suicidal ideation after beginning treatment with escitalopram, and suicidal ideation disappearing after stopping the treatment.[26]

Lexapro Pregnancy

Lexapro Overdose

Seek emergency medical attention. Symptoms of a Lexapro overdose include nausea, vomiting, tremor, drowsiness, dizziness, sweating, and a fast heartbeat.

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