Lexapro

Lexapro is an antidepressant that treats a variety of mental health conditions, including depression and anxiety-related disorders. The drug is not shown to be addictive, but can cause serious side effects. If use is stopped abruptly, withdrawal-like symptoms can develop.
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What is Lexapro (Escitalopram)? 

Lexapro, the brand name for the drug escitalopram, is an antidepressant that treats mental health conditions, such as:

  • Major depressive disorder (MDD) — a condition where you experience persistent feelings of sadness and loss of interest. These feelings may impact your day to day life and ability to function and feel normal.
  • Generalized anxiety disorder (GAD) — a condition where you experience recurring anxiety.
  • Bipolar disorder — a disorder that causes extreme mood swings.
  • Panic disorder and panic attacks

Lexapro is a selective serotonin reuptake inhibitor (SSRI). Serotonin is a chemical in the brain (known as a neurotransmitter) that carries signals between neurons. The drug prevents reabsorption of serotonin into neurons, allowing for better transmission of messages to the brain.

How to Use Lexapro

Lexapro pill

Lexapro is available in tablet form and should be stored at room temperature. People can take it in 5, 10, or 20 milligrams (mg) doses, or as a liquid.

The amount of Lexapro you take depends on your age and the condition being treated:

  • Generalized anxiety disorder — adults and older patients take 10 to 20 mg once per day in the morning or evening.
  • Depression — children 12 years and older, adults, and older patients take 10 to 20 mg once per day in the morning or evening.

Between 2011 and 2014, almost 13 percent of people 12 and over reported antidepressant medication use in the past month. 

National Center for Health Statistics (NCHS)
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Risks of Lexapro

SSRIs, including Lexapro, are generally safe for most people. However, you should be aware of certain risks associated with taking Lexapro. These risks include an increased risk of suicide, serotonin syndrome, hyponatremia, and more.

SSRIs can also increase suicidal thoughts or actions in children, teenagers, and young adults under 25. For this reason, the Food and Drug Administration (FDA) requires that all antidepressants carry black box warnings. These warnings are used only for serious safety concerns. 

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Lexapro should not be combined with drugs that increase your risk of bleeding. These drugs include nonsteroidal anti-inflammatory drugs (NSAIDs), warfarin, other blood thinners, or aspirin. If taken together, these combinations can contribute to your risk of gastrointestinal bleeding or other bleeding problems.

The overall goal of antidepressants is to reduce suicide risk over time. However, you may begin, or continue, to have suicidal thoughts or ideations at the beginning of Lexapro treatment. If these occur, contact emergency medical services or your doctor immediately.

Hyponatremia is a condition that occurs when the concentration of sodium in your blood is too low. SSRIs, such as Lexapro, interfere with the kidneys and normal hormonal processes in the brain, resulting in an imbalance in electrolytes. Signs of hyponatremia include:

  • Headache
  • Nausea and vomiting
  • Seizures
  • Coma
  • Memory impairment
  • Confusion
  • Muscle stiffness, cramps, spasms, or weakness
  • Irritability and restlessness
  • Drowsiness and fatigue
  • Difficulty concentrating

In severe cases, hyponatremia results in hallucinations, respiratory arrest, and death. If you experience any of the above symptoms, seek medical attention immediately. 

Two pills mixing equals dangerous

Drug Interactions

Combining Lexapro with other antidepressants, particularly monoamine oxidase inhibitors (MAOIs), should be avoided to prevent serious side effects. If you discontinue the use of Lexapro, you must wait five weeks before taking an MAOI. If you discontinue the use of MAOIs, you must wait two weeks before taking Lexapro.

Serious side effects can occur if the use of the two drugs overlaps, including:

  • Agitation or irritability
  • Restlessness
  • Seizures or severe convulsions
  • Confusion
  • High body temperature
  • Stomach or intestinal problems
  • Extremely high blood pressure

SSRIs allow serotonin to accumulate in the brain outside of neurons, increasing your chances of developing serotonin syndrome. This condition occurs when high levels of the neurotransmitter accumulate in your body.

Most often, serotonin syndrome is the result of combining two medications that increase serotonin levels. Examples of these include fentanyl, other antidepressants, the herbal supplement St. John’s wort, and amphetamines. Signs of serotonin syndrome include:

  • Sweating
  • High fever
  • Confusion
  • Rapid heart rate
  • Nausea and vomiting
  • Tremors
  • Dangerous changes in blood pressure
  • Lack of coordination
  • Restlessness
  • Anxiety or agitation
  • Coma
  • Diarrhea

If you have any of these symptoms, contact emergency medical services immediately. 

You should not consume alcohol while taking Lexapro. Alcohol can worsen the symptoms of depression, which can become dangerous if you take Lexapro to treat it. Due to these effects, it is best to talk with your doctor about your history of depression and alcohol use beforehand.

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Side Effects of Lexapro

The most common side effect of Lexapro is an improvement in mood. Other common side effects include:

  • Decreased energy levels
  • Trouble sleeping
  • Decreased sex drive(difficulty with orgasm, loss of interest in sexual intercourse)
  • Constipation or diarrhea
  • Dry mouth
  • Heartburn
  • Eye pain
  • Weight changes

These symptoms will begin to improve over the first week or two of treatment. SSRIs take four to five weeks to reach steady-state, or a constant concentration of the drug in your blood. This state is when you will get the full benefits from the drug.

It is important to continue taking Lexapro even if you feel well in order to maintain steady-state and properly treat your mental illness. 

Early studies linked weight gain and antidepressant use. However, these studies were small and short and did not provide a strong link between the two. A team of researchers from Massachusetts General Hospital surveyed over 19,000 men and women using antidepressants for weight gain. In summary, there were no major differences in weight gain using antidepressants, and in fact, some people lost weight. 

Pill bottle and skull

Lexapro Addiction Symptoms

The potential for abuse and addiction from taking Lexapro has not been studied extensively. However, it is not considered to be an addictive drug.

When someone uses a drug daily for a long time, they eventually become physically and psychologically dependent on it. They need to continue taking the drug in order to feel normal and function properly. After stopping use, discontinuation syndrome, or withdrawal-like symptoms, can set in.

Ceasing long-term use of Lexapro may result in the following withdrawal symptoms:

  • Nausea
  • Dizziness
  • Nightmares
  • General feelings of uneasiness
  • Mood swings
  • Irritability
  • Flu-like symptoms
  • Lethargy
  • Paresthesias (tingling or prickling sensation on the skin)

These symptoms are most likely to occur after quitting “cold-turkey” or abruptly. Tapering is an effective method for preventing severe withdrawal symptoms. This involves slowly decreasing the dose of the drug over a period of time, preventing shock to the body’s system.

The safest method of discontinuing the use of Lexapro is under the direct care of a medical professional. The mental health conditions treated by the drug are serious and require continued treatment. 

Graphic of 3 different types of medication bottles and pills.

Lexapro Abuse Treatment

Current research suggests that Lexapro is not addictive. Therefore, there is little information on treatment and few resources available on the topic. 

Celexa, the brand name of the drug citalopram, is similar to Lexapro in chemical structure. The main difference is that Lexapro is the drug escitalopram, which is a slightly different shape of the drug compared to Celexa. As a result, the two drugs bind receptors in the brain differently and can produce different effects. Lexapro works well for some people, while Celexa works better for others. 

Zoloft, the brand name of the drug sertraline, is another SSRI that is a different chemical from Lexapro. Both medications treat depression and anxiety disorders. However, Zoloft is used to treat a wide variety of other mental health conditions, including obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD) and and premenstrual dysphoric disorder (PMDD). 

Talk to your doctor if you are concerned about possible addiction and if you have a history of drug abuse. There are many different SSRIs available to treat a wide variety of mental health conditions, and switching medication may help. Some examples of other medications include Celexa and Zoloft.

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Resources

Food and Drug Administration. “Celexa (citalopram hydrobromide.)” FDA, Aug. 2011, https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/020822s042,021046s019lbl.pdf.

Food and Drug Administration. “Lexapro (escitalopram oxalate.)” FDA, Jan. 2017, https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021323s047lbl.pdf.

Food and Drug Administration. “Zoloft (sertraline hydrochloride.)” FDA, Dec. 2016, https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/019839S74S86S87_20990S35S44S45lbl.pdf.

LeWine, Howard. “Antidepressants cause minimal weight gain.” Harvard Health, Jun. 2014, https://www.health.harvard.edu/blog/antidepressants-cause-minimal-weight-gain-201406067202.

Hall-Flavin, Daniel K. “Antidepressants and alcohol: What’s the concern?” Mayo Clinic, Jun. 2017, https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/antidepressants-and-alcohol/faq-20058231.

Mayo Clinic. “Depression (major depressive disorder.)” Mayo Clinic, Feb. 2018, https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007.

Mayo Clinic. “Escitalopram (Oral Route.)” Feb. 2020, https://www.mayoclinic.org/drugs-supplements/escitalopram-oral-route/proper-use/drg-20063707.

Pratt, Laura A., Brody, Debra J., Gu, Qiuping. “Antidepressant Use Among Persons Aged 12 and Over: United States, 2011-2014.” National Center for Health Statistics, Aug. 2017, https://www.cdc.gov/nchs/data/databriefs/db283.pdf.

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Updated on: August 3, 2020
Author
Addiction Group Staff
About
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Medically Reviewed
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Annamarie Coy,
BA, CADACII/ICADC, ICPR, MATS
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