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Lexapro (Escitalopram)

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Updated October 03, 2011

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Indications and Usage:

Lexapro (escitalopram) is a selective serotonin reuptake inibitor (SSRI) used in the acute and maintenance treatment of major depressive disorder in adults and adolescents. It is also indicated for the treatment of generalized anxiety disorder (GAD) in adults.

Dosage and Administration:

Lexapro is available in 5, 10 and 20 mg scored tablets as well as a 1 mg per mL oral solution.

This medication should be take once daily, with or without food.

Although there is individual variation based on clinical response, the recommended dose for adolescents and adults is 10 mg daily, with a maximum dose of 20 mg. The recommended dose for older adults or patients with liver impairment is 10 mg per day. For patients with mild or moderate kidney impairment, no dosage adjustment is necessary; however, caution should be used in patients with severe kidney impairment.

When discontinuing Lexapro, a gradual dosage reduction is recommended in order to avoid discontinuation syndrome.

Contraindications:

  • Do not use Lexapro with or within 14 days of stopping a monoamine oxidase inhibitor (MAOI). Allow 14 days after stopping Lexapro before starting an MAOI as well.
  • Do not use at the same time as Pimozide.
  • Do not use if you have known hypersensitivity to escitalopram, citalopram (Celexa) or to any of the pill's inactive ingredients.

Adverse Reactions:

The most common adverse reactions include: insomnia, ejaculation disorder, nausea, increased sweating, fatigue, sleepiness, decrease sex drive and inability to orgasm.

Drug Interactions:

It is recommended that Lexapro not be used at the same time as other SSRIs, SNRIs or tryptophan supplements due to the risk for serotonin syndrome. It should be used cautiously in patients taking drugs that affect blood clotting (for example, ibuprofen, aspirin and warfarin) as there is an increased risk of abnormal bleeding.

Use in Specific Populations:

  • Pregnant and nursing mothers should consult their physician about whether the benefits of Lexapro outweigh any associated risks to their baby.
  • The safety and efficacy of Lexapro in children younger than the age of 12 has not been established.

Warnings and Precautions:

  • Patients should be monitored during the early stages of treatment and during dosage adjustments for worsening depression or suicidality.
  • The drug should be discontinued immediately and appropriate medical care given if serotonin syndrome or a neuroleptic malignant syndrome-like reaction occurs.
  • Discontinuation syndrome may occur if this drug is stopped abruptly.
  • Use with caution in patients with a history of seizures.
  • Use with caution in patients with a history of mania/hypomania.
  • Abnormally low levels of sodium in the blood may occur.
  • Use caution if the patient is taking drugs which affect blood clotting.
  • Use caution when operating machinery.
  • Use caution in patients who have conditions which affect metabolism or blood flow regulation.

Source:

Prescribing Information - Lexapro. Forest Pharmaceuticals, Inc. Accessed: January 11, 2010. http://www.lexapro.com

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