What is Lexapro (escitalopram) Used For?
Lexapro (escitalopram) has been approved by the US FDA for the treatment of depression and anxiety disorders. It is also prescribed “off-label” for certain other conditions, including:
- Panic disorder
- Hot flashes that can accompany menopause
- Obsessive compulsive disorder (OCD)
- Other types of conditions that may involve emotional distress
Types of antidepressants include Celexa, Prozac, Zoloft and Paxil which all act in a similar way on the CNS (central nervous system). SSRI drugs, such as Lexapro, should not be taken by a woman who is pregnant or nursing, as doing so can harm the baby. Lexapro may be significantly more potent in its serotonergic action than other SSRI drugs, and should not be taken by anyone under the age of 25. This comes from the FDA black box warning concerning Lexapro use and the risk of suicidality.
The prescribing physician determines the dosage based on age, medical condition, other prescription drugs being taken, and additional factors of importance such as sodium levels, cardiovascular health, and other issues.
Lexapro (escitalopram) Alternative Names and Slang
The generic name for this drug is escitalopram, pronounced ES-sye-TA-loh-pram, or escitalopram oxalate. Oxalate refers to a chemical process that is used in manufacturing the drug. Lexapro has not become a common drug of abuse on the street. When it is found on the street, the pills have been diverted or produced in an illegal lab or “pill mill”.
Escitalopram is sold under several trade or brand names, including Lexapro and Cipralex. Although escitalopram (Lexapro) sounds similar and has a similar molecular structure to citalopram (Celexa), the two SSRI drugs are NOT identical.
Comparing dosages, a dose of Lexapro (escitalopram) should be limited to half that of Celexa (citalopram) because Lexapro has twice the effect of Celexa on the neurotransmitters and receptors that both drugs target. For example, 10 mg. of Lexapro would be approximately equivalent to 20 mg. of Celexa.
Lexapro Side Effects
There are multiple side effects of Lexapro (escitalopram) that can occur, and some are extremely important to monitor due to their extreme health risks, though their occurrence is more rarely seen. Here are some of the more troubling potential Lexapro side effects to be aware of:
Hyponatraemia: should be monitored especially closely in older aged females, and also in any person who is underweight, and anyone with a history of liver disease or renal retention. Symptoms of this serious condition can include seizures, fatigue, dizziness, lethargy, cramps, cognitive impairment, and confusion, requiring immediate medical treatment should it arise.
Suicidality: Like all types of antidepressants, Lexapro is associated with increased suicidality most pronounced in children and the young adult population. For this reason, the FDA placed a black box warning on Lexapro with age restrictions.
Bleeding: Lexapro can increase the risk of bruising, vaginal bleeding, gastrointestinal bleeding, or other internal sites of potential hemorrhage.
SUICIDALITY: Paxil is not prescribed to the pediatric population due to a doubling of suicidality in trials.
Sexual Dysfunction: Sexual dysfunction can affect both males and females taking Lexapro. Commonly reported side effects are the inability to climax, impotence, and decreased libido. Lexapro can also affect the quality/quantity of sperm and therefore may interfere with the ability to conceive.
Hypomania/Mania: Lexapro can cause a condition of abnormally heightened euphoria, excitability, lack of the need for sleep, delusional thoughts, behaviors that are erratic or demonstrate impulsivity or poor judgment.
More commonly reported Lexapro side effects include:
- Worsening depression
- Increased sweating
- Somnolence (sleeping for excessively long periods of time)
At the Alternative to Meds Center, many therapies and mental health protocols are available that could be considered Lexapro alternatives. The goal at the center is to provide opportunities to achieve natural mental health without the need for prescription drugs.
Lexapro Withdrawal and Physical Symptoms
Before beginning the process of Lexapro withdrawal or other prescription drug cessation, a gradual reduction in doses is recommended to be done at regular intervals of, for instance, two to four weeks. This is to allow the adverse effects of Lexapro withdrawal to settle out before further reduction in dose is attempted. Getting off Lexapro can be made much more comfortable and gentle using a treatment plan that is so structured, along with enough education and guidance regarding how to get off Lexapro safely and gently.
Never abruptly stop taking an SSRI drug as it can greatly lengthen the Lexapro withdrawal treatment due to the potential associated health risks.
Here are some of the most commonly reported Lexapro withdrawal or discontinuation symptoms when coming off Lexapro (escitalopram):
- Brain zaps
- Visual disturbances
- Gastrointestinal upset, i.e. diarrhea, cramps, including flu-like symptoms
- Blurred vision
- Increased appetite or decreased appetite
- Weight gain or weight loss
- Changes in perception, i.e. taste, smell, sound, etc.
- Dry mouth
- Frequent urination
Discontinuing/Quitting Lexapro (escitalopram)
For some, side effects may ultimately outweigh the benefits of continuing to take an antidepressant, and this may lead to a decision to discontinue taking the drug and to look for Lexapro withdrawal help.
However, getting off Lexapro without help can be extremely uncomfortable. For some, the severity of Lexapro withdrawal symptoms is described as near to impossible to endure. This is the primary driver in developing Lexapro addiction or dependence. In such cases, inpatient care may be the best way forward for comfort, safety, and the greatest chance of success in meeting the challenges of withdrawal and the benefits of health and natural mental health regained in recovery.
In tapering from an SSRI drug, including Lexapro (escitalopram), gradually cutting the dose rather than abruptly stopping use is the medically recommended route to take.
Dangers of Quitting Lexapro: Serotonin Syndrome
The primary danger of quitting any SSRI drug is decreasing the dose too rapidly over too short a time. A slow reduction method may seem counter-productive, especially when side effects have developed to an intolerable level. But it is the best way to avoid the shock that can occur if withdrawal is too fast or too sudden.
There is one exception: “serotonin syndrome”.
Serotonin syndrome can occur when too much serotonin is activated in the body and can be life-threatening. Serotonin syndrome requires immediate medical intervention, by ambulance if possible, to the nearest emergency facility or ICU.
Although part of the remedy is to discontinue the SSRI (serotonergic) medication, this must be done in a medical setting where life-saving medical protocols are immediately accessible.
Signs of serotonin syndrome signal a potential life-threatening event, and include:
- Sudden rise in body temperature, fever
- Irregular heartbeat
- Losing consciousness
- Twitching muscles
- Rigid muscles, stiffness
- Dilated pupils
- Confusion, disoriented
- Heavy sweating
- Inability to speak clearly