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All about: Escitalopram oxalate

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Generic name: Escitalopram oxalate
Brand names: Lexapro

Why is Escitalopram oxalate prescribed?

Lexapro is prescribed for major depression--a persistently low mood that interferes with daily functioning. To be considered major, depression must occur nearly every day for at least two weeks, and must include at least five of the following symptoms: low mood, loss of interest in usual activities, significant change in weight or appetite, change in sleep patterns, agitation or lethargy, fatigue, feelings of guilt or worthlessness, slowed thinking or lack of concentration, and thoughts of suicide.

Lexapro is also prescribed for generalized anxiety disorder, a condition marked by excessive worry and anxiety that is hard to control and interferes with daily life. To be diagnosed with this disorder, your symptoms must have lasted at least 6 months and you must have at least three of the following: restlessness, fatigue, poor concentration, irritability, muscle tension, and sleep disturbances.

Lexapro works by boosting levels of serotonin, one of the chief chemical messengers in the brain. The drug is a close chemical cousin of the antidepressant medication Celexa. Other antidepressants that work by raising serotonin levels include Paxil, Prozac, and Zoloft.

Most important fact about Escitalopram oxalate

Do not take Lexapro for 2 weeks before or after taking any drug classified as an MAO inhibitor. Drugs in this category include the antidepressants Marplan, Nardil, and Parnate. Combining these drugs with Lexapro can cause serious and even fatal reactions marked by such symptoms as fever, rigidity, twitching, and agitation leading to delirium and coma.

How should you take Escitalopram oxalate?

Take Lexapro exactly as prescribed, even after you begin to feel better. Although improvement usually begins within 1 to 4 weeks, treatment typically continues for several months. Lexapro is available in tablet and liquid forms and can be taken with or without food.

--If you miss a dose...

Take the forgotten dose as soon as you remember. However, if it is almost time for your next dose, skip the one you missed and return to your regular schedule. Do not take two doses at once.

--Storage instructions...

Store at room temperature.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe to continue using Lexapro.

  • More common side effects may include:
    Constipation, decreased appetite, decreased sex drive, diarrhea, dizziness, dry mouth, ejaculation disorder, fatigue, flu-like symptoms, headache, impotence, indigestion, insomnia, nausea, runny nose, sinusitis, sleepiness, sweating

Why should Escitalopram oxalate not be prescribed?

You'll be unable to use Lexapro if it causes an allergic reaction, or if you've ever had an allergic reaction to the related drug Celexa. Remember, too, that you must never take Lexapro while taking an MAO inhibitor such as Marplan, Nardil, or Parnate.

Special warnings about Escitalopram oxalate

In clinical studies, antidepressants increased the risk of suicidal thinking and behavior in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of Lexapro or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Lexapro has not been studied in children or adolescents and is not approved for treating anyone less than 18 years old.

Additionally, the progression of major depression is associated with a worsening of symptoms and/or the emergence of suicidal thinking or behavior in both adults and children, whether or not they are taking antidepressants. Individuals being treated with Lexapro and their caregivers should watch for any change in symptoms or any new symptoms that appear suddenly--especially agitation, anxiety, hostility, panic, restlessness, extreme hyperactivity, and suicidal thinking or behavior--and report them to the doctor immediately. Be especially observant at the beginning of treatment or whenever there is a change in dose.

Lexapro makes some people sleepy. Until you know how the drug affects you, use caution when driving a car or operating other hazardous machinery.

In rare cases, Lexapro can trigger mania (unreasonably high spirits and excess energy). If you've ever had this problem, be sure to let the doctor know.

Also make sure that the doctor knows if you have liver problems or severe kidney disease. Your dosage may need adjustment.

Convulsions have been reported during Lexapro treatment. If you have a history of seizures, use Escitalopram oxalate with caution.

Serotonin-boosting antidepressants could potentially cause stomach bleeding, especially in older people or those taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), and ketoprofen (Orudis KT). Consult your doctor before combining Lexapro with NSAIDs or blood-thinning medications.

You should never stop taking Lexapro without consulting your doctor. An abrupt decrease in dose could cause withdrawal symptoms such as mood problems, lethargy, insomnia, and tingling sensations.

Possible food and drug interactions when taking Escitalopram oxalate

Do not use Lexapro if you are taking the related drug Celexa. Be sure to avoid MAO inhibitors when taking Lexapro. Although Lexapro does not interact with alcohol, the manufacturer recommends avoiding alcoholic beverages.

If Lexapro is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Lexapro with the following:

Aspirin
Carbamazepine (Tegretol)
Cimetidine (Tagamet)
Desipramine (Norpramin)
Drugs that act on the brain, including antidepressants, painkillers, sedatives, and tranquilizers
Ketoconazole (Nizoral)
Linezolid (Zyvox)
Lithium (Eskalith)
Metoprolol (Lopressor)
Narcotic painkillers
Nonsteroidal anti-inflammatory drugs such as Advil and Motrin
Sumatriptan (Imitrex)
Warfarin (Coumadin)

Special information if you are pregnant or breastfeeding

There have been reports of newborns developing serious complications after exposure to Lexapro late in the last 3 months of pregnancy. If you are pregnant or plan to become pregnant, inform your doctor immediately. Lexapro should be taken during pregnancy only if its benefits outweigh the potential risks.

Lexapro appears in breast milk and can affect a nursing infant. If you decide to breastfeed, Lexapro is not recommended.

Recommended dosage

ADULTS

The recommended dose of Lexapro tablets or oral solution is 10 milligrams once a day. If necessary, the doctor may increase the dose to 20 milligrams after a minimum of 1 week, but the higher dose is not recommended for most older adults and people with liver problems.

Overdosage

A massive overdose of Lexapro can be fatal. If you suspect an overdose, seek emergency treatment immediately.

  • Typical symptoms of Lexapro overdose include:
    Dizziness, sweating, nausea, vomiting, tremors, drowsiness, rapid heartbeat, seizures

In rare cases, an overdose may also cause memory loss, confusion, coma, breathing problems, muscle wasting, irregular heartbeat, and a bluish tinge to the skin.

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