Lexapro (Escitalopram): Mechanism of Action, Indications, Doses, Precautions

Product Overview
Lexapro (Escitalopram): Mechanism of Action, Indications, Doses, Precautions
Brand Name:
Cipralex, Lexapro
Other Names:
Escitalopram / Escitalopram oxalate
Active ingredient:
Escitalopram oxalate
Dosages (mg):
Drug Class:
Selective serotonin reuptake inhibitors (SSRIs)
Generalized anxiety disorder (GAD), major depressive disorder (MDD)

What is Lexapro? Lexapro (also known as Escitalopram) is the FDA-approved antidepressant of the SSRI (selective serotonin reuptake inhibitor) class. Since its introduction in 2001, the drug has won extreme recognition not only in the USA and Canada but around the world and become the most prescriptible treatment for generalized anxiety disorder (GAD) and major depressive disorder (MDD) for adults and adolescents over 12. Escitalopram is the only active agent, which is proved to cure even the severest depression with a suicidal tendency.

Lexapro mechanism of action

How does Lexapro work? The active component selectively inhibits (blocks) serotonin reuptake, increases the levels of neurotransmitter in the synaptic cleft, strengthens and prolongs the effect of serotonin on postsynaptic receptors. In other words, Lexapro uses have a positive influence on nerve cells communication in the central nervous system and normalize brain chemical balance.

The evident anti-depressive effect is achieved in 2-4 weeks after treatment onset. The maximum therapeutic outcome is reached in approximately three months. Food intake does not influence on Lexapro absorption. The medicine’s time-to-peak concentration is four hours. Lexapro half-life is 30 hours, but this index is variable depending on a patient’s age.


What is Lexapro used for? Lexapro was developed as the maintenance and urgent treatment for:

  • Major depressive disorder;
  • Generalized anxiety disorder;
  • Eating disorder;
  • Obsessive-impulsive disorder;
  • Panic disorder;
  • Phobias;
  • Premenstrual syndrome;
  • Seasonal affective disorder;
  • Social anxiety disorder and other disorders of the highest nervous activity.

A few words about Lexapro and alcohol abuse treatment. Lexapro is used to facilitate alcohol and drug rehabilitation for dually diagnosed patients who experience depression triggered by opiate withdrawal. Lexapro reduces alcohol consumption in addicts.

Doses and overdose

The prescribed dose of Lexapro is taken once a day, morning or evening regardless food. Teenagers suffering from MDD or GAD are recommended to take one pill of Lexapro 10mg. Lexapro 20mg can be taken at least three weeks after the initiation of treatment provided the depressive syndrome is not improved.

For adults and elderly patients the initial dose of Lexapro is 10mg once a day. The dosage can be increased to 20mg in not less than a week after the initiation. The duration of Lexapro treatment is 8 weeks. When this period is over, an attending physician checks the effectiveness of Lexapro and may prescribe to take Lexapro 5mg as a maintaining treatment or as a way of stopping Lexapro.

Abrupt cessation is not recommended because of unpleasant Lexapro withdrawal symptoms:

  • Burning or tingling feelings;
  • Anxiety;
  • Dizziness;
  • Fatigability;
  • Confusion;
  • Irritability;
  • Migraine;
  • Sleep problems.

Lexapro therapy regimen can be prolonged up to three months, though the course of treatment is very individual and must be periodically re-evaluated by your doctor.

The dosage is adjusted under the following conditions:

  • Individual patient’s response;
  • Renal, heart and liver conditions;
  • Different allergies to food or medicines;
  • Mental problems;
  • Suicidal attempts;
  • Alcohol or drugs addiction;
  • Glaucoma;
  • Metabolism disorder;
  • Bleeding problems.

The maximum dose of Lexapro is 20 mg per 24 hours. The overdose may result in serotonin syndrome, convulsions, nausea, and lightheadedness, modification in the blood pressure, sleep disorder, vomiting, sinus tachycardia, drowsiness, heartbeat changes, and coma. In case of Lexapro overdose call the ambulance immediately.

Side effects

Though Lexapro treats depression and mood problems, it has some side-effects such as:

  • appetite loss;
  • extravagant behavior;
  • bloody, black, or loose stools;
  • confusion;
  • chest pain;
  • the decrease in sexual drive;
  • difficulty in concentration;
  • dizziness;
  • excessive sweating;
  • fainting;
  • heartbeat changes;
  • increased fatigability;
  • stomach upset;
  • various allergic reactions.

Contraindications and Precautions

Escitalopram and Lexapro generics do not have an immediate action, but it takes 2-4 weeks for improvements to come. Before the positive effect is achieved there could be a higher risk of suicidal thoughts or attempts. Patients on Lexapro must be given higher attention and care unless the normal serotonin level is returned.

Contraindications to Lexapro are:

  • allergy to citalopram or escitalopram,
  • irregular heartbeat,
  • low blood level of sodium, magnesium of calcium,
  • simultaneous taking of pimozide, monoamine oxidase inhibitors (MAOI) or linezolid inhibitors, or drugs containing methylene blue,
  • seizures;
  • bipolar disorder;
  • hypomania;
  • abnormal bleeding;
  • stroke;
  • body dehydration.

Lexapro and pregnancy. Lexapro is prohibited during the first trimester of pregnancy because of the risk to provoke persistent pulmonary hypertension and weight loss of a fetus and even spontaneous abortion. If a pregnant woman takes Lexapro, she has a risk of temperature instability, hypertonia, irritability, and feeding difficulty. Lexapro is found in woman milk so the drug is prohibited during breastfeeding as well.

Drug interactions

The combination with alcohol aggravates the risk of Lexapro side effects, including difficulty in thinking and concentration, impairment in mental alertness and fine motor skills. Food consumption has no effect on Lexapro.

Lexapro must not be taken with any of the following medicines in order to avoid severe or even life-threatening complications:

  • dopamine transporter binders;
  • QT prolonging agents;
  • serotonin reuptake inhibitors;
  • serotoninergic agents;
  • any other antidepressants.

Lexapro diseases interactions are the matter of concern as well. At the beginning of Lexapro treatment patients with severe depression or maniac inclinations may experience aggravation of their symptoms or changes in behavior. Sufferers must be continuously observed and controlled both by families and attending physician.

Lexapro withdrawal is advised If symptoms progress:

  • Mild and moderate renal dysfunction does not require special Lexapro adjustment. Severe renal failure may require a reduced dose of Lexapro after a consultation with your doctor.
  • Patients with Hyponatremia must not take Lexapro as this drug aggravates the course of this disease.
  • Liver conditions require adjustment of Lexapro.
  • Lexapro has a negative impact on the Platelet Function of a body. That is why patients with active bleeding need to take Lexapro or its generics with caution.
  • Lexapro badly interacts with unstable epilepsy and seizures disorders. Caregivers have to balance clinical need of Lexapro treatment with this risk.

Lexapro vs Zoloft (Sertraline)

The market is full of various antidepressants, but there are some medications, which are the most recommended by doctors. As for SSRIs they are Lexapro and Zoloft. Which one is better? Actually, they have the same indication – to treat depression and anxiety. But! Zoloft is approved by FDA for children over 18 years, (except those with obsessive-compulsive disorder) while Lexapro is approved for children over 12 years. The active component of Zoloft is Sertraline while Lexapro is Escitalopram-based.

The other difference is in that Zoloft is not prescribed if a patient has any kidney conditions while Lexapro just requires dose adjustment under renal diseases. As for other features (price, side-effects, drug interactions, contraindications and withdrawal symptoms) Lexapro and Zoloft are practically identical.

Lexapro vs Celexa (Citalopram)

A wide selection of depression medications makes you embarrassed, doesn’t it? How to choose the best one for you when all the means are aimed to treat mood conditions?

Lexapro and Celexa belong to the SSRIs group. They both require a doctor’s prescription and work for increasing the serotonin level in your brain (serotonin is a chemical, responsible for mood and behavior). Celexa (citalopram) is not approved for children under 18 while Lexapro (escitalopram) is, you know.

The minimal dose of Celexa is 10mg, and Lexapro’s is 5mg.

Lexapro has a lower risk of severe drug-to-drug interactions if compared to Celexa. Lexapro has no serious interactions with pentamidine, amiodarone, quinidine, moxifloxacin, chlorpromazine, gatifloxacin, sotalol, and methadone, while Celexa – does.

Side effects, withdrawal symptoms, precautions and prices of Lexapro and Celexa do not have significant differences.

Wellbutrin (Bupropion) vs Lexapro

Wellbutrin (bupropion) does not belong to SSRI class, it is an atypical antidepressant. It changes activity of dopamine and norepinephrine in brain but this action is not clinically proven.

While Lexapro facilities not only mood problems but alcohol abuse as well, Wellbutrin is aimed to treat depression and improve sexual drive that is why Wellbutrin can be taken with other antidepressants to reduce their sexual side effects.

Lexapro may cause sleepiness and Wellbutrin can make a patient excited. Moreover, this drug increases risk of seizures, eating disorder (anorexia, bulimia), hypertension and heart failure.

Both these drugs have their pros and cons. Consult your doctor, which antidepressant is best for you and place an order at My Canadian Pharmacy to have your personal discount and special promotion.

Prozac (Fluoxetine) vs Lexapro

Prozac (fluoxetine) is a prescription medicine to treat various mental conditions. Unlike Lexapro, Prozac can treat bipolar disorder. This feature is the only meaningful difference between the two SSRIs.

Side effects tend to be similar, though side effects of Lexapro are milder in comparison with Prozac, for example, it has a low risk of sleep disorder, diarrhea, and nausea when taken for the first time.

Prozac’s half-life is longer than Lexapro’s so that the risk of Prozac side effects is higher. This fact makes Lexapro a better option for seniors. Also Prozac provokes extreme thirst and increases the need for urination.

Both these medications are powerful and really help patients to fight their depression. But you never know which one is right for you. Please, talk to your doctor before buying your antidepressant at My Canadian Pharmacy at the best discount.

Generic Lexapro

Lexapro generic name is escitalopram oxalate. This is the first generic of Lexapro which was approved by FDA in 2012 what proves that the generic has the identical action as the original.

Generic Lexapro was designed to help people and adolescents overcome their mood disorders and mental conditions.

Due to being available at a very attractive price, generic Lexapro has become as popular as the brand medicine to cure posttraumatic stress syndrome, depression, obsessive-compulsive and panic disorders, hot flashes during menopause, repeated episodes of anxiety, bipolar depression, and change of life symptom.

The wonder about generic Lexapro is that it has less severe side effects, which involve sickness, sleep disorder, drowsiness, excessive thirst, increased sweating.  According to generic Lexapro reviews on My Canadian Pharmacy, escitalopram oxalate usually does not provoke any adverse effects.

Precautions to generic Lexapro are:

  • allergy to citalopram;
  • history of manic depressive disorder;
  • liver failure;
  • intestinal bleeding;
  • hyponatremia;
  • heart rhythm condition;
  • phenylketonuria;
  • diabetes;

Your doctor will prescribe the optimal dose of generic Lexapro and you will easily buy your medication with great discount and free shipping at My Canadian Pharmacy.

Lexapro FAQs

Does Lexapro cause weight gain?

Let us bust this myth: if you eat much or have a couch-potato lifestyle, you will gain weight regardless Lexapro. Lexapro interferes with metabolism and digestion, affecting appetite what leads to significant weight loss at the treatment onset. That is why Lexapro is never prescribed for anorexia sufferers.

In several weeks, depression improvements become evident, serotonin level normalizes, and mood gets stable. Once you recover your everyday life and habits, you obtain your regular weight.

Is Lexapro compatible with alcohol?

According to FDA, Lexapro clinical trials do not prove negative interactions of Lexapro and alcohol. There is the suggestion to be yet confirmed that alcohol increases the effect of Lexapro. Alcohol abuse treatment is among off-label Lexapro uses.

While it is still unclear how alcohol and Lexapro interact in brain, My Canadian Pharmacy recommends against this combination.

Does Lexapro have sexual side-effects?

Changes in sexual desire occur due to a psychiatric condition (depression, anxiety, and so on), but not due to Lexapro treatment. Premarketing clinical trials did not find any association with sexual drive in both men and women. But there are reports that Lexapro causes priapism – prolonged and sometimes painful erection.

Lexapro is to deliver you from stress, depression, and anxiety – the main factor provoking sexual frustration. Once you get rid of negative factors, sexual drive is back. This is the answer for why doctors sometimes prescribe SSRIs to treat psychological impotence.