Lexapro, one of the most popular brand names of the serotonin reuptake inhibitor Escitalopram, is one of the most popular drugs in the United States. In fact, in 2019, an estimated 27.5 million prescriptions were handed out to just over 6 million patients. SSRIs like Lexapro are increasingly becoming part of first-line treatment for depression – with many people receiving them at the same time as behavioral therapy and talking therapy interventions.
If you or a loved one has been prescribed Lexapro or another Escitalopram brand, you’re probably wondering what it is, how it works, and whether or not it’s going to help. Unfortunately, like any prescription drug, answers are complicated, but this article should help.
1. Lexapro is an SSRI
Lexapro is one of a number of popular Selective Serotonin Reuptake Inhibitors or SSRIs. This drug class is commonly used to treat mood-related disorders and is approved by the FDA for treating depression. It’s also commonly used for off-label (non-FDA-approved) usage to treat panic disorders and extreme anxiety.
SSRIs are thought to slow serotonin reuptake prevention, reducing nerve pressure by increasing serotonin concentration between synapses. The result is normally relaxation and reduced depression. However, for many patients results vary. SSRIs can relieve symptoms of depression or even make them go away completely. In others, symptoms won’t change. For that reason, you’ll have to continue reporting your mood and how you feel to your doctor – usually starting 2-6 weeks after you start taking the drug. Then, after a period of adjusting your dosage, you and your doctor can decide if Lexapro is working for you. 40-60% of persons taking SSRIs report improvement in their symptoms within 6-8 week, compared to 20-40% of people taking a placebo.
2. It Takes 1-2 Weeks to See Effects
Lexapro does not immediately start working when you take it. Instead, you’ll have a period where it does nothing, where you experience side-effects but no positive effects, and then where it gradually begins to work. Here, Lexapro reaches peak blood levels about 5 hours after a dose, but levels take 1-4 weeks to build up enough to stabilize, meaning you won’t see results for then.
For that reason, most doctors will ask you to continue taking Lexapro for at least 6 weeks even if you’re not seeing improvements.
For most people, you’ll see results within about 2 weeks. However, you’ll get the fuller experience of Lexapro after 4-6 weeks, as early symptoms taper off and the drug stabilizes in your body. In most cases, side effects are strongest while you’re getting onto the drug, and you may feel actually sick.
3. Lexapro Interacts Badly with Many Other Medications
Lexapro can interact badly with many other medications. If you’re given a prescription, your doctor will likely go over your existing prescriptions with you. However, it’s also important to go over the drug list they hand you, because it also includes over the counter medications.
For example, cimetidine, ibuprofen, aspirin, alcohol, and St. John’s Wort should not be taken. Why? They thin the blood and so does Lexapro.
You’ll also have a list of prescription medication you can’t take with the drug. For example, Lorazepam, Lithium, Thioridazine, phenazine, linezolid, and many others. Here, you should never take any other antidepressant with Lexapro. In addition, if you’ve taken a MAOI (monoamine oxidase inhibitor) class anti-depressant, you’ll want to wait at least 14 days after quitting it before starting Lexapro. Examples of these include isocarboxazid, phenelzine, and selegiline.
4. Lexapro Isn’t Addictive but Does Cause Withdrawal Symptoms
SSRIs like Lexapro have a very low addiction profile, they don’t cause seeking behavior and they don’t make you feel good. However, they will cause you to become physically dependent on the drug. This means that you will experience withdrawal symptoms when you quit the drug. In most cases, that will occur even if you’ve only been on the drug for a few weeks.
In addition, you’ll normally have a “crash” phase after quitting SSRIs. The period between when you have a drug blocking serotonin reuptake and when your brain adjusts and (hopefully) starts producing more serotonin to compensate can be a few weeks. In some cases, you might have to go back onto an antidepressant if it does not.
For this reason, you’ll almost always have to taper off of drugs like Lexapro. That will mean slowly cutting the drug down, reducing your daily dose by half about every week or even two weeks.
Finally, withdrawing from Lexapro is a lengthy process. Many people report experiencing headaches, insomnia, and nausea for weeks after quitting. And, rebound syndrome, sometimes called “second phase” withdrawal, where your old symptoms come back, can last for months. Most importantly, if rebound doesn’t’ go away, you’ll have to move back into treatment and likely try a different prescription.
5. You’ll Have to Watch for Serious Side-Effects
Lexapro is extremely safe and has a very low side effect profile compared to many other antidepressants. However, it can cause serious side-effects and you will want to monitor your health and mental health with your doctor. For example, persons under the age of 24 are at risk of developing suicidal ideation. Other age groups face the same risk but at a greatly reduced rate. However, if you start thinking about suicide while on Lexapro, you should immediately talk to your doctor.
In addition, Lexapro can make you drowsy. This might mean you can’t drive or operate heavy machinery while taking it. If that interferes with your work, you’ll want to talk to your doctor about changing your prescription. You’ll also want to pay attention to dizziness, heart palpitations, nausea, persistent headaches, confusion, falls, unexplained bruises or bleeding, and shortness of breath. All of these are symptoms of serious side effects, and you should seek out immediate medical attention.
6. Lexapro Doesn’t Replace Therapy
SSRIs like Lexapro aren’t a cure for depression. Instead, they’re mostly used as a relapse preventive. Here, you’ll normally receive a prescription for 1-2 years following treatment. In fact, taking Lexapro following treatment is considerably more effective than getting either just treatment or just Lexapro. Here, with treatment and an SSRI, about 23% of patients relapse within 1-2 years versus about 50% without the SSRI.
Lexapro is a very popular mental health drug that can and does save lives. If you or a loved one has been prescribed the drug, you can most likely use it safely and will most likely see good results from it. However, it’s important to follow prescription advice, to monitor your health and mental health, and to talk to your doctor if something isn’t right.
If you or you loved one need help with mental health treatment, drug rehab, or alcohol rehab Compassion Recovery Center is here to help. Contact us to ask about our mental health programs and how we can support your specific requirements as you move into treatment.
