About Lexapro
Lexapro is an antidepressant medication used for treating depression
in adults. Lexapro belongs to a group of antidepressant drugs
called SSRIs (selective serotonin reuptake inhibitor), which
are thought to work by increasing the amount of serotonin
(a chemical involved in communication between nerve cells)
available to the brain, so that it comes back to a normal
level. Low levels of serotonin are believed to be associated
with mood disorders, and high levels of serotonin seem to
have an antidepressant effect.
Lexapro is only available by prescription, and it may take
up to 4 weeks to be fully effective. This medication works
best when taken at the same time every day.
Lexapro Side Effects
Lexapro side effects may go away as the body adjusts to treatment,
but let your doctor know if any of the following side effects
continue or are irritating.
Common to Less Common Lexapro Side Effects: Abdominal
cramps or gas, cold-like symptoms, chills, cough, diarrhea,
dry mouth, fatigue, insomnia, loss of sexual desire or function,
low blood pressure (may result in dizziness on standing up),
muscle aches, nausea or vomiting, sweating, tenderness oround
eyes or cheeks, tremor. These side effects typically appear
early in treatment, and usually diminish with continued use.
If any of them persist, or are bothersome, speak to your doctor.
Other Lexapro side effects occurred in less than 2% of patients
compared with incidence of side effects for placebo.
Take care to avoid operating a vehicle or other heavy machinery
until you know how you react to Lexapro. Lexapro side effects may include
impaired thinking and motor skills, or cause blurred vision.
Cautions: Lexapro should be used cautiously in patients
with: manic or bipolar disorders, blood circulation and metabolism
difficulties, or a history of seizures. Lexapro may not be
an appropriate medication for patients with brain damage or
disease, or congenital brain defects. Lexapro dosages should
be lower for patients with kidney or liver trouble. Tell your
doctor if you have ever had an allergic reaction to Lexapro,
to an antidepressant or anxiety medication of any type, or
any other medication.
Allergies: If you have an allergic reaction
to this medication, or to Celexa (citalopram), you should
not use it.
Lexapro Interactions
Lexapro and alcohol have not been shown to interfere with
each other, but taking them together is not recommended. It's
possible that the combination may be hard on the liver.
Certain medications and supplements may increase the risk of serotonin
syndrome in combination with Lexapro. Serotonin syndrome may cause
confusion, restlessness, lowered coordination, shivering or trembling,
diarrhea, fever, sweating, twitching, or behaving with an excitement
you can't control. If you experience a cluster of these symptoms,
and you suspect that it may be due to a drug interaction or overdose,
seek medical attention immediately. (This condition is very rare.)
Lexapro interactions with the following drugs may be limited by following your doctor's advice. Always tell your doctor if you are taking any of the following:
- Anticonvulsants such as Cerebyx
(fosphenytoin), Dilantin
(phenytoin), Sinemet (carbidopa, levodopa), or Tegretol
(carbamazepine) may require patient monitoring when
used with Lexapro.
- Appetite suppressants like Phentermine/Adipex
(fastin), Pondimin (fenfluramine), or Meridia
(sibutramine) may cause serious and dangerous side effects
in combination, do not combine these therapies.
- Azole antifungals such as Diflucan
(fluconazole), Nizoral
(ketoconazole), or Sporanox
(itraconazole), may alter your heartbeat if used with
Lexapro.
- Benzodiazepines (a class of antidepressants, anti-panic
agents, and muscle relaxants) such as Ativan
(lorazepam), Valium
(diazepam), Halcion
(triazolam), Restoril
(temazepam), Librium(chlordiazepoxide),
Xanax (alprazolam),
Tranxene-SD (clorazepate), Paxipam (halazepam), ProSom (estazolam),
Klonopin (clonazepam)
should be used cautiously with Lexapro.
- Beta Blockers - Drugs like Inderal
(propranolol), Lopressor
(metoprolol), Tenormin
(atenolol), and others may build up in the body to toxic
levels when combined with SSRIs. Your doctor may adjust
dosages to compensate.
- BuSpar (buspirone)
- Do not combine.
- Calan (verapamil) -
Increases blood levels of Lexapro and increases risk of
serotonin syndrome.
- Cardizem (diltiazem)
- Increases the risk of serotonin syndrome.
- Cough medicine (dextromethorphan) - Avoid combining.
- Desyrel (trazodone) - Risk
of Lexapro toxicity.
- Effexor (venlafaxine)
- When used with Lexapro, increases the chance of developing
the rare, but serious, side effect known as serotonin syndrome.
- Gingko - May act as an MAO inhibitor, do not combine.
- Ginseng - May act as an MAO inhibitor, do not combine.
- Indian Snakeroot - Do not combine.
- Kava kava - Acts centrally in the nervous system, do not
combine with Lexapro.
- Ma Huang - Do not combine.
- MAO inhibitors - Lexapro must never be mixed with MAO
(monoamine oxidase) inhibitors, a class of antidepressants
and antisenility drugs, such as Eldepryl (selegiline), Furoxone
(furazolidone), Nardil (phenelzine), Marplan (isocarboxazid),
or Parnate (tranylcypromine). Never use Lexapro within
5-6 weeks of starting or stopping an MAO inhibitor.
This drug interaction could cause severe heart problems
or death. Patients over 65 should allow a longer wait period
between using Lexapro and an MAO, as these medications may
stay in their system longer than in other patients.
- Migraine medications of the triptan class such as Amerge
(naratriptan), Imitrex
(sumatriptan), Maxalt
(rizatriptan), or Zomig (zolmitriptan) can cause coordination
difficulties when mixed with SSRIs.
- Narcotic pain medication like Codeine, Demerol
(meperidine), Buprenex (buprenorphine), Darvon (propoxyphene),
Dilaudid (hydromorphone), MS Contin or Kadian (morphine),
nalbuphine, OxyContin
(oxycodone), Percocet
(oxycodone and acetaminophen), Stadol (butorphanol),
Talwin compound (pentazocine), Vicodin
(hydrocodone and acetaminophen), or Vicoprofen
(hydrocodone and ibuprofen) should be used cautiously
with Lexapro, as these medications also act on the central
nervous system.
- Quinaglute (quinidine)
- Sedatives like Fioricet
(butalbital, acetaminophen, and caffeine), Fiorinal,
Phenobarbitol, Seconal, or other barbiturates.
- Selective serotonin reuptake inhibitors (SSRIs) of any
other type, like Paxil
(paroxetine), Prozac
(fluoxetine), Luvox
(fluvoxamine), or Zoloft
(sertraline) should not be mixed together.
- Sleep medication like Ambien
(zolpidem), Sonata
(zaleplon), or over the counter sleeping pills should
be used with Lexapro only as, and if, advised by your doctor.
- St. John's Wort - May raise serotonin levels too high,
do not combine.
- Street drugs such as LSD, Ecstasy (MDMA), or marijuana.
These drugs also affect serotonin levels in the brain and
may react strongly with an SSRI like Lexapro. These interactions
have not been studied in clinical tests and the side effects
may prove very dangerous.
- Tricyclic antidepressants such as Elavil
(amitriptyline), Asendin (amoxapine), Anafranil (clomipramine),
Pertofrane or Norpramin (desipramine), Sinequan
(doxepin), Tofranil (imipramine), Aventyl or Pamelor
(nortriptyline),
Vivactil (protriptyline),
and Surmontil (trimipramine), may increase the risk of side
effects from Lexapro. The use of Lexapro with Elavil, Anafranil,
or Tofranil can increase the chance of developing serotonin
syndrome.
- Tryptophan or 5-HTP (Contained in certain amino acid supplements
or by itself) - This supplement may increase the risk of
serotonin syndrome when mixed with Lexapro.
- Ultram (Tramadol) -
May increase the risk of seizure, avoid this combination.
- Viagra (sildenafil)
- Wellbutrin/Zyban
(bupropion)
Talk with your doctor if you are considering mixing an antidepressant
and anxiety medication like Lexapro with any other antidepressant,
or any medication that may cause drowsiness. Anxiety medication
can have increased, unexpected, or severe side effects when mixed
with other medications that affect the central nervous system.
Lexapro Dosages
Lexapro dosages usually begin at 10 mg/day. The dosage may be stepped
up to 20 mg/day according to your doctor's advice. If you
are planning to stop taking Lexapro, ask your doctor about
reducing your dose gradually. It is not usually recommended
for patients to stop Lexapro all at once.
People with kidney or liver trouble, the elderly, or those
with weak constitutions should take no more than 10 mg/day.
Lexapro dosage should not generally exceed 20 mg/day.
Lexapro overdose may cause coma, irritability, dizziness,
drowsiness, racing heartbeat, facial flushing, nausea, sweating,
tremor, or vomiting, and should be treated by a healthcare
professional immediately.
Be sure to follow your doctor's dosage guidelines and instructions
directly, including whether your medication should be taken
in the morning or evening.
Lexapro Directions
Lexapro is normally taken once a day, and can be taken with or
without food, according to your doctor's instructions. If
you miss a dose, do not take a double dose the following day.
Depending on what time of day your doctor has directed that
you take your treatment, they may suggest a window of time
where you could take the missed dose if you remember it.
Lexapro should be stopped slowly, by gradually decreasing dosage
as directed by your doctor. Suddenly stopping Lexapro treatment can
cause increased side effects.
Lexapro should be stored away from heat and light. The oral solution
should not be allowed to freeze.
Lexapro and Pregnancy
Lexapro has not adequately been studied in humans for safety during
pregnancy. Lexapro has been studied in animals, and shown
to increase the death rate in unborn animals at doses higher
than typically prescribed. Incidences of retarded growth were
also reported. Animal studies are not always predictive of
results in humans, but this medication is not generally recommended
for pregnant women.
Advise your doctor if you are pregnant, or are planning a pregnancy
if you are considering taking Lexapro. The manufacturer recommends
that Lexapro be taken during pregnancy only if the benefit justifies
the possible risk to the fetus.
Similar precautions apply for breastfeeding, where some amount
of Lexapro may pass to the child. Discuss the risks and benefits of
treatment with your doctor.
Lexapro and Children
Lexapro has not been studied for use in children.
Lexapro and Seniors
Lexapro has not been shown to have different side effects in the
elderly than in the general population, but it appears to
stay in the system longer. Patients 65 years or older are
generally treated with a 10 mg/day dosage.
Lexapro is a trademark of Forest
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This document is provided for information only. It is not a substitute for consultation with a physician, either to diagnose symptoms or prescribe treatment. Any dosages mentioned are general guidelines only, please follow the directions of your doctor or pharmacist exactly when taking medication. We have made every effort to ensure that this information is accurate, but only your doctor can say if a medication, or drug combination, is safe for you. Information intended for US residents only.
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