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Escitalopram (Lexapro) is, research has shown, one of the most effective and well-tolerated antidepressants on the market. What do you need to know if you're prescribed this drug?

Antidepressants play an essential role in the treatment of moderate to severe depression. An incredibly wide range of options now graces the market, and escitalopram is far from an uncommon choice. What sets this antidepressant apart from the rest — and what do you need to know about it if your doctor has prescribed it to you?

What is escitalopram (Lexapro)?

Escitalopram, also available under the brand names Cipralex and Lexapro, among others (depending on where you live), is an antidepressant that belongs to the selective serotonin reuptake inhibitor (SSRI) family. This means that they affect your mood and state of mind by increasing levels of the neurotransmitter serotonin in the brain. SSRIs, in general, have a reputation for inducing fewer side effects than older-generation antidepressants. Patients are less likely to want to stop taking them, something that in turn translates to larger odds that your antidepressant will be able to do its work and relieve your depression. 

A large review of over 500 antidepressant trials that examined the efficacy and tolerability of 21 different antidepressants actually found that ​escitalopram came out best, together with four other antidepressants. That is, escitalopram was revealed to be both more effective and more tolerable than many other antidepressants — a pretty good combination, if you ask us!

Escitalopram: What dosage can you expect, and how should you take this antidepressant?

Lexapro comes in tablets of five, 10, and 20 mg, as well as a liquid oral solution. The recommended starting dosage is 10 mg for everyone, and this can be increased to up to 20 mg daily in adolescents and adults battling major depressive disorder if needed. For elderly patients, more than 10 mg daily is not recommended. Studies have not shown that doses higher than 20 mg a day lead to more symptom relief. 

Regardless of the dose you're on, you can be expected to take Lexapro (escitalopram) once a day, and you can take it with food or on its own with some water.

Keep in mind that it usually takes a week to a month before you notice any improvements in your depression symptoms, and some patients wait even longer. Not seeing a difference immediately doesn't mean that your escitalopram isn't working for you, so be patient and keep using it as prescribed.

Do not discontinue escitalopram without your doctor's guidance. When you are ready to stop taking your antidepressant, your doctor will work with you to gradually decrease your dose in order to prevent withdrawal symptoms.

What side effects are possible while taking Lexapro (escitalopram)?

A dry mouth, nausea, diarrhea, constipation, sneezing, and a runny nose are some of the possible physical side effects of Lexapro, along with excessive sweating. Some patients feel drowsy, dizzy, and have heartburn. It is further possible to feel fatigued, experience an increased appetite, and notice changes in libido. When you first start taking Lexapro, you may experience flu-like symptoms. 

While that all sounds pretty scary, we refer you back to the study above — while all medications have potential side effects, escitalopram is generally well-tolerated. If you do have side effects, it is likely they will subside over time. If they do not, or if they get worse, always let your doctor know!

Rare but more serious side effects that should lead you to seek immediate emergency medical attention are:

  • Hallucinations (auditory or visual)
  • Fever
  • Confusion
  • A rapid heart beat or irregular heat beat
  • Intense muscle stiffness
  • Symptoms of an allergic reaction — such as hives, swelling, and difficulty breathing

What else do you need to know before you start taking escitalopram?

Always inform your prescribing doctor about all the important stuff that could interfere with your medication or make it dangerous for you, like:

  • Known drug allergies
  • Other medical conditions you have
  • Medications you take, including over the counter ones
  • If you use alcohol rather a bit or take street drugs

Your doctor will take these factors into consideration when deciding which antidepressant is right for you. For example, you cannot take Lexapro while you are also on a monoamine oxidase inhibitor or the drug pimozide. 

Because escitalopram can make you drowsy, don't drive a car or operate heavy machinery when you first begin using this antidepressant. Wait until you know how escitalopram affects you. And once you're taking escitalopram, let any doctor know about it before they perform any kind of surgery on you — this includes dental surgery. 

Escitalopram and its brand name versions, like Lexapro, are prescribed to adolescents and young adults. Research has shown, however, that young people under 24 who begin taking antidepressants sometimes experience a sudden upswing in symptoms, including new or worsened suicidality. For this reason, young people newly taking Lexapro should be monitored carefully. Anyone, of any age, who notices worse depression symptoms after they start taking an antidepressant should seek prompt medical attention. 

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