Lexapro Side Effects
Lexapro Canada
Lexapro
Information
Lexapro Resources |
|
Primary Disease Name: Depression
Primary Drug Name: Lexapro
Chemical Drug Name: escitalopram oxalate
What is Lexapro?
Lexapro is an antidepressant that is the newest member of the
family of medications known as selective serotonin reuptake
inhibitors (SSRIs). LEXAPRO was developed by isolating a part of the
CELEXATM (citalopram HBr) molecule, known as an isomer. As a result,
LEXAPRO is able to provide effective and well-tolerated therapy for
depressed patients.
For many patients, relief from symptoms such as depressed mood or
anxiety symptoms associated with depression may begin after taking
LEXAPRO for 1 or 2 weeks, but most people can expect to feel the
full benefits of LEXAPRO in 4 to 6 weeks.
For the greatest
benefit, LEXAPRO should always be taken exactly as prescribed by a
healthcare professional or doctor. It is important to continue
taking LEXAPRO even after relief from depression begins. People
don't suddenly become depressed, and full recovery takes time.
Healthcare professionals or doctors may recommend continued LEXAPRO
treatment even if symptoms are improving or resolved, to help keep
the depression from coming back.
top of
page
Lexapro Side Effects
LEXAPRO is well tolerated by most people. The most frequent
lexapro side effects reported with LEXAPRO are nausea, insomnia,
problems with ejaculation, drowsiness, increased sweating, and
fatigue. Most of the Lexapro side effects experienced by patients
taking LEXAPRO are mild and transient, and they usually do not cause
patients to stop taking LEXAPRO.
People taking LEXAPRO
generally do not suffer from agitation, nervousness, or anxiety any
morthan people not taking LEXAPRO. Furthermore, patients who were
treated with LEXAPRO experienced no clinically important weight
changes as a result of therapy. Patients should be sure to talk with
their healthcare professional or doctor promptly if they have any
side effects when taking LEXAPROT (escitalopram oxalate). A simple
adjustment in dose may be all that is required.
Other
Lexapro Side Effects
The following Lexapro side effects
have been established in clinical trials:
Autonomic Nervous System Disorders
dry mouth
increased sweating
Central & Peripheral
Nervous System
Disorders
diziness
Gastrointestinal
Disorders
nausea
diarrhea
constipation
indigestion
abdominal pain
general
influenza-like
symptoms
fatigue
psychiatric disorders
insomnia
somnolence
appetite decreased
libido
decreased
Respiratory System
Disorders
rhinitis
sinusitis
Urogenital
ejaculation
Disorder
impotence
anorgasmia
Lexapro Side
Effects Associated with Discontinuation of Treatment:
Among the 715 depressed patients who received Lexapro in
placebo-controlled trials, 6% discontinued treatment due to an
adverse event, as compared to 2% of 592 patients receiving placebo.
In two fixed dose studies, the rate of discontinuation for adverse
events in patients receiving 10 mg/day Lexapro was not significantly
different from the rate of discontinuation for adverse events in
patients receiving placebo. The rate of discontinuation for adverse
events in patients assigned to a fixed dose of 20 mg/day Lexapro was
10% which was significantly different from the rate of
discontinuation for adverse events in patients receiving 10 mg/day
Lexapro (4%) and placebo (3%). Adverse events that were associated
with the discontinuation of at least 1% of patients treated with
Lexapro, and for which the rate was at least twice the placebo rate,
were nausea (2%) and ejaculation disorder (2% of male patients).
top of
page
Lexapro Mechanism of Action
Lexapro is an antidepressant from the family of drugs known as
selective serotonin reuptake inhibitors or SSRIs. Lexapro helps to
restore the brain's chemical balance by increasing the supply of a
substance in the brain called serotonin. Lexapro appears to relieve
depression by increasing serotonin without affecting many of the
other chemicals in the brain that influence mood. Physicians are
advised to discuss the following issues with patients for whom they
prescribe LEXAPRO.
In a study in normal volunteers, LEXAPRO
10 mg/day did not impair psychomotor performance. The effect of
LEXAPRO on psychomotor coordination, judgment, or thinking has not
been systematically examined in controlled studies. Because
psychoactive drugs may impair judgment, thinking or motor skills,
patients should be cautioned about operating hazardous machinery,
including automobiles, until they are reasonably certain that
LEXAPRO therapy does not affect their ability to engage in such
activities.
Patients should be told that, although LEXAPRO has
not been shown in experiments with normal subjects to increase the
mental and motor skill impairments caused by alcohol, the
concomitant use of LEXAPRO and alcohol in depressed patients is not
advised.
Patients should be made aware that escitalopram is
the active isomer of Celexa (citalopram hydrobromide) and that the
two medications should not be taken concomitantly.
Patients
should be advised to inform their physician if they are taking, or
plan to take, any prescription or over-the-counter drugs, as there
is a potential for interactions.
top of
page
Lexapro Clinical Pharmacology
The mechanism of antidepressant action of escitalopram, the
S-enantiomer of racemic citalopram, is presumed to be linked to
potentiation of serotonergic activity in the central nervous system
resulting from its inhibition of CNS neuronal reuptake of serotonin
(5-HT). In vitro and in vivo studies in animals suggest that
escitalopram is a highly selective serotonin reuptake inhibitor
(SSRI) with minimal effects on norepinephrine and dopamine neuronal
reuptake. Escitalopram is at least 100 fold more potent than the
R-enantiomer with respect to inhibition of 5-HT reuptake and
inhibition of 5-HT neuronal firing rate. Tolerance to a model of
antidepressant effect in rats was not induced by long-term (up to 5
weeks) treatment with escitalopram. Escitalopram has no or very low
affinity for serotonergic (5-HT1-7) or other receptors including
alpha- and beta-adrenergic, dopamine (D1-5), histamine (H1-3),
muscarinic (M1-5), and benzodiazepine receptors. Escitalopram also
does not bind to or has low affinity for various ion channels
including Na+, K+, Cl- and Ca++ channels. Antagonism of muscarinic,
histaminergic and adrenergic receptors has been hypothesized to be
associated with various anticholinergic, sedative and cardiovascular
side effects of other psychotropic drugs.
top of
page
How to Take Lexapro
LEXAPRO is easy to take. It should be taken once a day with a
full glass (8 ounces) of water, at any time of day, with or without
food. For best results, LEXAPRO should be taken every day-and
prescriptions should be filled ahead oftime to avoid missing a dose.
LEXAPRO can be taken with most other medications. An
exception is another family of antidepressants called monoamine
oxidase inhibitors (MAOIs),* such as Nardil® (phenelzine sulfate
tablets, USP)? and Parnate® (tranylcypromine sulfate).? LEXAPRO and
MAOIs should not be taken together or within 14 days of each other.
Before taking LEXAPRO, it is important for patients to tell their
healthcare professional or doctor if they are taking any other
medications, including over-the-counter medications, herbal
remedies, diet supplements, etc.
top of
page
Lexapro Dose / Supply
LEXAPRO is available in two doses. LEXAPRO comes as a 10mg
tablet, and 20mg tablet
top of
page
Types of Depression
Depressive disorders come in different forms. There are several
different diagnoses for depression, mostly determined by the
intensity of the symptoms, the duration of the symptoms, and the
specific cause of the symptoms, if that is known.
Psychology
Information Online provides information on the following depressive
disorders. Follow the title link for more information about each
type of depression:
1. Major Depression -
This is the most serious type of depression, in terms of number of
symptoms and severity of symptoms, but there are significant
individual differences in the symptoms and severity. You do not need
to feel suicidal to have a major depression, and you do not need to
have a history of hospitalizations either, although both of these
factors are present in some people with major depression. There is
no official diagnosis of "moderate depression."
2.
Dysthymic Disorder - This refers to a low to moderate level
of depression that persists for at least two years, and often
longer. While the symptoms are not as severe as a major depression,
they are more enduring and resistant to treatment. Some people with
dysthymia develop a major depression at some time during the course
of their depression.
3. Unspecified
Depression - This category is used to help researchers who
are studying other specific types of depression, and do not want
their data confounded with marginal diagnoses. It includes people
with a serious depression, but not quite severe enough to have a
diagnosis of a major depression. It also includes people with
chronic, moderate depression, which has not been present long enough
for a diagnosis of a Dysthymic disorder. (You get the idea!)
4. Adjustment Disorder, with Depression -
This category describes depression that occurs in response to a
major life stressor or crisis.
5. Bipolar
Depression - This type includes both high and low mood
swings, as well as a variety of other significant symptoms not
present in other depressions.
top of
page
Lexapro Dosage and Administration
Major Depressive Disorder Initial Treatment
The recommended dose of LEXAPRO is 10 mg once daily. A
fixed dose trial of LEXAPRO demonstrated the effectiveness of both
10 mg and 20 mg of LEXAPRO, but failed to demonstrate a greater
benefit of 20 mg over 10 mg (see Clinical Efficacy Trials under
Clinical Pharmacology). If the dose is increased to 20 mg, this
should occur after a minimum of one week.
LEXAPRO should be
administered once daily, in the morning or evening, with or without
food.
Special Populations
10 mg/day is
the recommended dose for most elderly patients and patients with
hepatic impairment.
No dosage adjustment is necessary for
patients with mild or moderate renal impairment. LEXAPRO should be
used with caution in patients with severe renal impairment.
Treatment of Pregnant Women During the Third
Trimester
Neonates exposed to LEXAPRO and other SSRIs
or SNRIs, late in the third trimester have developed complications
requiring prolonged hospitalization, respiratory support, and tube
feeding (see PRECAUTIONS). When treating pregnant women with LEXAPRO
during the third trimester, the physician should carefully consider
the potential risks and benefits of treatment. The physician may
consider tapering LEXAPRO in the third trimester.
Maintenance Treatment
It is generally
agreed that acute episodes of major depressive disorder require
several months or longer of sustained pharmacological therapy beyond
response to the acute episode. Systematic evaluation of continuing
LEXAPRO 10 or 20 mg/day for periods of up to 36 weeks in patients
with major depressive disorder who responded while taking LEXAPRO
during an 8-week, acute- treatment phase demonstrated a benefit of
such maintenance treatment (see Clinical Efficacy Trials, under
Clinical Pharmacology). Nevertheless, patients should be
periodically reassessed to determine the need for maintenance
treatment.
Generalized Anxiety Disorder
Initial
Treatment
The recommended starting dose of LEXAPRO is 10
mg once daily. If the dose is increased to 20 mg, this should occur
after a minimum of one week.
LEXAPRO should be administered once
daily, in the morning or evening, with or without food.
Maintenance Treatment
Generalized
anxiety disorder is recognized as a chronic condition. The efficacy
of LEXAPRO in the treatment of GAD beyond 8 weeks has not been
systematically studied. The physician who elects to use LEXAPRO for
extended periods should periodically reevaluate the long term
usefulness of the drug for the individual patient.
Discontinuation of Treatment with LEXAPRO
Symptoms associated with discontinuation of LEXAPRO and other
SSRIs and SNRIs, have been reported (see PRECAUTIONS). Patients
should be monitored for these symptoms when discontinuing treatment.
A gradual reduction in the dose rather than abrupt cessation is
recommended whenever possible. If intolerable symptoms occur
following a decrease in the dose or upon discontinuation of
treatment, then resuming the previously prescribed dose may be
considered. Subsequently, the physician may continue decreasing the
dose but at a more gradual rate.
Switching Patients
To or From a Monoamine Oxidase Inhibitor
At least 14
days should elapse between discontinuation of a MAOI and initiation
of LEXAPRO therapy. Similarly, at least 14 days should be allowed
after stopping LEXAPRO before starting a MAOI (see Contraindications
and Warnings).
top of
page
Lexapro Storage
Keep this medication in the container it came in, tightly closed,
and out of reach of children. Store it at room temperature and away
from excess heat and moisture (not in the bathroom). Throw away any
medication that is outdated or no longer needed. Talk to your
pharmacist about the proper disposal of your medication.
top of
page
Lexapro Warnings
Potential for Interaction with Monoamine Oxidase
Inhibitors
In patients receiving serotonin reuptake inhibitor drugs in
combination with a monoamine oxidase inhibitor (MAOI), there have
been reports of serious, sometimes fatal, reactions including
hyperthermia, rigidity, myoclonus, autonomic instability with
possible rapid fluctuations of vital signs, and mental status
changes that include extreme agitation progressing to delirium and
coma. These reactions have also been reported in patients who have
recently discontinued SSRI treatment and have been started on a
MAOI. Some cases presented with features resembling neuroleptic
malignant syndrome.
Furthermore, limited animal data on the
effects of combined use of SSRIs and MAOIs suggest that these drugs
may act synergistically to elevate blood pressure and evoke
behavioral excitation. Therefore, it is recommended that LEXAPRO
should not be used in combination with a MAOI, or within 14 days of
discontinuing treatment with a MAOI. Similarly, at least 14 days
should be allowed after stopping LEXAPRO before starting a
MAOI.
Serotonin syndrome has been reported in two patients
who were concomitantly receiving linezolid an antibiotic which is a
reversible non-selective MAOI.
top of
page
Lexapro Precautions
General
Discontinuation of
Treatment with LEXAPRO
During marketing of Lexapro and
other SSRIs and SNRIs (Serotonin and Norepinephrine Reuptake
Inhibitors), there have been spontaneous reports of adverse events
occurring upon discontinuation of these drugs, particularly when
abrupt, including the following: dysphoric mood, irritability,
agitation, dizziness, sensory disturbances (e.g. paresthesias such
as electric shock sensations), anxiety, confusion, headache,
lethargy, emotional lability, insomnia, and hypomania. While these
events are generally self-limiting, there have been reports of
serious discontinuation symptoms.
Patients should be
monitored for these symptoms when discontinuing treatment with
LEXAPRO. A gradual reduction in the dose rather than abrupt
cessation is recommended whenever possible. If intolerable symptoms
occur following a decrease in the dose or upon discontinuation of
treatment, then resuming the previously prescribed dose may be
considered. Subsequently, the physician may continue decreasing the
dose but at a more gradual rate
Abnormal Bleeding
Published case reports have documented the occurrence
of bleeding episodes in patients treated with psychotropic drugs
that interfere with serotonin reuptake. Subsequent epidemiological
studies, both of the case-control and cohort design, have
demonstrated an association between use of psychotropic drugs that
interfere with serotonin reuptake and the occurrence of upper
gastrointestinal bleeding. In two studies, concurrent use of a
nonsteroidal anti-inflammatory drug (NSAID) or aspirin potentiated
the risk of bleeding. Although these studies focused on upper
gastrointestinal bleeding, there is reason to believe that bleeding
at other sites may be similarly potentiated. Patients should be
cautioned regarding the risk of bleeding associated with the
concomitant use of LEXAPRO with NSAIDS, aspirin, or other drugs that
affect coagulation.
Hyponatremia
One
case of hyponatremia has been reported in association with LEXAPRO
treatment. Several cases of hyponatremia or SIADH (syndrome of
inappropriate antidiuretic hormone secretion) have been reported in
association with racemic citalopram. All patients with these events
have recovered with discontinuation of escitalopram or citalopram
and/or medical intervention. Hyponatremia and SIADH have also been
reported in association with other marketed drugs effective in the
treatment of major depressive disorder.
Activation
of Mania/Hypomania
In placebo-controlled trials of
LEXAPRO in major depressive disorder, activation of mania/hypomania
was reported in one (0.1%) of 715 patients treated with LEXAPRO and
in none of the 592 patients treated with placebo. One additional
case of hypomania has been reported in association with LEXAPRO
treatment. Activation of mania/hypomania has also been reported in a
small proportion of patients with major affective disorders treated
with racemic citalopram and other marketed drugs effective in the
treatment of major depressive disorder. As with all drugs effective
in the treatment of major depressive disorder, LEXAPRO should be
used cautiously in patients with a history of mania.
Seizures
Although anticonvulsant
effects of racemic citalopram have been observed in animal studies,
LEXAPRO has not been systematically evaluated in patients with a
seizure disorder. These patients were excluded from clinical studies
during the product's premarketing testing. In clinical trials of
LEXAPRO, cases of convulsion have been reported in association with
LEXAPRO treatment. Like other drugs effective in the treatment of
major depressive disorder, LEXAPRO should be introduced with care in
patients with a history of seizure disorder.
Suicide
The possibility of a suicide attempt is inherent in
major depressive disorder and may persist until significant
remission occurs. Close supervision of high risk patients should
accompany initial drug therapy. As with all drugs effective in the
treatment of major depressive disorder, prescriptions for LEXAPRO
should be written for the smallest quantity of tablets consistent
with good patient management, in order to reduce the risk of
overdose.
Interference with Cognitive and Motor
Performance
In a study in normal volunteers, LEXAPRO 10
mg/day did not produce impairment of intellectual function or
psychomotor performance. Because any psychoactive drug may impair
judgment, thinking, or motor skills, however, patients should be
cautioned about operating hazardous machinery, including
automobiles, until they are reasonably certain that LEXAPRO therapy
does not affect their ability to engage in such activities.
top of
page
Lexapro Information for Patients
Physicians are advised to discuss the following issues with
patients for whom they prescribe LEXAPRO.
In a study in
normal volunteers, LEXAPRO 10 mg/day did not impair psychomotor
performance. The effect of LEXAPRO on psychomotor coordination,
judgment, or thinking has not been systematically examined in
controlled studies. Because psychoactive drugs may impair judgment,
thinking or motor skills, patients should be cautioned about
operating hazardous machinery, including automobiles, until they are
reasonably certain that LEXAPRO therapy does not affect their
ability to engage in such activities.
Patients should be
told that, although LEXAPRO has not been shown in experiments with
normal subjects to increase the mental and motor skill impairments
caused by alcohol, the concomitant use of LEXAPRO and alcohol in
depressed patients is not advised.
Patients should be made
aware that escitalopram is the active isomer of Celexa (citalopram
hydrobromide) and that the two medications should not be taken
concomitantly.
Patients should be advised to inform their
physician if they are taking, or plan to take, any prescription or
over-the-counter drugs, as there is a potential for interactions.
Patients should be cautioned about the concomitant use of
LEXAPRO and NSAIDs, aspirin, or other drugs that affect coagulation
since the combined use of psychotropic drugs that interfere with
serotonin reuptake and these agents has been associated with an
increased risk of bleeding.
Patients should be advised to notify
their physician if they become pregnant or intend to become pregnant
during therapy.
Patients should be advised to notify their
physician if they are breast feeding an infant.
While
patients may notice improvement with LEXAPRO therapy in 1 to 4
weeks, they should be advised to continue therapy as directed.
top of
page
Antidepressant Medication and Information - Lexapro
Side Effects - Paxil Side Effects - Paxil CR Side Effects -
Zoloft Side Effects -
Arthritis Medication
and Information - Arcoxia
Side Effects- Celebrex
Side Effects - Mobic Side
Effects - Vioxx Side
Effects - Asthma
Medication and Information - Advair Side
Effects - Cholesterol Medication and Information - Advicor
Side Effects - Crestor Side
Effects - Inegy Side Effects - Lescol
Side Effects - Lipitor Side
Effects - Pravachol
Side Effects - Vytorin
Side Effects - Zetia Side
Effects - Zocor Side
Effects - Epilepsy
Medication and Information - Neurontin Side Effects - Osteoporosis Medication and Information - Actonel
Side Effects - Fosamax
Side Effects
Link to Us
*Legal Disclaimer - All of the information
provided in and through this Web site is intended solely for general
information and should NOT be relied upon for any particular
diagnosis, treatment, or care. This website strongly encourages
patients and their families to consult with qualified medical
professionals for treatment advice on individual
cases. |
