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Lexapro Fact Sheet

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Medication Name (brand): 
Lexapro
Medication Name (clinical): 
escitalopram
Manufacturer: 

Forest Labs, licensed from H. Lundbeck A/S; patent expires 2009.

Indications: 
  • Major depression
  • Generalized anxiety disorder
  • Denied FDA approval for social anxiety disorder and panic disorder
Mechanism: 

Serotonin Reuptake Inhibitor; S-isomer of Celexa

Dosing: 
  • Supplied in 5 mg, 10 mg and 20 mg off-white scored tablets, and as a peppermint flavored oral solution (5 mg/ml)

  • Begin at 5 mg QHS because initial sedation is common.
  • Target dose of 10-20 mg for most patients.
  • Dose of 10 mg QD was claimed to be as effective as Celexa 40 mg QD but clinical experience since its release has not been consistent with this. Many patients end up on 20 mg QD or higher.
  • No dosing adjustment required for elderly or moderate kidney or liver impairment.

Side Effects: 
  • Most common are nausea, fatigue, insomnia, and sexual dysfunctioN

  • Anecdotally, Lexapro has the fewest side effects of all the SSRIs.
  • Black Box Warning: In clinical trials, SSRIs and SNRIs increased the risk of suicidality in children (from 2% to 4%). No actual suicides occurred in these trials.
  • Pregnancy Risk Category C

Drug-drug Interactions: 
  • Rare: Lexapro has only mild inhibitory effect on P450 2D6

  • Other drugs unlikely to affect metabolism because Lexapro is metabolized in parallel by 3 different enzyme systems

Pearls: 

Lexapro may ease depressive and anxiety symptoms more quickly than Celexa (generally by week one)

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