Lexapro Nation
Lexapro®, a patented formulation of escitalopram oxalate, is a drug used to treat generalized anxiety disorder (GAD), social anxiety disorder (SAD), and various forms of depression and anxiety. It is the successor to Celexa® (citalporam hydrobromide), and was created by isolating the medicinal component of Celexa. Basically, what that means is that Forest Laboratories (the drug's manufacturer) sifted away all the other stuff that was in Celexa that caused a lot of unpleasant side effects and renamed it Lexapro.
Like its predecessor, Lexapro is a selective serotonin reuptake inhibitor (SSRI). It is typically taken in doses of 10mg to 20mg (and up to 30 or 40mg, depending on the patient's needs and how successful the doctor is at convincing one's medical insurance provider that that much is necessary), depending on the severity of the patient's symptoms and how well she or he responds to lower doses. As with most other SSRIs, most people take Lexapro at the start of their day, and like other SSRIs, the patient must maintain the drug regimen by taking one dose each day, typically at around the same time.
My experiences with Lexapro
I've been taking Lexapro for about six months as of this writing. First off I guess I should explain why I take it -- I take it because I have generalized anxiety disorder. Without supplanting the writeup on that subject, that means that I'm prone to random panic attacks of varying severity, depression, nervousness, and some difficulty communicating with other people in social settings.
I'd taken a number of SSRIs and tricyclic antidepressant drugs before (namely Zoloft®, Paxil® and Remeron®), but none of them really worked on me. Zoloft was good for combatting depression but didn't do much to help with the anxiety problems I was having. Paxil ended up plateauing on me after about six months. Remeron made me more irritable than Leona Helmsley on a bad day. Despite these setbacks, I was determined to find something that worked against all of my mental problems. After discovering that Zoloft wasn't really helping me, I was given a prescription for Lexapro and a number of sample packs of it by my psychiatrist, so I started taking 10mg of it each day instead of Zoloft, eventually progressing to 20mg after my body got used to the drug. Compared to other SSRIs I've taken, Lexapro has a relatively short lead-in time (i.e., the time your body takes to get accustomed to the new chemicals) which lasts only about a week. The only immediate side effect I experienced during the first week was sleepiness; it was ever so hard to stay awake and alert until I got used to it. After that, though, it's been smooth sailing.
It's been six months since then and I've generally felt pretty good. Definitely much better than I ever felt on any other prescription drugs I've been given to enhance my mood. However, Lexapro doesn't fully help with my anxiety problems, so I was also given a prescription for Ativan®, which I take once a day with the Lexapro. The two drugs combined have more or less solved my problems with generalized anxiety disorder.
Side effects
Though Lexapro is a refinement of a previous drug known for its multitude of side effects, it still has some of its own that should be known before one embarks on a daily dosage.
The list isn't too long, really, and most of the side effects are cake compared to a lot of other SSRIs. They include:
- mild nausea (I haven't experienced this one)
- insomnia (my lifelong insomnia was not exacerbated by Lexapro, but it didn't go away when I started taking it)
- anorgasmia in both sexes (I can't verify this one as I've been single for longer than I've been on Lexapro)
- ejaculatory delay (ditto)
- somnolence (verified, but only during the lead-in time)
- increased sweating (I haven't experienced this one)
- decreased libido (verified)
- memory gaps (verified, but only in combination with other psychiatric drugs, mostly benzodiazepines)
Some people have reportedly experienced weight gain and loss while on Lexapro as well. I can't verify that claim as I do not own a scale.
Some undocumented side effects also exist. As with all drugs that interact directly with a person's serotonin production, you can't experience the effects of psychotropic drugs like MDMA, 5-Meo-DIPT or 2C-T-7 while you're on Lexapro or have recently stopped taking it (this is an effect of all SSRIs). In fact it is probably quite dangerous to combine Lexapro (or any other SSRI) with such drugs due to the increased risk of giving yourself serotonin syndrome. Also, pharmacists usually recommend avoiding the consumption of alcohol while on Lexapro. I can verify that claim, as I get drunk a lot faster than normal (with far fewer drinks) while under Lexapro's influence, and it seems to be much easier to make myself sick by drinking too much than it would be otherwise. Incidentally, my psychiatrist told me that if you find yourself getting drunk with only a few drinks, it means that Lexapro is working; not very scientific, but hey, he's the one with the doctorate.
Other than combining it with monoamine oxidase inhibitors (MAOIs), which you can't really combine with any other drugs at all, Lexapro seems to be pretty safe as far as interactions with other prescription drugs go. I take mine with a benzodiazepine (Ativan) as well as a non-benzodiazepine hypnotic sleep inducer (Ambien®) every day and I've seen no ill effects caused by such a combination.
Etc.
Lexapro is generally considered a "Tier 3" drug by most health insurance companies, and thus it usually is quite expensive, even with insurance. A single prescription of 30 pills (one month's supply) will run you $15-$45 with insurance, depending on your state of residence (sorry, non-USians, I don't know about the prices in other countries), or $90-$120 without insurance. I looked, but was unable to find any info on when the drug will go off patent (that is, when the drug will become available as a generic).
Like almost all other anti-anxiety drugs, Lexapro is available only by prescription, although you may be able to order it by mail without one from various pharmacies in Canada and Mexico, if such places still exist and offer mail-order service.
Finally, though I'm not a doctor, I'd recommend taking Lexapro to anyone who didn't get along with Zoloft or Paxil. Beyond that, I can't really say because those are the only other SSRIs I have experience with. I'd say that it is the most effective anti-anxiety medication I've ever had.
Sources other than my own experiences:
Forest Laboratories -- http://www.frx.com/
Lexapro Side Effects, Interactions and Information — http://www.drugs.com/xq/cfm/pageid_0/usr_USR88621.htm/type_USR/bn_Lexapro/qx/index.htm