Lexapro (Escitalopram) for Anxiety, Social Phobia, Depression

Lexapro for Anxiety Disorders

Escitalopram has anxiolytic properties and is beneficial for treating various anxiety disorders, including generalised anxiety disorder (GAD), social anxiety (social phobia), panic disorder 10, and obsessive-compulsive disorder (OCD).

Escitalopram lessens stress and anxiety level; takes off depressive thoughts and worry. It helps to better handle the life situations and to be more motivated to accomplish daily activities. Escitalopram significantly reduces fear of blushing in persons with social anxiety11.

Many psychiatrists consider that escitalopram is the best SSRI for GAD and social anxiety. It may help to cope with resistant social anxiety.

Among nine treatments for generalised anxiety disorder escitalopram was rated second in remission 3.

Long-term escitalopram therapy may prevent relapse in GAD4 for up to 18 months. In the study the risk of relapse was four times higher in the placebo group compared to the escitalopram group. That's a key answer on the question: "How long should you take this? What will happen if you stop antidepressant?" Well the answer is, your risk of relapse is four times higher.

Escitalopram vs Paroxetine in GAD

Escitalopram was found to be superior to paroxetine with respect to overall efficacy and tolerability5. What was interesting is that escitalopram 10 mg was more effective than paroxetine 20 mg.

Also, escitalopram offers a more cost-effective first-line treatment for GAD compared with paroxetine6.

Dosage for anxiety disorders: The recommended dose of escitalopram in generalised anxiety disorder and social anxiety is 10 mg daily, increasing to a maximum of 20 mg daily.

Lexapro for Depression

Escitalopram is suitable as a first-line treatment for moderate to severe major depressive disorder. It is often more effective than citalopram and other SSRIs in the treatment of depression, including severe depression1.

Escitalopram is the most selective of all the SSRIs, having little or negligible affinity for numerous other receptors. It binds to the serotonin transport molecule and boosts the concentration of serotonin in the synapse.

Dosage for depression: Initially, 10 mg once daily; dose may be increased as tolerated to a maximum of 20 mg once daily.

How long does Lexapro take to work?

Depression
Escitalopram works fairly rapidly and tends to work faster than other SSRIs2. You may expect improvement beginning in 1-2 weeks, although the full effect may take 4 to 6 weeks8.

Anxiety disorders
Most people start feeling improvement by week 2. Escitalopram can take up to 8 weeks to reach full anti-anxiety effect9.

Generally, when Lexapro is used for the treatment of depression, GAD, or social anxiety, a period of at least 4 weeks is worthwhile before considering whether to continue to take it or choosing other options7. Sometimes, up to 8 weeks are required to reach full effectiveness.

How long to stay on Lexapro?

The duration of treatment depends on the personal psychiatric history, but is usually at least 6 months. It will be longer for those who have had two or more previous episodes of depression. Once your depression is gone you may continue escitalopram for up to 6-12 months.

How to come off Lexapro?

The withdrawal results in fewer and less intense discontinuation symptoms than from either paroxetine or venlafaxine.

Don't discontinue escitalopram abruptly. Abrupt cessation may result in withdrawal symptoms such as confusion, lethargy, insomnia, tingling or shock like sensations. Onset of these symptoms usually occurs within a week of discontinuation and may last from a few days to several weeks.

Reducing dose by 10-25% every 2 weeks would be a sensible attempt to come off. More gradual steps allow more time for the brain to adapt to the decreasing levels of escitalopram. Keep in mind that Lexapro is available in liquid form which allows you to taper off at a very gradual pace.