OriginalDrugs

Lexapro (Escitalopram)

  • Generic name: Escitalopram oxalate
  • Brand names: Lexapro, Cipralex
  • Drug class: Selective serotonin reuptake inhibitor (SSRI), Antidepressant

What is Lexapro used for?

  • Depression
  • Social anxiety disorder (SAD)
  • Generalised anxiety disorder (GAD)
  • Panic disorder

Patent expiration and generic availability

Lexapro patent has expired in March 2012. On March, 2012 Teva Pharmaceuticals gained U.S. FDA approval to sell the first generic version of Lexapro in 5 mg, 10 mg, and 20 mg strengths. As meanwhile the generic Lexapro in not widely available in U.S.

Contraindications

  • Concomitant use with pimozide
  • Concomitant use or within 2 weeks of MAO inhibitors

Drug interactions

Can you take Lexapro and NSAIDs, e.g. ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn)?
Most people can safely take escitalopram (Lexapro) and NSAIDs at the same time. However, there is an increased risk of bleeding with the concurrent use of NSAIDs. Precautions are necessary in high-risk patients, such as those with acid-peptic disease and those with a history of bleeds1.

Can you take Lexapro and tramadol (Ultram)?
Taking escitalopram with tramadol increases the risk of serotonin syndrome, which is a rare but serious condition resulting from over-stimulation of serotonin receptors in the brain. Nevertheless, concurrent use of escitalopram and tramadol is not contraindicated and is possible under doctor's supervision to avoid the potentially lethal consequences.

Can you take Lexapro with birth control pills (e.g. Yaz, Yasmin)?
Escitalopram does not decrease the effectiveness of the birth control pills.

Can you take Lexapro with Bupropion (Wellbutrin)?
The combination of escitalopram and bupropion is commonly used for treating patients with depression who have an inadequate response. These antidepressants have disparate and possibly complementary mechanisms of action. The combination of escitalopram and bupropion SR is effective, well tolerated2, and may help reverse sexual side effects.

Can you take Lexapro with Benzos, e.g. lorazepam (Ativan), clonazepam (Klonopin), alprazolam (Xanax)?
There are no significant drug interactions between escitalopram and benzodiazepines such as lorazepam, clonazepam, alprazolam, diazepam. In fact, adding benzodiazepines to an SSRi antidepressant is commonly used in the treatment of anxiety disorders3.

Can you take Lexapro with lamotrigine (Lamictal)?
There is no drug interaction between escitalopram and lamotrigine4. However, there has been a report of myoclonus occurred in patients receiving escitalopram and lamotrigine concomitantly5.

Can you take Lexapro with Benadryl?
Lexapro Prescribing Information4 does not mention any interactions between escitalopram and Benadryl (diphenhydramine) as well as with any other allergy or cough/cold medicines. So escitalopram can be taken with Mucinex (guaifenesin), NyQuil, or Claritin (loratadin).

Information about Lexapro in the treatment of anxiety and depression.

References

  • 1. Andrade C, Sandarsh S, Chethan KB, Nagesh KS. Serotonin reuptake inhibitor antidepressants and abnormal bleeding: a review for clinicians and a reconsideration of mechanisms. J Clin Psychiatry. 2010 Dec;71(12):1565-75 PubMed
  • 2.Leuchter AF, Lesser IM, Trivedi MH, Rush AJ, Morris DW, Warden D, Fava M, Wisniewski SR, Luther JF, Perales M, Gaynes BN, Stewart JW. An open pilot study of the combination of escitalopram and bupropion-SR for outpatients with major depressive disorder. J Psychiatr Pract. 2008 Sep;14(5):271-80 PubMed
  • 3. Dunlop BW, Davis PG. Combination treatment with benzodiazepines and SSRIs for comorbid anxiety and depression. Prim Care Companion J Clin Psychiatry. 2008;10(3):222-8.
  • 4. Lexapro Prescribing Information PDF
  • 5. Rosenhagen MC, Schmidt U, Weber F, Steiger A. Combination therapy of lamotrigine and escitalopram may cause myoclonus. J Clin Psychopharmacol. 2006 Jun;26(3):346-7.
  • 6. Rampono J, Hackett LP, Kristensen JH et al. Transfer of escitalopram and its metabolite demethylescitalopram into breastmilk. Br J Clin Pharmacol. 2006;3:316-22. PubMed
  • 7. Bellantuono C, Bozzi F, Orsolini L, Catena-Dell'Osso M. The safety of escitalopram during pregnancy and breastfeeding: a comprehensive review. Hum Psychopharmacol. 2012 Nov. PubMed

Last updated: February, 2015

Advanced Consumer Info
Lexapro

forest
  • Pregnancy Category: C. May be considered safe during pregnancy7.
  • Breastfeeding:
    Limited data indicates that maternal doses of escitalopram up to 20 mg daily produce low levels in milk and unlikely to cause adverse effects in breastfed infants6.
  • Elimination half-life: 27-33 hours
  • Mechanism of action: Escitalopram selectively block the reuptake of serotonin in the presynaptic neurons without affecting other neurotransmitters significantly.
  • Reasons to choose Lexapro:
  • 1. Escitalopram oxalate is the best-tolerated SSRI with least side effects and fewest drug interactions.
  • 2. Escitalopram works fairly quickly and most people get improvement in 1-2 weeks.
  • 3. About 47% of patients who don't respond to Celexa benefit from Lexapro.