Escitalopram

Brand Name:

Lexapro

Drug Class:

Selective Serotonin Reuptake Inhibitor

How it works:

Boosts the effects of a neurotransmitter found in the brain called Serotonin.

What makes it unique:

This is the same compound as the “S” version of Citalopram but without the pesky “R” version that gets in the way of “S”.

Side effects:

Headaches and stomach aches are common when starting, but then often goes away. Sexual dysfunction can also occur. Agitation, insomnia or bruising can occur.

Rare side effects include hyponatremia, seizures, induction of mania, and activation of suicidal ideation in people age 24 and younger.

How effective is it:

(1) A study compared the sister medications of Escitalopram and Citalopram. 169 patients received Escitalopram, 171 received Citalopram and 166 received a placebo. A depression scale called the MADRS decreased by 17.3 in the Escitalopram group and 13.8 in the Citalopram group. The difference was seen as early as week one. It is important to compare different antidepressant medications against each other. With so many options available, comparative information is very valuable.

(2) There was a large meta-analysis of 2,687 patients. 1,345 patients were taking Escitalopram, 1,102 were taking other medications in the same class as Escitalopram, and 240 were taking an antidepressant called Venlafaxine. Escitalopram was superior to all comparators in overall treatment effect. This additional comparative data included a medication from a different class and continued to show the value of Escitalopram.

Clinical experience:

This is commonly the starting place for people being treated with an antidepressant. It is generally well-tolerated and works in a straight forward manner without some of the bells and whistles of other antidepressants. Pharmaceuticals should never be used as the sole treatment for mental illnesses. Therapy, exercise, meditation or other treatments should always accompany prescriptions.

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Sources:
1. Azorin JM, Llorca PM, Despiegel N, et al. [Escitalopram is more effective than citalopram for the treatment of severe major depressive disorder]. Encephale. 2004 Mar-Apr;30(2):158-66.

2. Kennedy SH, Andersen HF, Lam RW. Efficacy of escitalopram in the treatment of major depressive disorder compared with conventional selective serotonin reuptake inhibitors and venlafaxine XR: a meta-analysis. J Psychiatry Neurosci. 2006 Mar;31(2):122-31.

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