Escitalopram is a popular and versatile prescription medication that is used to treat depression and anxiety. Though it is considered relatively safe, there are some negative side-effects to be aware of. Read on to find out how it works and what you should know about its potential drawbacks if you\u2019re on it.<\/p>\n
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Disclaimer:<\/em><\/strong> This post is not a recommendation or endorsement for escitalopram. This medication is only approved for the treatment of certain specific medical disorders, and can only be taken by prescription and with oversight from a licensed medical professional. We have written this post for informational purposes only, and our goal is solely to inform people about the science behind escitalopram\u2019s effects, mechanisms, and current medical uses.<\/em><\/p>\n Escitalopram is an antidepressant that belongs to the selective <\/em>serotonin<\/em><\/a> reuptake inhibitor<\/em> (SSRI) class of drugs.<\/p>\n It gained FDA approval in 2002 to treat depression<\/a> (in adults and adolescents) and general anxiety<\/a> disorder (in adults). It can also be used \u201coff-label\u201d for other disorders, such as PTSD, OCD, panic disorder, and premenstrual syndrome (PMS<\/a>), to name just a few [R<\/a>, R<\/a>, R<\/a>, R<\/a>, R<\/a>].<\/p>\n For a more in-depth look at the current medical uses of escitalopram, as well as the potential future uses currently being researched, check out this post<\/a>.<\/p>\n Escitalopram is commonly marketed under the brand names Lexapro, Cipralex, Seroplex, Sipralexa, and Morcet.<\/p>\n Escitalopram is often compared to citalopram<\/em>, a closely-related SSRI which is actually the \u201cparent\u201d drug of escitalopram.<\/p>\n Citalopram is a mixture (racemic<\/em>) containing 2 versions of the active drug, while escitalopram only has one. These 2 versions are mirror images of the same drug (\u201cenantiomers<\/em>\u201d), just like how your right hand is the mirror image of your left hand.<\/p>\n It is believed that escitalopram\u2019s version of the active molecule is better-suited for treating mental disorders – similar to how your right hand only fits properly in a right-handed glove and not in a left-handed glove [R<\/a>].<\/p>\n In general, most reviews comparing the two have concluded that escitalopram tends to be more effective at treating depression than citalopram [R<\/a>, R<\/a>, R<\/a>, R<\/a>, R<\/a>].<\/p>\n Neurons \u201ctalk\u201d to each other by sending chemical messengers (neurotransmitters<\/em>) to one another. One of the most important and well-known neurotransmitters is serotonin<\/strong><\/a>,<\/strong> which is believed to play a significant role in mood. Lower levels of serotonin are associated with worsened mood and increased hostility\/aggression [R<\/a>].<\/p>\n Escitalopram, similar to other SSRI medications, essentially increases the amount of serotonin in the brain. It does this by blocking the transporters<\/em> that take up serotonin back into neurons, making it so that serotonin has longer and stronger effects on general brain activity [R<\/a>].<\/p>\n However, escitalopram is different from other selective serotonin reuptake inhibitors because it binds to serotonin transporters at several different places (\u201corthosteric<\/em>\u201d and \u201callosteric<\/em>\u201d sites), instead of just one. This property might be one of the reasons why escitalopram is often reported to be more effective than other antidepressant drugs (although more research will be needed to know for sure) [R<\/a>, R<\/a>].<\/p>\n According to some early evidence from cell, rat, and human studies, escitalopram may also treat depression in part by promoting brain cell growth<\/a> (in the hippocampus) [R<\/a>, R<\/a>, R<\/a>]. However, this mechanism is still mostly speculative, and a lot more research will be needed to see how significant this effect might be, or how relevant it is to escitalopram\u2019s effects as an antidepressant.<\/p>\n Taking escitalopram at the recommended dosage – and in full accordance with a doctor\u2019s directions – is generally considered safe. Some studies have even reported that, compared to other SSRI medications, escitalopram may cause relatively lower rates of side effects [R<\/a>, R<\/a>].<\/p>\n Nonetheless, like any drug, escitalopram has a number of potential adverse side-effects that are important to be aware of.<\/p>\n Keep in mind that if you have a condition that might require you to be treated with escitalopram, the best way to minimize your risk of adverse side-effects is to make sure your doctor is fully informed about your medical history, any other drugs you are currently taking, and other relevant factors.<\/strong><\/p>\n Three different studies have reported the development of serotonin syndrome<\/a>, a condition that occurs when there is too much serotonin in the brain. In 2 of these cases, drug interactions may have been at play [R<\/a>, R<\/a>, R<\/a>].<\/p>\n There are also 2 separate instances where hair loss (alopecia<\/em>) was reported [R<\/a>, R<\/a>].<\/p>\n A double-blind randomized controlled trial in 43 healthy male volunteers reported that escitalopram actually increased<\/em> fears of public speaking – the opposite of the effects that some studies have reported in anxiety disorder patients [R<\/a>].<\/p>\n According to one case study, a 56-year old depressed male experienced mania while taking escitalopram [R<\/a>].<\/p>\n There has also been a report of a 45-year old woman experiencing hypnic jerks<\/em> (sudden and uncontrollable muscle twitches or spasms that occur while falling asleep) on escitalopram [R<\/a>].<\/p>\n Restless leg syndrome<\/em> (RLS) was reportedly induced in one 34-year-old woman who had no prior history of the condition [R<\/a>].<\/p>\n There have also been 2 individual case reports of restlessness (akathisia<\/em>) while taking escitalopram [R<\/a>, R<\/a>].<\/p>\n There have been 2 instances reported where escitalopram use was associated with grinding teeth (bruxism<\/em>) during sleep [R<\/a>].<\/p>\n Fatigue and sleepiness were the most commonly reported side effects for older adults with generalized anxiety disorder, according to one study [R<\/a>].<\/p>\n One study reported that over 10% of PTSD patients experienced diarrhea and drowsiness while being treated with escitalopram [R<\/a>].<\/p>\n Another study has reported that over 10% of depressed adolescents experienced nausea, insomnia<\/a>, menstrual cramps, and headaches<\/a> as a result of escitalopram treatment [R<\/a>].<\/p>\n Other side-effects that have been reported include [R<\/a>]:<\/p>\n One of the unfortunate drawbacks of all selective serotonin reuptake inhibitor<\/em> (SSRI) drugs is that they can often cause negative side effects for sexual function, such as a loss of libido or inability to achieve orgasm.<\/p>\n For example, one study claims that almost 15% of anxiety patients reported experiencing ejaculation disorder, with about 5% reported significantly reduced libido or anorgasmia<\/em> (inability to reach orgasm) [R<\/a>].<\/p>\n Sexual dysfunction (lower sexual pleasure, desire, orgasm frequency, etc.) rates were reported to be significantly higher in depressed patients taking escitalopram compared to those treated with a placebo. However, sexual functioning was reported to improve for patients who were no longer depressed [R<\/a>].<\/p>\n Reduced libido was also reported as a side effect in another study in premenstrual dysphoric disorder patients [R<\/a>].<\/p>\n In rats, chronic use of escitalopram sometimes leads to erectile dysfunction (potentially by lowering nitric oxide levels) [R<\/a>].<\/p>\n Although escitalopram is considered safe when used as directed under the supervision of medical professionals, it is possible to experience withdrawal symptoms – especially if the medication is stopped suddenly.<\/p>\n For this reason, doctors will usually advise their patients to gradually taper off their use of escitalopram, rather than stopping all at once. In any case, the most important factor is to always to talk to your doctor about any changes in your medication, and to follow any advice they give you as carefully and accurately as possible.<\/strong><\/p>\n In one study, when 14 out of 25 patients suddenly stopped using escitalopram for depression, they developed antidepressant discontinuation syndrome<\/em>. Its symptoms include [R<\/a>]:<\/p>\n Abruptly stopping the drug also reportedly led to mania in a woman undergoing treatment for unipolar depression [R<\/a>].<\/p>\n According to one case study, a man with panic disorder reported experiencing \u201cbrain zaps\u201d (sensations of electric shocks inside the head) after he suddenly stopped taking escitalopram [R<\/a>].<\/p>\n Psychiatrists generally avoid triggering antidepressant discontinuation syndrome by slowly tapering patients off the drug, giving them prescriptions for progressively small doses over an extended period of time. For these reasons, it is important to consult a medical expert if you are thinking of stopping your antidepressant treatment.<\/p>\n Although escitalopram has a number of relatively well-supported medical uses when administered by qualified medical professionals, there are a number of factors that doctors may look for that might disqualify someone from receiving escitalopram treatment (due to elevated risk of negative side-effects or other adverse reactions).<\/p>\n Some of these \u201ccontraindications\u201d include [R<\/a>]:<\/p>\nWhat Is Escitalopram?<\/span><\/h2>\n
Escitalopram vs. Citalopram<\/span><\/h3>\n
Mechanism of Action<\/span><\/h3>\n
Potential Side-Effects<\/span><\/h2>\n
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Escitalopram and Sexual Dysfunction<\/h4>\n
Escitalopram Withdrawal<\/span><\/h3>\n
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Contraindications<\/span><\/h2>\n
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