Surprisingly, around 46% of adults in the US are expected to grapple with mental illness at some point of time in their lives. Additional data adds a different dimension to the problem of mental illness. The number of affected individuals seeking and receiving treatment for mental illnesses is only 41% of all those with some condition. This is attributed to various reasons, including the apprehension of side effects of medication. We will look at the side effects of Lexapro to understand more about escitalopram, used to treat depression and anxiety.

Drug description and side effects of Lexapro

Belonging to the category of selective serotonin re-uptake inhibitor, Lexapro is typically used for restoring the balance and function of serotonin. This helps in the management of depression and anxiety. Serotonin is responsible for actions related to emotions, and an imbalance causes feelings of depression and anxiety. Among the different SSRIs, Lexapro is regarded as having the best selectivity, which makes it the most suitable for treating depression and anxiety. Consequently, the side effects of Lexapro are lesser when compared to other drugs used for treating the condition.

Mechanism of action of Lexapro

An understanding of the mechanism of Lexapro will help grasp the reason for the limited side effects of Lexapro. The drug is known for its allosteric action, which explains the faster action and the better outcomes associated with the medication. The mechanism of action of the drug involves enhanced serotonergic activity by binding to the primary binding site, which prevents the absorption of the neurotransmitter by the presynaptic nerve ending. Additionally, Lexapro is also known to bind to a secondary allosteric site, which ensures that absorption of 5-HT is inhibited. I tis this combination of actions that make the drug more effective in treating the condition when compared with other drugs used for treating the condition. The drug has very limited/no binding with histamine and muscarinic receptors, and the reported side effects are mainly as a result of the little activity.

Lexapro interaction with other drugs/formulations

Before we look at the side effects of Lexapro it is necessary to look at the interaction of the drug with other medications. Patients on certain medications need to inform the treating specialists about all medications to prevent drug interactions. This includes herbal formulations and commonly available generic, OTC medications. For instance, patients on blood thinners are likely to experience bleeding as a result of the drug interaction. Similarly, patients on NSAIDs – non steroidal anti inflammatory drugs are also at risk of experiencing bleeding. Additionally, patients on other medications for treating depression and anxiety are also likely to experience the “serotonin syndrome” as a result of higher serotonin levels in the body.

What is serotonin syndrome, considered as one of the side effects of Lexapro

Serotonin syndrome is regarded as one of the side effects of Lexapro and it caused when medications result in excessive levels of serotonin in the body. A chemical, serotonin is required for the brain to function normally, and is important for nerve cells to function. However, excessive serotonin levels will result in certain conditions and symptoms that are collectively known as serotonin syndrome. Manifestations include shivering, possible diarrhea, fever, seizures, and stiffness in the muscles. The condition needs to be treated and can turn serious if not managed on time or effectively. It is necessary to regulate the dosage of medications that are intended to restore the balance of serotonin, and it is extremely important when a new drug is included as part of treatment. Two methods are typically used to resolve the condition. The first is to pause the medications that resulted in accumulation of serotonin, and the second option is to use serotonin blockers that help manage the high levels of serotonin in the body.

What are the commonly reported side effects of Lexapro?

The commonly reported side effects of Lexapro include a feelings of anxiety, difficulty in falling asleep, adverse impact on libido, ED (erectile dysfunction), feelings of weakness, experiencing abnormal dizziness, vomiting/nausea, difficulty in passing stools as a result of constipation, dryness in the mouth, sudden loss of appetite, and abnormal sweating. Surprisingly, younger children experience additional side effects that include bleeding from the nose, difficulty when passing urine, abnormal thirst, and below par growth, apart from an agitated movement of muscles. These side effects are not known to last long, and typically resolve naturally. However, in certain individuals, the symptoms last longer or are intense in nature. Regardless of the intensity or the nature of side effects, it is important to keep the treating specialist informed of the condition to ensure that side effects are managed on time.

Commonly reported side effects of Lexapro of a serious nature

In a limited number of cases, there is a possibility of adverse side effects of Lexapro. By virtue of its mechanism of action, the drug is not known to have limited adverse effects on a very small percentage of patients. Some of the side effects include severe allergies, seizures, lower levels of salt, impact on eyesight and a possibility of manic depression.

Common allergies include difficulty breathing, inflammation/swelling in the eyes, the face, tongue and mouth. Patients may also experience severe rashes and blisters accompanied withpain in the joints and possible fever. Individuals who have a past history of seizures are at risk of experiencing convulsions while taking Lexapro. It is therefore necessary to inform the treating specialist of past medical history. One of the severe side effects of Lexapro includes a lowering of salt levels in the body. The risk is higher among individuals on diuretics and individuals who experience dehydration. As a result of the side effects, patients may experience difficulty in concentrating on tasks, possible seizures, inability to memorize or think clearly, and headache. Mani depression is one among the serious side effects of Lexapro, and patients on medication for treatment of bipolar disorder are regarded as high risk. Some of the common symptoms include abnormal behavior that is not grounded, delusional thoughts that are grand in nature, high speed conversations, an increase of energy levels and unusual extremities of happiness and irritation. Among the adverse side effects of the medication, impact on eyesight counts as serious. The drug may cause a dilation of the pupils and this could result in pain in the eye, and impaired vision, apart from inflammation or redness around the eye. The vision of patients can be affected, even if the patient did not have any past history of complications.

Precautions that are necessary to manage/mitigate the side effects of Lexapro

One of the side effects of Lexapro is interaction with MAO inhibitors (monoamine oxidase inhibitors). It is therefore necessary to ensure that there is sufficient gap between the use of Lexapro or MAO inhibitors. For instance, if a patient who is on MAO inhibitors is prescribed a dose of Lexapro, the patient should stop MAO inhibitors and there should be a gap of two weeks before Lexapro is taken as medication. Similarly, if a patient is on Lexapro, and is prescribed MAO inhibitors, Lexapro needs to be stopped and MAO inhibitors need to be administered only after a clear gap of two weeks. Other precautions include intimating the treating specialist about pre-exiting conditions such as bleeding problems, clotting, liver/kidney problems, low sodium levels and bipolar disorder.


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