Understanding Lexapro and Its Purpose
Lexapro (escitalopram) is an SSRI antidepressant prescribed for major depressive disorder (MDD) and generalized anxiety disorder (GAD). It works by increasing serotonin levels in the brain to regulate mood. The aim is to alleviate symptoms such as persistent sadness, excessive worry, and low energy. Therapeutic benefits typically appear after one to four weeks or more of consistent use.
Intended Behavioral Changes: The Therapeutic Effect
Lexapro aims to improve mood, reduce anxiety, and help individuals re-engage with life. Patients often report increased energy, better focus, and renewed interest in activities. The goal is to restore one's personality from the effects of depression or anxiety, not fundamentally change it. Treatment is often recommended for at least 6 to 12 months after symptoms subside to prevent recurrence.
Unintended Behavioral Changes and Side Effects
Lexapro can also lead to unintended behavioral and emotional changes. Monitoring these is important, especially when starting or adjusting the dosage.
The Phenomenon of Emotional Blunting
A notable side effect is emotional blunting, where individuals feel emotionally numb or detached, affecting both positive and negative feelings. This may be due to SSRIs reducing sensitivity to rewards. It differs from the anhedonia seen in depression.
Other Common Behavioral Side Effects
Other side effects include:
- Agitation: Some may feel more nervous or restless.
- Fatigue: Feeling tired or sleepy is common.
- Sleep Issues: Difficulty sleeping (insomnia) or increased sleepiness can occur.
- Sexual Dysfunction: Decreased libido or difficulty with orgasm is frequently reported.
Comparison of Common SSRIs: Lexapro vs. Zoloft
Lexapro and Zoloft (sertraline) are both SSRIs but have differences:
| Feature | Lexapro (Escitalopram) | Zoloft (Sertraline) |
|---|---|---|
| FDA-Approved Uses | MDD, GAD. | MDD, OCD, Panic Disorder, PTSD, Social Anxiety Disorder, PMDD. |
| Mechanism | Highly selective for serotonin. | Primarily affects serotonin, with mild effects on dopamine. |
| Common Side Effects | Nausea, insomnia, fatigue, sexual dysfunction, dry mouth, increased sweating. | More likely to cause gastrointestinal issues initially. |
| Dosing | Typically 10-20 mg. | More flexible, with tablets from 25 mg to 100 mg. |
Serious Warnings and When to Contact a Doctor
Lexapro has an FDA boxed warning for increased suicidal thoughts and behaviors in young adults (under 25). Report any new or worsening depression or suicidal ideation immediately.
Serotonin syndrome, a serious condition from excessive serotonin, requires immediate medical attention for symptoms like agitation, confusion, rapid heartbeat, and fever.
Managing Behavioral Changes
Do not stop Lexapro abruptly due to withdrawal symptoms. Discuss side effects with your doctor, who may suggest:
- Dose Adjustment: Lowering the dose can help.
- Timing Changes: Taking it in the morning or evening might alleviate sleep issues.
- Lifestyle: Exercise and good sleep hygiene can manage fatigue and sleep problems.
- Switching Medication: A different antidepressant like bupropion might be considered if side effects persist.
Conclusion
Lexapro is intended to change behavior by reducing depression and anxiety symptoms. However, it can also cause unintended changes like emotional blunting or agitation. The effects are individual, and open communication with your healthcare provider is crucial to manage side effects and ensure effective treatment.
For more information from an authoritative source, visit the National Alliance on Mental Illness (NAMI) page on Escitalopram.
