By Irfana
B.Sc (Psychiatry Ward)
27 April 2022 -
Medically reviewed by
Sumayya
D. Pharm
Can You Take Lexapro and Alcohol Together?
Table of Contents

What Is Lexapro?

Lexapro is an anti-depressant belonging to a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Its generic name is escitalopram. It works by preventing serotonin from being reabsorbed, resulting in an increased amount in the brain. Serotonin is a neurotransmitter that affects one's mood and well-being. This alteration helps in treating people suffering from anxiety and depression. You can also buy Lexapro online from a certified online pharmacy but it is recommended to get a doctor's prescription first.

Forms and Strength

Lexapro is available in the form of film-coated tablets, round in shape, containing escitalopram oxalate in 5, 10, and 20 mg tablet strengths.

In the oral form, escitalopram is available in a 5mg/5mL strength solution.

How Should You Take Lexapro?

Follow the directions on the prescription label or follow the intake as prescribed by the doctor. There might be occasional changes in your dosage given by your doctor.

Make sure you take the medicine at the same time every day, with or without food. While you measure the oral dosage, keep in mind to use a measuring device such as a dosing syringe. Do NOT use a kitchen spoon.

The time a proper dosage takes to improve symptoms could range up to 4 weeks. In case you don’t see a difference, consult your doctor.

Your doctor would normally track your progress on a regular basis. In the case of a child, keep checking for weight and height gain.

If you observe any changes in sexual function such as loss of interest in sex, trouble having an orgasm, problems with erection, or ejaculation, contact your doctor immediately.

Dosage

Standard adult dosage for Generalized Anxiety Disorder:

Initial dose- 10 mg orally once a day; increase to 20 mg once a day if necessary after at least one week of treatment.

Maintenance dose- 10 to 20 mg orally, once a day.

Maximum dose- 20 mg orally once a day.

Note: Treatment should be evaluated on a regular basis to decide whether or not it is necessary to continue treatment; efficacy beyond eight weeks has not been systematically studied.

Usage- For acute treatment of generalized anxiety disorder.

Standard adult dosage for depression:

Initial dose- 10 mg orally once a day; increase to 20 mg daily if necessary after at least one week of treatment.

Maintenance dose- 10 to 20 mg orally once a day

Maximum dose- 20 mg orally once a day

Note: Acute episodes may require sustained pharmacological therapy beyond response to the acute episode for several months or longer. Patients should be periodically evaluated to determine the need for maintenance treatment.

Usage- For acute and maintenance treatment of a major depressive disorder.

Standard pediatric dosage for depression:

Age limit: 12 years and older

Initial dose- 10 mg orally once a day; increase only if necessary after at least three weeks of treatment to 20 mg once a day.

Maintenance dose- 10 to 20 mg orally once a day.

Maximum dose- 20 mg orally once a day.

Note: Acute episodes may require sustained pharmacological therapy beyond response to the acute episode for several months or longer. Patients should be periodically evaluated to determine the need for maintenance treatment.

Usage- For acute and maintenance treatment of major depressive disorder.

Side Effects

Common side effects of Lexapro include:

  • Painful urination
  • Dizziness, drowsiness, fatigue, weakness
  • Feeling anxious or agitated
  • Increased muscle movement or feeling shaky
  • Insomnia
  • Nausea
  • Dry mouth, sweating, loss of appetite, increased thirst
  • Constipation
  • Nose bleeding, heavy menstruation
  • Decreased sex drive
  • Difficulty having an orgasm or impotence

Seek emergency medication immediately if you face any symptoms of serotonin syndrome such as agitation, hallucinations, fever, and sweating, shivering, palpitation, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Contact your doctor instantly in case you face:

  1. Tunnel vision, blurred vision, eye pain or swelling, or seeing halos around lights
  2. Unusual risk-taking behavior, constantly racing thoughts, feelings of extreme happiness or sadness.
  3. Burning or stinging sensation while urinating
  4. Experiencing slow growth or weight gain in children
  5. Decreasing levels of sodium- slurred speech, confusion, headache, severe weakness, vomiting, loss in coordination as in feeling unsteady
  6. Severe nervous reactions- high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out, stiffness of muscles.

Get immediate medical help if you encounter any allergic signs to Lexapro, such as skin rashes, hives, difficulty breathing, and swelling of the face, lips, and throat.

Interaction with Alcohol

Lexapro and alcohol work individually on altering brain signals. When taken together, they might cause drowsiness and liver problems. 

Study On The Interaction Of Alcohol With Lexapro

A study conducted at the Department of Mental Health and Alcohol Research, Finland, it shown that in the clinical environment, alcoholism combined with major depressive disorder provided a significant issue. The outcomes of using selective serotonin reuptake inhibitors to treat depression have been variable.

According to the study, eighty alcohol-dependent individuals with major depressive disorder were randomized 1:1 to receive escitalopram 20 mg in municipal alcohol clinics. Patients received their usual care at the clinics during the 26-week research period. The patients were seen weekly for the first month, then every three and six months after that. The Alcohol Use Disorders Identification Test (AUDIT), the Obsessive-Compulsive Drinking Scale (OCDS), and the Drinking Diary were used as outcome measures.

In both groups, the completion rate was high, especially among the patients who had been abstinent at the start of the research. However, those who were not abstinent dropped out. Alcohol intake, as judged by the AUDIT QF (quantity-frequency) score, and alcohol craving, as measured by the OCDS, were both considerably reduced in both groups. Early commencement of the first depressive episode, like early onset of the first alcohol intoxication, predicted poor treatment results in patients treated with escitalopram.

If you drink while on Lexapro, you will not feel any more intoxicated than you would usually. On the other hand, combining anti-depressants and alcohol is not advised: it can be lethal and harmful. (Muhonen LH, Lahti J, Sinclair D, Lönnqvist J, Alho H.2008 Oct)

Mechanism

By preventing the reuptake of serotonin into the presynaptic neuron, escitalopram raises Intra synaptic levels of the neurotransmitter. Escitalopram has the highest selectivity for the serotonin transporter (SERT) compared to the norepinephrine transporter (NET) of all the SSRIs now available, resulting in a milder side-effect profile than less-selective SSRIs.

Escitalopram is a P-glycoprotein substrate, P-glycoprotein inhibitors like verapamil and quinidine, it may help it cross the blood-brain barrier. Escitalopram's antidepressant-like effects were improved in preclinical research in rats when it was combined with a P-glycoprotein inhibitor.

Who Should Take Lexapro?

Lexapro is a medication used to treat depression in adults, children, and teenagers aged 12 and up. It is also used to treat generalized anxiety disorder (GAD) in adults, which is defined as excessive worry and tension that interferes with daily life and lasts for six months or more.

Who Should Not Take Lexapro?

Here is a list of the conditions under which it is advised NOT to take Lexapro:

  1. A disorder with an excess antidiuretic hormone called syndrome of inappropriate antidiuretic hormone
  2. Low amount of sodium in the blood
  3. Low amount of potassium
  4. Low amount of magnesium
  5. Risk of bleeding
  6. Manic-depression
  7. Suicidal thoughts
  8. Serotonin syndrome
  9. Closed-angle glaucoma
  10. Heart attack within the last 30 days
  11. Abnormal heart rhythm
  12. Prolonged QT interval
  13. Liver problems
  14. Bleeding from the stomach, esophagus, duodenum
  15. Seizures
  16. Chronic kidney disease (stage 4-severe)

Warning for Others

  1. For pregnant women: Research has shown adverse effects to the fetus when the mother takes the drug.
  2. For seniors: This drug can decrease sodium levels; seniors may be at even higher risk for low sodium levels.
  3. For children: Children may experience a decreased appetite and weight loss.
  4. In case of an overdose: Overdose of Lexapro could cause serotonin toxicity, QT prolongation, and bradycardia.

Storage

Lexapro is suggested to be stored at room temperature, away from light and moisture. Do not store in the bathroom.

Key Take Away

Lexapro is an anti-depressant used to treat anxiety and depression. It works by assisting in the restoration of a natural substance (serotonin) equilibrium in the brain. If not taken cautiously, it could cause painful urination, swelling, stiffness of muscles, low sodium levels, and so on. 

It is suggested not to take Lexapro with alcohol as it can be harmful or, at worst, lethal. 

FAQ

  • What to do if I miss a dose?

Ans. Make sure you take the skipped dose as soon as possible but skip it if it is almost time for your next dose.

  • Can I have an occasional drink while on Lexapro?

Ans. It may be safe to have an occasional intake of alcohol. However, a person should consult a doctor before consuming alcohol with any anti-depressant. 

  • Is Lexapro the same as Xanax?

Ans. No. Lexapro is an SSRI drug taken for anxiety and depression, the consumption being limited to once daily. In contrast, Xanax is a benzodiazepine taken for anxiety and panic disorders, consumption extending to 3 to 4 times a day.

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