LYCOS RETRIEVER 
Lexapro: Patients
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Randomized, double-blind, placebo- and active comparator-controlled study compared the onset of antidepressant efficacy of Cymbatla (duloxetine) versus Lexapro (escitalopram) and placebo in the treatment of patients with major depressive disorder. Both duloxetine and escitalopram showed significantly greater improvement on the primary efficacy measure than placebo over the 8-week acute treatment period, while no differences were observed between drugs or between drugs and placebo on response and remission rates at 8 weeks. Escitalopram at a starting dose of 10 mg QD was better tolerated than duloxetine at a starting dose of 60 mg QD. This study met its pre-defined primary objective of assessing if duloxetine was non-inferior to escitalopram in antidepressant onset efficacy, and the results show that duloxetine is at least as fast as (non-inferior to) escitalopram.
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Animal studies suggest that the abuse liability of Lexapro is low. Lexapro has not been systematically studied in humans for its potential for abuse, tolerance or physical dependence. The premarketing clinical experience with Lexapro did not reveal any drug seeking behavior. However, these observations were not systematic and it is not possible to predict on the basis of this limited experience the extent to which a CNS-active drug will be misused, diverted, and/or abused once marketed. Consequently, physicians should carefully evaluate Lexapro patients for history of drug abuse and follow such patients closely, observing them for signs of misuse or abuse (eg., development of tolerance, incrementations of dose, drug seeking behavior).
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Symptoms associated with discontinuation of Lexapro and other SSRIs and SNRIs have been reported (see PRECAUTIONS). Patients should be monitored for these symptoms when discontinuing treatment. A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose but at a more gradual rate.
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In clinical studies, many patients treated with Lexapro began to feel improvement in their depression beginning in 1 or 2 weeks, although full antidepressant effect may take 4 to 6 weeks. You should follow up with your healthcare provider and report your progress.
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The proportions of patients who withdrew owing to adverse events were 7.5% in the Lexapro (escitalopram) group and 11.2% in the Effexor XR (venlafaxine XR) group. The mean number of discontinuation emergent signs and symptoms in the venlafaxine XR group (mean: 5.0) was significantly higher than for the escitalopram group (mean: 2.4).
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The FDA recently completed a bulk evaluation of 372 studies involving approximately 100,000 patients and 11 antidepressants, including Lexapro, Zoloft, Prozac and Paxil. When the results are analyzed by age, it becomes clear there is an elevated risk for suicidal thoughts and behavior among adults 18 to 25 that approaches that seen in children, the FDA said in documents released before their scheduled December 13, 2006 meeting of its psychopharmacologic drugs advisory committee.
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