Lexapro (Escitalopram) Addiction/Abuse
Escitalopram, which also goes by the brand name Lexapro, is a commonly prescribed antidepressant. Lexapro is a selective serotonin reuptake inhibitor (SSRI). These are the most commonly prescribed type of antidepressants along with tricyclics. SSRIs like Lexapro are one of the most frequently prescribed antidepressants for people recovering from alcoholism. SSRIs are preferred because they have the highest rates of success compared to other antidepressants. They also have mild side effects that are easily managed by adjusting the dose.
On average, patients will need to try two or three different types of antidepressants before finding one that works. The process of finding the right antidepressant can take several months because of the long period of onset that many of these medications have. Escitalopram is often the first line of antidepressants that doctors prescribe to patients newly diagnosed with major depressive disorder.
Lexapro is an effective treatment for these disorders because of its ability to address the serotonin deficiency that causes them. Not all cases of depression are caused by a serotonin deficiency. For those that are, Lexapro can be an effective option for reducing symptoms of depression.
Escitalopram works by delaying the reabsorption of serotonin. Serotonin is the neurotransmitter that is primarily responsible for stabilizing mood and promoting feelings of general well-being. Having low serotonin activity can result in depression. Serotonin is only able to induce feelings of well-being when it is released into the synaptic gap between neurons. SSRIs like Lexapro work by keeping serotonin molecules in the space between neurons for an extended period.
While Lexapro is most commonly prescribed to treat depression, it’s also used to treat a variety of mental health disorders that are common amongst people dealing with alcohol use disorder. Indications for the use of escitalopram include post-traumatic stress disorder (PTSD), social anxiety disorder (SAD), obsessive-compulsive disorder (OCD), generalized anxiety disorder (GAD), and premenstrual dysmorphic disorder (PDD).
Side effects of taking escitalopram are usually easy to manage and are most common while adjusting to being on or off the drug. Side effects of taking Lexapro may include fluctuations in weight, headache, drowsiness, low sex drive, nausea, and restlessness. On rare occasions, more serious complications can occur. Potential serious side effects include skin inflammation, high fever, rapid heart rate, and seizures. Speak to your doctor immediately if you begin to experience any of these issues.
Lexapro takes on average one to two weeks before symptoms of depression begin to improve. At four weeks, patient begins to feel the full effects of the drug. If at this time, escitalopram continues to be ineffective, your doctor will most likely make the call to discontinue use.
Lexapro is commonly prescribed to people who are in recovery from substance use disorder. In many people with major depressive disorder, escitalopram is effective at reducing alcohol cravings. For this reason, doctors will use it as both an adjunct treatment for addiction and a primary treatment for depression.
The serotonin transporter gene has been strongly linked to alcoholism. The serotonin imbalances that influence alcoholism are often the cause of major depressive disorder in these patients. While Lexapro is never a cure for addiction, addressing this overlapping imbalance can minimize symptoms of both disorders.
Escitalopram does not reduce alcohol cravings or symptoms of depression for all patients. On rare occasions, medicating with Lexapro while in recovery results in an increase in drug and alcohol cravings.
Much more remains to be understood about the relationship between serotonin, addiction, and the role that SSRIs like escitalopram can play in treatment. Several cases have been reported where patients who formerly did not have substance use disorder developed an addiction to alcohol while taking Lexapro. Upon stopping the medication, patient’s alcohol cravings quickly subsided and returned to normal.
Cessation of Lexapro use can result in withdrawal symptoms collectively referred to as discontinuation syndrome. The most severe complications and side effects of the use of escitalopram occur when the patient stops taking the drug abruptly. The normal protocol for discontinuing the use of escitalopram involves a gradual reduction in dose. Patients who had been taking 40 mg a day will gradually reduce to 10 mg a day over the course of a few weeks before finally stopping.
Even when doses are gradually reduced, symptoms of discontinuation syndrome can occur. These can include irritability, headache, insomnia, dizziness, anxiety, excessive dreaming, flu-like symptoms, vertigo, nausea, and confusion. Feelings of hopelessness and thoughts of suicide are less common but are most likely to occur in patients under the age of 25.
Abruptly stopping treatment or accidentally missing doses can make the onset of symptoms more severe, especially in regards to suicidal ideations. This risk makes proper support and aftercare with your doctor critical.
Discontinuation syndrome begins 24 to 48 hours after doses are reduced and can peak after five days. For most people, symptoms stop after one to two weeks. However, many individuals report that it can take three months before their brains have adjusted to being off the drug.
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