Get $25 Off On Subscription Orders!

Lexapro Review: Superior To Most Antidepressants?

Lexapro Review: Superior To Most Antidepressants?

| |
Read our Editorial Guidelines to learn more about what makes our site the premier resource for online health information.
| |
Read our Editorial Guidelines to learn more about what makes our site the premier resource for online health information.

Read our Editorial Guidelines to learn more about what makes our site the premier resource for online health information.

Disclaimer: None of the information in this article constitutes medical advice, and is just the opinion of the writer(s). We recommend that patients follow their doctor’s guidance in regards to prescription medication.

Lexapro is one of the most popular antidepressant medications, and comes from a class of drugs called Selective Serotonin Reuptake Inhibitors (SSRIs). The generic name for this drug is escitalopram, and we will use these two terms interchangeably throughout the article. They are the same chemical compound; Lexapro is just a brand name.

In this article we’ll review the medical research on Lexapro to determine if it’s likely to be effective for depression and anxiety. We’ll also cover a natural alternative that patients may wish to talk to their doctor about, because it may cause significantly fewer side effects.

Does Lexapro Work?

Escitalopram is proven to be effective for major depression. This doesn’t mean it will work for all patients; just that it works on average.

A medical review of Lexapro published in the CNS Drugs Journal analyzed 18 different studies on Lexapro for depression and concluded that the drug was an “effective and generally well tolerated treatment.”

Drugs have to go through an extensive development and approval process to be cleared for use by the Food and Drug Administration (FDA), so while there are some concerns about the long-term safety of certain pharmaceutical drugs, they usually do work on average.

Another extensive medical review of Lexapro for major depressive disorder found that it was significantly more effective than other antidepressant drugs. Lexapro was shown in this study to be not only superior to several other SSRI medications such as Paxil, but also superior to Serotonin/Noradrenaline Reuptake Inhibitors (SNRIs) which is another class of antidepressant.

This is an impressive result, since Lexapro isn’t being compared to placebo but to other active medications. In fact, we mentioned in our Celexa review that Lexapro was proven to be a better option for depression in a head-to-head research review.

We can conclude from the above-linked research that Lexapro is effective for treating depression.

Lexapro is also prescribed for anxiety. A meta-review of Lexapro for generalized anxiety disorder found that it was effective for both short-term and long-term treatment. The studies assessed by the researchers ranged between 8-76 weeks.

A more specific clinical trial evaluated the efficacy of Lexapro for panic disorder. 366 patients with panic disorder received either Lexapro, Celexa, or placebo, in a well designed and double-blinded study. 

Lexapro was significantly more effective than placebo in treating panic disorder, and the number of patients reporting zero panic attacks increased with Lexapro use. One significant stat is that the rate of discontinuation of the study due to adverse events was actually lower with Lexapro than with placebo, suggesting the drug’s side effects were negligible in this patient group.

How Does Lexapro Work?

We believe it’s important for patients to understand how their medications work.

Lexapro is an SSRI, so it limits re-uptake of serotonin, which is a neurotransmitter that directly influences mood, and seems to be linked to depression.

Limiting reuptake of this compound artificially increases its levels in the brain, which can have a normalizing effect on patients with depression. Research is still unclear on exactly how SSRIs can be effective, but the theory is that patients with no mental health issues tend to have higher circulating levels of serotonin than those with depression.

Lexapro Side Effects

Lexapro does have side effects, and in our opinion the side effects are more severe than with more natural treatment modalities like therapy or certain types of supplementation.

Another medical review of Lexapro found that the most common side effects were insomnia, ejaculation disorder, nausea, increased sweating, fatigue and drowsiness.

One patient out of 125 taking Lexapro developed suicidal ideation, and 6 patients out of 544 (slightly over 1%) attempted suicide. However this review only compared the side effect rates of suicidal tendencies between Lexapro and other antidepressant use, so it’s hard to tell whether the drug actually increases risk of suicide.

Patients with major depression are generally at a higher risk of suicide attempt, so it would have been useful to see this risk compared with a placebo group.

It’s also notable that in the above-linked review, patients taking 20 milligrams (mg) of Lexapro were significantly more likely (10% vs. 4%) to drop out of the trial due to uncomfortable side effects than patients taking 10 mg. It may be worthwhile for patients with moderate depression to speak with their doctor about starting on a 10 mg rather than 20 mg dose to minimize side effects.

The FDA does require a black box warning to be listed on Lexapro packaging and materials, indicating that the drug may increase risk of suicidal thinking and behavior.

Should I Take Lexapro Generic?

As mentioned in the intro paragraph, the generic version of Lexapro is escitalopram.

While we generally recommend generic drugs over brand-name drugs, Lexapro actually caused fewer psychiatric hospitalizations when compared to the generic escitalopram in a medical review of generic vs. brand-name drugs. 

The researchers noted that this difference may have been caused by poor study design, but for patients who can access the drugs at the same cost through insurance, we believe these results make Lexapro seem to be the superior option.

Lexapro Vs. Zoloft

As two of the most popular antidepressant medications, many consumers are curious whether Lexapro or Zoloft are proven to be more effective. There is medical research comparing the two directly.

A review published in the International Clinical Psychopharmacology journal compared studies on both compounds and found that Lexapro “is the first choice judged by combined efficacy and tolerability”, which suggests that Lexapro is not only more likely to work but more likely to have significant side effects.

A 2004 clinical trial tested whether Lexapro or Zoloft were more effective for treating major depression. Lexapro caused a 74% remission in symptoms compared to 77% for Zoloft, but the side effect rate was 11% lower in patients taking Lexapro (45% vs. 56%). This led to researchers concluding that Lexapro was the best option overall.

We believe that patients considering both medications may want to speak with their doctors about Lexapro, because it appears to be as effective if not more, and appears to cause fewer side effects.

Natural Antidepressant Alternative - Lithium

Because pharmaceutical antidepressants like Lexapro have a relatively high risk of side effects, patients with more minor symptoms (mild-to-moderate depression rather than major depression) may want to speak to their doctor about lithium supplementation as a potential alternative.

Lithium is a metal that has been tested extensively for antidepressant effect when taken orally at low doses. It’s available over-the-counter (OTC); not requiring a prescription for purchase.

An extensive medical review of lithium supplementation for treatment of mood disorders found that the compound may be effective for depression alone, but also enhanced the effectiveness of pharma antidepressants when taken as an adjunctive therapy. Lithium also had pronounced anti-suicide effects, which is the opposite of many prescription antidepressants.

The only lithium dose mentioned in the above-linked study is 150 mg/day.

Another meta-review analyzed the results of 39 individual trials on lithium supplementation for depressive disorder. The researchers found that lithium was effective on average, and seemed to be especially effective for those with depression and bipolar disorder.

The doses used in the studies varied considerably, and there doesn’t seem to be a medical standard for lithium dosage in treatment of depression. Even though this compound can be purchased OTC at pharmacies, we strongly recommend patients work with their doctor on establishing a safe dosage if they decide to try lithium for treatment of their depression.

Stay up-to-date on our research reviews


Lexapro is effective for treating depression. There is significant research on its efficacy for depression and a decent amount of research suggesting it works for anxiety-related conditions as well.

Lexapro appears to be safer and as effective if not more when compared with other popular antidepressants like Zoloft.

Because Lexapro, like most SSRIs, may increase the risk of suicidal behavior and sexual side effects, we believe that patients with mild or moderate depression may benefit from speaking with their doctor about trying lithium supplementation as a treatment modailty that may be less risky if the appropriate dosage is used.

Liquid error: Could not find asset snippets/search-bar.liquid