Lexapro is an antidepressant of selective serotonin reuptake inhibitors group (SSRIs). SSRI antidepressants are the most-prescribed drugs in modern clinical practice. The fact is that these drugs are effective in treatment of depression and also safe for a long-term use, comparing to other groups of antidepressants.
Acting on cerebral neurons Lexapro antidepressant inhibits serotonin reuptake, increasing the concentration of serotonin in the presynaptic gap. Increase of free serotonin concentration in presynaptic gap is what creates an antidepressant effect.
Lexapro surpasses any known SSRI (e.g. Fluoxetine, Paroxetine, Fluvoxamine or Citalopram) by selectivity of serotonin effect, since Lexapro serotonin reuptake inhibition is ten times higher than R-Citalopram. Comparative analysis will show if there are Lexapro alternatives among all SSRIs.
Usage
SSRI antidepressants are prescribed for the treatment of major depression. However, only few SSRI drugs indications claim to treat major depression, such as: Lexapro and Citalopram. Other popular SSRIs (Fluoxetine, Paroxetine, Fluvoxamine) are designed to treat more than just major depression. For instance:
- Fluoxetine is prescribed for the treatment of major depression, as well as obsessive-compulsive disorder (OCD) and premenstrual dysphoric disorder.
- Paroxetine is prescribed to treat major depression and also to prevent relapses of depression symptoms and OCD symptoms; obsessive-compulsive disorders; panic disorders; social anxiety disorder; generalized anxiety disorder and post-traumatic stress disorder.
- Fluvoxamine is indicated for the treatment of major depression in adults and also obsessive-compulsive disorders (OCD) in children (8 years old and over).
Therefore Fluoxetine, Paroxetine and Fluvoxamine are Lexapro alternatives in the treatment of obsessive-compulsive disorders (OCD). Hence, to treat obsessive-compulsive disorder in children, Lexapro can be replaced by Fluvoxamine.
Drug interaction
Those patients who are prescribed to take Lexapro, should be aware that this antidepressant must never be taken with antipsychotic Pimozide. Nearly all SSRIs cannot be taken along with Pimozide antipsychotic. Fluvoxamine is the only exception. If adult patients have to take Pimozide for depression treatment, they should take Lexapro alternatives, namely Fluvoxamine SSRI.
Elderly patients
Any SSRI, including Lexapro in elderly patients does not require individual dose adjustment, since the drug is equally tolerated by young and elderly patients. But if taken the maximum dose, it is recommended to decrease the drug dose gradually. Only Fluoxetine SSRI has equal tolerability in elderly and middle-age patients. Thus, Fluoxetine is a good Lexapro alternative for the treatment of depression at elderly age.
SSRIs time of use
Antidepressant Lexapro as well as Fluoxetine and Paroxetine, is recommended to use in the first half of the day. But Citalopram and Fluvoxamine are recommended to be taken in the evening. If antidepressant is recommended for use in the evening, it means the drug normalizes physiological sleep (increases the duration and depth of sleep). It is known that physiological sleep disorder is among the depression symptoms. When treating depression, accompanied by sleep disorder, Citalopram and Fluvoxamine are used as Lexapro alternatives.
Three of four paragraphs comparing popular SSRI antidepressants, have described Fluvoxamine as Lexapro alternative. So we can make a conclusion that among Lexapro alternatives for the treatment of major depression, Fluvoxamine antidepressant takes the first place.
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