How does escitalopram (Cipralex and Lexapro) help to treat depression and anxiety?

Doctor's Answers 1

Selective serotonin reuptake inhibitors (SSRIs) refer to medications that are originally developed to act as antidepressants; they treat depression by increasing levels of serotonin in the brain. Serotonin is one of the neurotransmitters that carry signals between brain nerve cells (neurons).

SRIs block the reabsorption (reuptake) of serotonin into the pre-synaptic neurons. This makes more serotonin available to improve the transmission of messages between neurons. Serotonin will also spend more time at the synaptic cleft before they get reabsorbed into the pre-synaptic neuron.

SSRIs are called selective because they mainly affect serotonin, not other neurotransmitters. The other neurotransmitters that are commonly implicated in depression include norepinephrine and dopamine.

It is interesting that SSRIs, apart from treating depression, can also be used to treat anxiety disorders, obsessive-compulsive disorder and impulse control disorders. The following SSRIs are available in Singapore:

  • Escitalopram (Lexapro)
  • Fluoxetine (Prozac)
  • Paroxetine (Seroxat)
  • Sertraline (Zoloft)
  • Fluvoxamine (Faverin)

The main difference in the various SSRIs is their potencies at blocking serotonin reuptake and in how quickly your body metabolizes or gets rid of the drug. Many patients do not experience side effects from the medicines; they do tolerate them quite well. Others may report having these side effects:

  • nausea or vomiting
  • loose stools
  • sleepiness
  • headache
  • dry mouth
  • disturbed sleep
  • nervousness
  • agitation or restlessness
  • dizziness
  • reduced sexual desire
  • difficulty reaching orgasm or inability to maintain an erection (erectile dysfunction)
  • changes in appetite, leading to weight loss or weight gain

If you do not tolerate one SSRI well, you may tolerate another one well. It may take a while before your doctor finds out which medication suits you the best.

Similar Questions

Are there any alternatives to anti-depressants for severe depression and anxiety?

Thanks for your question, and I’m very sorry to hear that you are going through such a horrible time. I can only imagine how tough it must be. Before I answer further, I’m going to give the caveat that it’s next to impossible to offer advice about any psychiatric problem without seeing you face to face, or at the very least, having all the salient information about mood, sleep, suicidal ideation etc. I’m going to assume off the bat that the diagnosis of depression has been established by the doctors you’ve seen.

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Answered By

Dr Shi Hui Poon


Are there any alternatives like psychotherapy that are able to completely replace medication for anxiety and depression?

Thank you for asking this question for the benefit of everyone. It sounds that you are having a tough time, and its double whammy when the treatment gives you unbearable side effects. Unfortunately in medicine, it is often times a zero sum game. Everything seems to have its "costs" and "benefits". Fortunately for you, there are alternatives, like psychotherapy or more commonly known as talk therapy. The good side is that if it works for you, the effect is equivalent to medications, and the effects lasts way longer than medications.

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Answered By

Dr Paul Ang

General Practitioner

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