Lexapro vs Effexor

Lexapro

• The usual starting dose of Lexapro for treating depression in adults or adolescents is 10 mg once daily in the morning or evening. The dose may be increased to 20 mg once daily after 1 week.
• Benefit may not be seen until treatment has been given for up to 4 weeks. A daily dose of 20 mg may not be more effective than 10 mg daily for treatment of depression.
• The dose for treating generalized anxiety disorder is 10 mg once daily.
• Lexapro can be taken with or without food.

Effexor

• Venlafaxine should be taken with food at doses specifically directed by a physician. Individual doses vary greatly among individuals. The anti-depressant effects are not maximal for 1-2 weeks. If discontinued, the dose of venlafaxine should gradually be reduced under the direction of a physician.
• For patients with difficulty swallowing tablets or capsules, capsules of Effexor XR can be opened and the contents sprinkled on a spoonful of applesauce but removal from the capsule allows immediate release of the drug so it is no longer an extended release drug.
• The dose for treatment of depression using the immediate release formulation is 75 to 375 mg daily divided in 2 or 3 doses and given every 8 or 12 hours. The extended release dose is 37.5 mg to 225 mg once daily. Dosing is usually begun with low initial concentrations and adjusted as needed by the treating doctor.
• Generalized anxiety and panic disorder are treated with 37.5 mg to 225 mg once daily using the extended release formulation. Social anxiety is treated with 75 mg daily using the extended release formulation.

Lexapro

• All SSRIs, including Lexapro, should not be combined with drugs in the monoamine oxidase (MAO) inhibitor class of antidepressants such as isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), selegiline (Eldepryl) and procarbazine (Matulane) or other drugs that inhibit monoamine oxidase such as linezolid (Zyvox) and intravenous methylene blue. Such combinations may lead to confusion, high blood pressure, high fevers, tremor or muscle rigidity, and increased activity. At least 14 days should elapse after discontinuing Lexapro before starting an MAO inhibitor. Conversely, at least 14 days should elapse after discontinuing an MAO inhibitor before starting Lexapro.
• Similar reactions occur when SSRIs are combined with other drugs that increase serotonin in the brain, for example tryptophan, St. John's wort, meperidine (Demerol), lithium (Lithobid, Eskalith), triptans (for example, sumatriptan [Imitrex, Alsuma]), and tramadol (Ultram)
• Use of selective serotonin inhibitors may increase the risk of gastrointestinal bleeding in patients taking warfarin (Jantoven, Coumadin), aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and other drugs that cause bleeding.

Effexor

• Venlafaxine should not be used in combination with a monoamine oxidase inhibitor (MAOI) such as phenelzine (Nardil), tranylcypromine (Parnate), isocarboxazid (Marplan), and selegiline (Eldepryl), or within 14 days of discontinuing the MAOI. At least 5 days should be allowed after stopping venlafaxine before starting an MAOI.
• Combinations of SNRIs and MAOIs may lead to serious, sometimes fatal, reactions including very high body temperature, muscle rigidity, rapid fluctuations of heart rate and blood pressure, extreme agitation progressing to delirium, and coma. Similar reactions may occur if venlafaxine is combined with antipsychotics, tricyclic antidepressants or other drugs that affect serotonin in the brain. Examples include tryptophan, sumatriptan (Imitrex), lithium, linezolid (Zyvox), tramadol (Ultram), and St. John's Wort.
• Combining venlafaxine with aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), warfarin (Coumadin) or other drugs that are associated with bleeding may increase the risk of bleeding, because venlafaxine is associated with bleeding.
• Most medications affecting the brain such as venlafaxine have the potential to slow reflexes or impair judgment. Therefore, caution is advised especially early in the course of treatment.
• Safety has not been established in children below the age of 18 years.

Lexapro

• The safety of Lexapro during pregnancy and breastfeeding has not been established. Therefore, Lexapro should not be used during pregnancy unless, in the opinion of the physician, the expected benefits to a patient outweigh unknown hazards to the fetus.
• Lexapro is excreted in human milk. Lexapro should not be given to nursing mothers unless, in the opinion of the physician, the expected benefits to the patient outweigh the possible hazards to the child.

Effexor

• The effects of venlafaxine on the fetus during pregnancy are unknown.
• It is not known if venlafaxine is secreted in breast milk, and therefore, if it may have an effect on nursing infants.

Lexapro (escitalopram) and Effexor (venlafaxine) are antidepressants used for treatment of major depression. Lexapro is also used to treat anxiety in adults. Lexapro belongs to the drug class selective serotonin reuptake inhibitors (SSRIs) while Effexor is a selective serotonin and norepinephrine reuptake inhibitor (SSNRI).

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• Lexapro (escitalopram)
• venlafaxine sustained-release - oral, Effexor XR
• escitalopram - oral, Lexapro
• venlafaxine - oral, Effexor
• venlafaxine, Effexor XR (Effexor has been discontinued in the US)
• Beta Blockers vs. SSRIs