SSRIs considered to have the best safety profile in the elderly are citalopram, escitalopram , and sertraline.  These have the lowest potential for drug-drug interactions based on their cytochrome P-450 interactions.
Tricyclic antidepressants , especially amitriptyline and dothiepin ,16 are known to pose a high risk of death in overdosage. These drugs should therefore be avoided in older people whose medication is not supervised and who are at risk of taking an overdose.
Common side effects of Lexapro include: diarrhea, drowsiness , ejaculatory disorder, headache, insomnia, nausea , and delayed ejaculation. Other side effects include: anorgasmia, constipation, dizziness , dyspepsia, fatigue, decreased libido, diaphoresis, and xerostomia.
Patients with major depressive disorder treated with the selective serotonin reuptake inhibitor ( SSRI ) escitalopram experienced significant drops in the levels of 2 neurotoxic compounds that can cause memory loss and dementia .
Buspirone is an anti-anxiety drug that has been shown to be effective for older adults. Benzodiazepines , another anti-anxiety drug, are effective but should be prescribed carefully to older adults because of risk of memory impairment, unsteadiness, and falls.
Common side effects of Lexapro include: drowsiness , dizziness , sleep problems (insomnia), nausea , upset stomach, gas, heartburn, constipation,
Selective serotonin reuptake inhibitors ( SSRIs ). These medications generally cause fewer bothersome side effects and are less likely to cause problems at higher therapeutic doses than other types of antidepressants are.
New research links certain medications to dementia risk amitriptyline , paroxetine, and bupropion (most commonly taken for depression) oxybutynin and tolterodine (taken for an overactive bladder) diphenhydramine (a common antihistamine, as found in Benadryl ).
Diphenhydramine and amitriptiline are the most common inappropriately prescribed medications with high risk adverse events while propoxyphene and doxazoxin are the most commonly prescribed medications with low risk adverse events.
You can take escitalopram at any time of day, as long as you stick to the same time every day. If you have trouble sleeping, it’s best to take it in the morning .
Drug interactions of Lexapro include monoamine oxidase inhibitors (MAOIs), tryptophan, St. John’s wort, meperidine, lithium, triptans, tramadol, warfarin, aspirin , nonsteroidal anti-inflammatory drugs ( NSAIDs ), and other drugs that cause bleeding.
Fatigue, drowsiness Take a brief nap during the day. Get some physical activity, such as walking. Avoid driving or operating dangerous machinery until the fatigue passes. Take your antidepressant at bedtime if your doctor approves. Talk to your doctor to see if adjusting your dose will help.
Dosage. If you are experiencing the first episode of depression or anxiety, you may take Lexapro for a defined period such as between six months and one year. However, for individuals experiencing a chronic mental health condition, it may be necessary to take Lexapro for an extended period over many years.
It has also been noted that escitalopram might reduce the level of sodium in the blood of people who are age 65 and older. Low sodium levels can cause memory problems or confusion. If someone takes too much of the drug, it may also cause forgetfulness.
The study of 58 healthy volunteers found those who were given the antidepressant drug escitalopram , which increases serotonin levels, put in more effort to get a reward.