Table of Contents (hide)
- 1. Lexapro is US FDA-Approved to Treat:
- 2. Lexapro (escitalopram oxalate) is Approved Elsewhere for:
- 3. Clinically Significant or Otherwise Common Off-Label Uses of Lexapro (escitalopram oxalate)
- 4. When/Why You Should Take Lexapro (escitalopram oxalate)
- 5. When/Why You Should NOT Take Lexapro (escitalopram oxalate)
- 6. Less Common/Experimental Off-Label Uses of Lexapro
- 7. Failed Off-Label Uses
- 8. Potentially Dangerous Off-Label Uses
Drugs are officially approved to be used for certain things, and they may be approved for one thing in one country but something else entirely in another.1
Meds are often prescribed for conditions (e.g. Topamax for bipolar disorder), or people (e.g. adolescents being prescribed any SSRI or SNRI except Prozac or Lexapro) they aren’t approved to treat. This is known as off-label prescribing. Some off-label prescribing is so common that lots of people think the medication is a first-line treatment for the condition it’s prescribed to treat (e.g. Trileptal for bipolar disorder). If a drug company’s sales force (a.k.a. pharm reps) is too aggressive in pushing a med for off-label applications where it doesn’t work as well as people think, the FDA will now come down hard on them (e.g. Novartis getting heavily fined for promoting Trileptal as a treatment for bipolar disorder).
Off-label prescribing is not necessarily bad. Drugs that almost, or would almost, pass a clinical trial for some indication still work for a lot of people. As long as the reason for not clearing the hurdles of phase III clinical trials wasn’t the death of too many participants, or some other intolerable side effect.
§1. Lexapro is US FDA-Approved to Treat:
- Major depressive disorder (MDD) in adults
- MDD in adolescents (Prozac is the only other modern antidepressant approved to treat MDD in adolescents)
- Generalized anxiety disorder (GAD) in adults.
§2. Lexapro (escitalopram oxalate) is Approved Elsewhere for:
- Everywhere else in the world where you find Lexapro / Cipralex / etc. (escitalopram), it’s approved to treat social anxiety disorder and panic disorder, with or without agoraphobia, along with MDD and GAD.
- Cipralex / Lexapro is also approved to treat OCD in:
- New Zealand
- the UK
§3. Clinically Significant or Otherwise Common Off-Label Uses of Lexapro (escitalopram oxalate)
- Social anxiety disorder (SAnD) - it’s OK; sucking less than most other meds is Lexapro’s biggest advantage.
- Obsessive compulsive disorder (OCD) - the odds are good it’ll work.
- Post traumatic stress disorder (PTSD) - not a lot of data.
- Panic Disorder
- Bipolar depression.
See the page on Lexapro’s efficacy for details on the likelihood Lexapro will work for approved indications and off-label uses.
Just because a medication is approved or commonly prescribed for a particular condition doesn’t necessarily mean you should be taking it for that condition. There could be a drug that might be better to try first, or at least talk to your doctor about trying first, such as Topamax instead of Depakote as a daily med to prevent migraines (and Topamax has its own reasons why you should and should not take it). Or the condition you have isn’t bad enough to warrant medication at all. E.g. any antidepressant if you’re not so depressed that you can function at relatively the same level as you do when you’re not depressed.
§4. When/Why You Should Take Lexapro (escitalopram oxalate)
You haven’t tried any antidepressant before, you and your doctor both think you need one, your symptoms don’t scream Wellbutrin (anhedonia, unable to conceive on how to begin anything), but are still pretty bad and you need something to work sooner than later. And your insurance will pay for it.
§5. When/Why You Should NOT Take Lexapro (escitalopram oxalate)
If Celexa didn’t work for you, or Celexa is working for you with side effects that really aren’t as bad as you think they are.
The only side effects that are less likely to be problems with Lexapro than Celexa are drowsiness and weight gain. The key phrase being less likely. The good news is switching back to Celexa if Lexapro doesn’t work for you is less likely to result in SSRI poop-out or becoming treatment-resistant when neither of those would have happened if you just stayed with Celexa. The bad news is “less likely to” does not equal “won’t.”
When all else fails and you’ve run out of other options, Lexapro may be your last best chance at treating an obscure or treatment-resistant condition.
Be careful! Otherwise safe meds can be downright dangerous when used for some things.
§6. Less Common/Experimental Off-Label Uses of Lexapro
- Impulsive-compulsive Internet Usage Disorder. IC-IUD is better known as “Internet addiction,” and it’s real. The big question is: if you found this page when searching for Internet addiction, Internet usage disorder, or something similar, do you have IC-IUD, cyberchondria, or both? And if it’s both, should you take a medication for it? Lexapro seems to help with IC-IUD, talk therapy combined with workbooks is still your best bet for cyberchondria.
§7. Failed Off-Label Uses
- Fear of public speaking. When you have no brain cooties. It didn’t just fail, Lexapro made it worse! Why someone thought taking an SSRI as required would be a good idea is beyond me. But either they don’t know how to write an abstract, or how SSRIs work, as the conclusion contradicts the title.
- Kleptomania. In all fairness, nothing seems to work for kleptomania. A woman who was in the lock ward with me had been undergoing ECT for a month to treat kleptomania, and she was still stealing stuff.
§8. Potentially Dangerous Off-Label Uses
1 Before Cymbalta (duloxetine) was approved as an antidepressant in the US it was already approved in the EU, but only for stress urinary incontinence and sold under the trade name Yentreve. Duloxetine is now sold in the EU as an antidepressant under the trade name Cymbalta.
A better known, if slightly different example is bupropion. According to the 2007 edition of Mosby's Drug Consult, in the US, Canada and Singapore you can get both Wellbutrin (bupropion) as an antidepressant or as Zyban (bupropion) to stop smoking. In Korea, Thailand and most of South America (but not Brazil) you can get bupropion (under various trade names) only as an antidepressant. In Brazil, the EU & UK, Israel, India, Australia and New Zealand it's only available as Zyban to help you stop smoking.
Date created 05 Dec 2010 - 13:49 Page Creator: Jerod Last edited by: Jerod Poore
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1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.
2 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?
[begin rant] I rent a dedicated server for Crazy Meds. It’s sitting on a rack somewhere in Southern California along with a bunch of other servers that other people have rented. The hardware is identical, but no two machines have exactly the same operating systems. I don’t even need to see what is on any of the others to know this. If somebody got their server at the exact same time, with the exact same features as I did, I’m confident that there would be noticeable differences in some aspects of the operating systems. So what does this mean? For one thing it means that no two computers in the same office of a single company have the same operating system, and the techs can spend hours figuring out what the fuck the problem could be based on that alone. It also means that application software like IP board that runs the forum here has to have so many fucking user-configurable bells and whistles that even when I read the manual I can’t find every setting, or every location that every flag needs to be set in order for a feature to run the way I want it to run. And in the real world it means you can get an MBA not only with an emphasis on resource planning, but with an emphasis on using SAP - a piece of software so complex there are now college programs on how to use it. You might think, “But don’t people learn how to use Photoshop or Adobe Illustrator in college?” Sure, in order to create stuff. And in a way you’re creating stuff with SAP. But do you get a Bachelor of Fine Arts degree with an emphasis on Photoshop?
Back in the Big Iron Age the operating systems were proprietary, and every computer that took up an entire room with a raised floor and HVAC system, and had less storage and processing power than an iPhone, had the same operating system as every other one, give or take a release level. But when a company bought application software like SAP, they also got the source code, which was usually documented and written in a way to make it easy to modify the hell out of it. Why? Because accounting principles may be the same the world over, and tax laws the same across each country and state, but no two companies have the same format for their reports, invoices, purchase orders and so forth. Standards existed and were universally ignored. If something went wrong it went wrong the same way for everyone, and was easy to track down. People didn’t need to take a college course to learn how to use a piece of software.
I’m not against the open source concept entirely. Back then all the programmers read the same magazines, so we all had the same homebrew utilities. We even had the forerunner to QR Code to scan the longer source code. Software vendors and computer manufacturers sponsored conventions so we could, among other things, swap recipes for such add-ons and utilities. While those things would make our lives easier, they had nothing to do with critical functions of the operating system. Unless badly implemented they would rarely cause key application software to crash and burn. Whereas today, with open source everything, who the hell knows what could be responsible some part of a system failing. [/end rant]
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