Lexapro and Long Term Effectiveness for GAD (Generalized Anxiety Disorder)

What is Lexapro?

Chances are, if you watch TV or listen to the radio, you have heard of Lexapro, a drug that makes people happier than they have been in years. You have probably also heard commercials for Lexapro that talk about lowering anxiety, especially for those with generalized anxiety disorder (GAD). But what is this supposed miracle drug, Lexapro? What does it do to our bodies? And, ultimately, what is the long term effectiveness of Lexapro for GAD?

First off, Lexapro is a prescription medication most commonly prescribed for those with depression or generalized anxiety disorder. Lexapro is considered to be an antidepressant, or in scientific terms, an SSRI. SSRI stands for selective serotonin reuptake inhibitor, which sounds very confusing but is actually quite simple, and easily explains what Lexapro does on a neurological level. So, in order to understand the long term effectiveness of Lexapro for GAD, we first need to understand what Lexapro does in the brain.

What does Lexapro do?

Lexapro is an SSRI, or selective serotonin reuptake inhibitor. It specifically acts on the neurotransmitter serotonin, which is a chemical in our brain that needs to stay in a delicate balance in order for us to feel happy, anxious, or sad at appropriate times. People who have depression or generalized anxiety disorder take Lexapro to keep this delicate balance in check, which allows them to lead more normal lives.

How does Lexapro keep that balance in check? Well, when serotonin is released in our brains (in situations when we are happy, sad or anxious) it is released by neurons, cells in our brain that “fire” off chemical signals that are the basis of our emotions. These neurons release serotonin, which then hangs around in a special place between the neurons of our brain called the synaptic cleft, the levels of which end up affecting our emotions. Serotonin is then transferred from the cleft to other neighboring neurons, a process called reuptake, which can end the emotion we were feeling before.

Lexapro acts on the reuptake process, specifically inhibiting, or blocking, the reuptake of serotonin from the synaptic clefts. Thus, because the levels of serotonin in our brains are directly related to our happiness and anxiety levels, Lexapro basically stabilizes serotonin, and thus achieves a normal balance of positive emotions and anxiety in our brains.

What is the long term effectiveness of Lexapro for GAD?

Now that we know how Lexapro works, we can discuss its effectiveness, especially in treating GAD. Generalized Anxiety Disorder is characterized by high anxiety levels, restlessness, fatigue, and muscle tension. Serotonin imbalances in the brain have been shown to have strong correlations to the symptoms of Generalized Anxiety Disorder, and Lexapro has been clinically proven to balance serotonin levels, and therefore improve all of these symptoms over a short term 8-week trial period. But what about the long term effectiveness of Lexapro?

A double-blind study published in 2005 that compared the effectiveness of Lexapro vs. Paxil specifically focused on the long-term effectiveness of the drug. In the study, 120 participants were randomly assigned to either the group taking Lexapro, or the group taking Paxil. Then, they filled out a survey scale called HAMA (Hamilton Anxiety Score), which asks questions on positive and negative life satisfaction and levels of anxiety. After the first surveys were completed, each group continued to take their assigned medication for 24 weeks, and at the end of the trial period all participants filled out another set of surveys.

The results from the above study are impressive, in that both groups experienced much less overall anxiety and higher life satisfaction. Those taking Lexapro were slightly happier overall, but also had fewer negative side effects when compared to the Paxil group. In fact, those taking Paxil were much more likely to report constipation (14.5% vs. 1.6%) and anorgasmia (26.2% vs. 5.6%). The authors of the article even recommended making Lexapro the drug of choice for GAD.

While there is clinical research that shows a long term increase in quality of life among GAD patients who continue taking Lexapro, there seems to be no strong scientific consensus on the topic. Those with GAD are strongly encouraged to talk with their doctors about the possible pros and cons of taking Lexapro, especially for long term treatment.

References

1. Healthy Place - https://www.healthyplace.com/lexapro/patient-center/lexapro-pharmacology-escitalopram-oxalate/menu-id-1861/

2. Web MD - https://www.webmd.com/anxiety-panic/guide/generalized-anxiety-disorder

3. Pub Med - https://www.ncbi.nlm.nih.gov/pubmed/17825130

4. MT.gov - https://medicaidprovider.hhs.mt.gov/pdf/bielskistudy.pdf