By Melissa Tennen, HealthAtoZ writer
The assaults pounded her one after another. Her father's death. A difficult pregnancy. A divorce. Becoming a single parent to 4-year-old Brianna.
And then, crash...Donna Johnson realized she was depressed.
"I really struggled with the decision to go on antidepressants," Johnson said. "It was just the realization that I could not handle this on my own without medication."
She worried about the side effects when she started taking Celexa®: a diminished sex drive, a chance of weight gain and daytime sleepiness from Celexa. They all had become too much for Johnson. Her doctor found an answer - Lexapro®.
Lexapro is a selective serotonin re-uptake inhibitor (SSRI), which work on brain chemicals controlling emotion and thought. Experts believe that serotonin, which normally remains outside of brain cells, are absorbed by cells in people with depression, altering mood by changing normal levels of serotonin.
Lexapro promises to help lift depression without the typical side effects of similar drug giants Prozac and Zoloft. While providing good results with treatment, SSRIs can cause sexual problems, weight gain and insomnia. Some 40 percent of people on a given SSRI stop because of side effects. Lexapro's maker, Forest Laboratories in New York City, said the only significant side effect is nausea, which usually goes away as the body adjusts. Also, the drug's potency is stronger, requiring less medication to get the same result. With the high cost of patented prescription drugs, this makes Lexapro more cost competitive.
The drug also works faster, taking one to two weeks for people to start feeling better. Other SSRIs may take four to six weeks to take effect. With severe depression, this is particular good news. The sooner a person is helped out of a depressive episode, the less likely the risk of suicide.
Celexa, a predecessor to Lexapro, is no longer promoted by its manufacturer since it can now be available generically, meaning that Forest no longer has exclusive rights to make Celexa.
Psychiatrist Andrew Farah, M.D., welcomes the new drug.
"I'm really confident about this drug," said Farah, medical director for behavioral health at High Point Regional Health Systems in North Carolina and one of the first physicians to prescribe Lexapro. "It represents the elegant refinement of this class of drugs," he says.
Lexapro's approval by the Food and Drug Administration (FDA) was based on clinical trials of 1,100 men and women with moderate to severe depression between the ages of 18 to 65 years old.
Antidepressants mean big bucks for pharmaceutical companies. Eli Lily lost its patent for Prozac in 2001, allowing other manufacturers to create less costly versions. Prozac was the first SSRI to hit the market in 1988 and perhaps the most famous. Eli Lilly has tried to recapture its multi-billion dollar product by creating other related drugs such as Sarafem, a drug to treat premenstrual dysphoric disorder (PMDD). Sarafem is similar to Prozac's formulation.
Each year, nearly 19 million American adults suffer from a depressive illness, according to the National Institutes of Health. One out of every four women and one out of every 10 men are diagnosed with depression throughout their lifetime. Annually, depression costs the United States an estimated $44 billion in terms of lost workdays, productivity and other factors. The World Health Organization predicts depression will be the leading cause of disability by the year 2020.
 Children, teens and adults being treated with antidepressants, particularly anyone being treated for depression, should be watched closely for worsening of depression and for increased suicidal thinking or behavior. Close watching may be especially important early in treatment or when the dose is changed - either increased or decreased. Bring up your concerns immediately with a doctor.
Paxil may increase the risk for birth defects, particularly heart defects, when women take it during the first three months of pregnancy, according to a 2005 advisory from the FDA. The FDA is waiting for the results of recent studies to better understand the higher risk. Discuss with your doctor about the health risks of Paxil if you plan to become pregnant or are in the first three months of pregnancy. You may want to consider taking a different antidepressant. Do not stop taking the drug without first talking to your doctor.
This article was reviewed and updated June 2007.
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