Medication approval journey

escitalopram (Lexapro)

Approved for Major depressive disorder in adults

FDA approvedSSRI antidepressantTaper risk: moderate

Before changing anything

Stopping abruptly causes withdrawal effects that can be severe

Stopping or reducing an SSRI too fast commonly causes withdrawal symptoms — dizziness, electric-shock sensations, insomnia, agitation. These are often more severe and far longer-lasting than the "one to two weeks" many people are told. Any change should be a slow, prescriber-supervised taper.

How long the trials actually ran

The gap between how long the trials ran and how long people actually take these medications is the single most important thing on this page. It is not evidence that longer use is unsafe or ineffective. It is evidence that longer use was not what got tested.

The approval, step by step

  1. Step 1

    What the approval was actually based on

    Which studies did the FDA rely on, how long did they run, and who was in them?

    The efficacy of Lexapro as a treatment for major depressive disorder was established in three, 8-week, placebo-controlled studies conducted in outpatients between 18 and 65 years of age who met DSM-IV criteria for major depressive disorder.
  2. Step 2

    The approval

    When was it approved, under what application, and by whose review?

    Approved
    August 14, 2002
    Application
    NDA021323
    Review
    STANDARD
  3. Step 3

    What was added after it was on the market

    Which warnings arrived only after millions of people were already taking it?

  4. Step 4

    What independent research has found since

    What has been learned by people who were not selling it?

  5. Step 5

    What still is not known

    Which questions you might reasonably have has nobody answered yet?

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