Lexapro is a selective serotonin reuptake inhibitor (SSRI) antidepressant used to treat depression and anxiety disorders. Recent research indicates that drugs included in this class may be associated with an increased risk of birth defects and autism when used during pregnancy.

What is Lexapro?

Lexapro is marketed by Forest laboratories, and was approved by the U.S. Food & Drug Administration (FDA) in 2002. The medication is currently approved to treat:

  • Major depressive disorder in adults and adolescents 12 or older
  • Generalized anxiety disorder in adults

Like other SSRIs, Lexapro works by blocking the reabsorption, or reuptake, of the neurotransmitter serotonin in the brain.

Lexapro Side Effects

Rare side effects that require medical attention include:

  • Coma
  • Confusion
  • Convulsions
  • Decreased urine output
  • Dizziness
  • Fast or irregular heartbeat
  • Headache
  • Increased thirst
  • Muscle pain or cramps
  • Nausea or vomiting
  • Shortness of breath
  • Swelling of the face, ankles, or hands
  • Unusual tiredness or weakness

Common side effects associated with Lexapro include:

  • Constipation
  • Decreased interest in sexual intercourse
  • Diarrhea
  • Dry mouth
  • Ejaculation delay
  • Gas in the stomach
  • Heartburn
  • Inability to have or keep an erection
  • Loss in sexual ability, desire, drive, or performance
  • Sleepiness or unusual drowsiness
  • Trouble sleeping

Less common side effects include:

  • Bloated or full feeling
  • Burning, crawling, itching, numbness, prickling, “pins and needles”, or tingling feelings
  • Chills
  • Cough
  • Decreased appetite
  • Excess air or gas in the stomach or intestines
  • Fever
  • General feeling of discomfort or illness
  • Increased sweating
  • Joint pain
  • Muscle aches and pains
  • Inability to have an orgasm
  • Pain in the neck or shoulders
  • Pain or tenderness around the eyes and cheekbones
  • Passing gas
  • Runny nose
  • Shivering
  • Sneezing
  • Sore throat
  • Stuffy nose
  • Tightness of the chest
  • Tooth problems
  • Trouble breathing
  • Unusual dreams
  • Unusual drowsiness, dullness, tiredness, weakness or feeling of sluggishness
  • Yawning

Lexapro and Suicide

The labels for Lexapro and other SSRI antidepressants include a Black Box Warning regarding a potential association with suicidal thoughts in children, adolescents and young adults. The Black Box, the FDA’s most serious safety alert, was originally added to the label in 2004 to warn of an increased risk of suicidality in children and adolescents. It was later expanded to include young adults, ages 18 to 24. Read More

Lexapro, Birth Defects & Autism

Lexapro is a Pregnancy Category C drug, which indicates that its affects on a developing pregnancy are not well-studied. It should not be taken by expectant or nursing mothers unless the benefits outweigh the risks.

Recently, some studies have indicated that Lexapro and other SSRIs might be associated with an increased risk of certain birth defects. In 2006, the FDA issued a warning regarding a possible association between SSRI and persistent pulmonary hypertension of the newborn (PPHN). However, conflicting studies have since caused the agency to backtrack.

Other birth defects that may be associated with the use of SSRIs include:

  • Aorta coarctation
  • Heart defects
  • Transposition of the great arteries (TGA)
  • Tetralogy of fallot (TOF)
  • Hypoplastic left heart syndrome
  • Craniosynostosis (skull defect)
  • Club foot
  • Omphalocele
  • Spina bifida

A recent study also found that children exposed to SSRIs during the last two trimesters of pregnancy were 117% more likely to be diagnosed with autism spectrum disorder.

  1. FDA (2014) “Approved Medication Guide” http://www.fda.gov/downloads/Drugs/DrugSafety/ucm088620.pdf
  2. FDA (2007) “FDA Drug Safety Communication: Antidepressant Use in Children, Adolescents, and Adults.” http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm096273.htm
  3. FDA (2006) “FDA Public Health Advisory: Treatment Challenges of Depression in Pregnancy and the Possibility of Persistent Pulmonary Hypertension in Newborns.” http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm124348.htm
  4. NCBI (2006) “SSRI Antidepressants and Birth Defects” http://www.ncbi.nlm.nih.gov/pubmed/17167929
  5. BMJ (2009) “Selective serotonin reuptake inhibitors in pregnancy and congenital malformations: population based cohort study” http://www.bmj.com/content/339/bmj.b3569
  6. MedPage Today (2011) “More Evidence SSRIs in Pregnancy Boost Birth Defect Risk” http://www.medscape.com/viewarticle/745430
  7. NEJM (2007) “Use of Selective Serotonin-Reuptake Inhibitors in Pregnancy and the Risk of Birth Defects” http://www.nejm.org/doi/full/10.1056/NEJMoa066584
  8. JAMA Pediatrics (2016) “Antidepressant Use During Pregnancy and the Risk of Autism Spectrum Disorder in Children” http://archpedi.jamanetwork.com/article.aspx?articleid=2476187
Last Modified: February 23, 2016

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