Lexapro Vs. Trazodone: Drug Comparison

Lexapro^® (escitalopram) is a selective serotonin reuptake inhibitor (SSRI) used to treat anxiety and depression by increasing available serotonin levels in the brain, which helps improve mood and reduce anxiety. Its FDA-approved indications include the treatment of major depressive disorder (MDD) and generalized anxiety disorder (GAD) in adults and adolescents. Off-label uses may include treating panic disorder, obsessive-compulsive disorder (OCD), and social anxiety disorder. Lexapro is available in tablet and oral solution forms, taken once daily. Common side effects include nausea, insomnia, and sexual dysfunction, and it carries a boxed warning for an increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults, particularly during the initial stages of treatment.

Trazodone is an antidepressant that works by inhibiting serotonin reuptake and blocking certain serotonin receptors, helping to improve mood and alleviate symptoms of depression. Its FDA-approved indication is for the treatment of major depressive disorder (MDD) in adults. Off-label uses include treating insomnia, anxiety, and chronic pain. Trazodone is available in tablet form, typically taken once or twice daily, often at bedtime due to its sedating effects. Common side effects include swelling, drowsiness, nasal congestion, dizziness, and dry mouth. There is a risk of increased suicidal thoughts and behaviors in children, adolescents, and young adults, similar to other antidepressants.

Selective serotonin reuptake inhibitor (SSRI)

Selective serotonin reuptake inhibitor (SSRI)

Lexapro (escitalopram) is indicated for the:

• Treatment of major depressive disorder (MDD) in adults and pediatric patients 12 years of age and older

• Treatment of generalized anxiety disorder (GAD) in adults and pediatric patients 7 years and older

Trazodone is indicated:

• For the treatment of major depressive disorder (MDD)

• Typically taken orally once daily

• Comes in 5 mg, 10 mg (scored), and 20 mg (scored) tablets

• Typically taken orally in divided doses per day

• Comes in 50 mg, 100 mg, 150 mg, and 300 mg tablets

Most commonly observed adverse reactions (incidence ≥ 5% and at least twice the incidence of placebo patients) are:

• Insomnia

• Ejaculation disorder (primarily ejaculatory delay),

• Nausea

• Sweating increased

• Fatigue and sleepiness

• Decreased libido

• Inability to orgasm

Most common adverse reactions (incidence ≥ 5% and twice that of placebo) are:

• Swelling

• Blurred vision

• Fainting

• Drowsiness

• Fatigue

• Diarrhea

• Nasal congestion

• Weight loss

• Do not use MAOIs intended to treat psychiatric disorders with Lexapro or within 14 days of stopping treatment with Lexapro. Do not use Lexapro within 14 days of stopping an MAOI intended to treat psychiatric disorders. In addition, do not start Lexapro in a patient who is being treated with linezolid or intravenous methylene blue

• Concomitant use of pimozide

• Known hypersensitivity to escitalopram or citalopram or any of the inactive ingredients

• Drug interactions: SSRIs, SNRIs, tryptophan, drugs that affect hemostasis (NSAIDs, aspirin, warfarin)

• Concomitant use of monoamine oxidase inhibitors (MAOIs), or use within 14 days of stopping MAOIs

• Drug interactions: CNS depressants, CYP3A4 inhibitors, CYP3A4 inducers, digoxin, phenytoin, warfarin

• Serotonin syndrome

• Discontinuation syndrome

• Seizures

• Activation of mania/hypomania

• Low blood sodium: Can occur in association with syndrome of inappropriate antidiuretic hormone secretion

• Increased risk of bleeding

• Interference with cognitive and motor performance

• Angle closure glaucoma

• Use in patients with concomitant illness

• Sexual dysfunction

• Pregnancy: SSRI use, particularly later in pregnancy, may increase the risk for persistent pulmonary hypertension and symptoms of poor adaptation (respiratory distress, temperature instability, feeding difficulties, hypotonia, tremor, irritability) in the neonate

• Serotonin syndrome

• Cardiac arrhythmias

• Positional low blood pressure and fainting

• Increased risk of bleeding

• Prolonged erection

• Activation of mania or hypomania

• Potential for cognitive and motor impairment

• Angle-closure glaucoma

WARNING: SUICIDAL THOUGHTS AND BEHAVIORS

Increased risk of suicidal thoughts and behavior in pediatric and young adult patients taking antidepressants. Closely monitor all antidepressant-treated patients for clinical worsening and emergence of suicidal thoughts and behaviors. Lexapro is not approved for use in pediatric patients less than 7 years of age.

WARNING: SUICIDAL THOUGHTS and BEHAVIORS

Antidepresants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients.

Closely monitor for clinical worsening and emergence of suicidal thoughts and behaviors.

Trazodone hydrochloride tablet is not approved for use in pediatric patients.

*This information is from the label for brand name Lexapro^®. See the Full Prescribing Information for more complete information. Escitalopram, the active ingredient in Lexapro, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient escitalopram.

*This information is from the trazodone hydrochloride label used by Accord Healthcare, Inc. See the Full Prescribing Information for more complete information. This information may not be accurate for all medications that include the active ingredient trazodone.