Zulresso vs. Lexapro

Zulresso (brexanolone) Injection and Lexapro (escitalopram) are antidepressants used to treat depression.

Zulresso is specifically used to treat postpartum depression (PPD) in adults. Zulresso is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) called the Zulresso REMS.

Lexapro is also used to treat anxiety in adults.

Zulresso and Lexapro are different types of antidepressants. Zulresso is a neuroactive steroid gamma-aminobutyric acid (GABA) A receptor positive modulator and Lexapro is a selective serotonin reuptake inhibitor (SSRI).

Side effects of Zulresso and Lexapro that are similar include drowsiness and dry mouth.

Side effects of Zulresso that are different from Lexapro include sleepiness, loss of consciousness, flushing, and hot flushes.

Side effects of Lexapro that are different from Zulresso include dizziness, sleep problems (insomnia), nausea, upset stomach, gas, heartburn, constipation, weight changes, yawning, ringing in the ears, decreased sex drive, impotence, and difficulty having an orgasm.

Both Zulresso and Lexapro may interact with other antidepressants and other drugs that make you sleepy (sleeping pills, narcotics, muscle relaxers, or medicines for anxiety or seizures.

Lexapro may also interact with alcohol, nonsteroidal anti-inflammatory drugs (NSAIDs), medicines to treat mood disorders or mental illness, lithium, St. John's wort, tramadol, L-tryptophan, blood thinners, migraine headache medications, and stimulants or ADHD medications.

Do not stop using Lexapro suddenly, or you could have unpleasant withdrawal symptoms.

Common side effects of Zulresso include:

• nausea
• diarrhea
• dry mouth
• constipation
• vomiting
• gas
• dizziness
• abnormal dreams
• itching, and
• decreased sexual desire

Common side effects of Lexapro include:

• drowsiness,
• dizziness,
• sleep problems (insomnia),
• nausea,
• upset stomach,
• gas,
• heartburn,
• constipation,
• weight changes,
• dry mouth,
• yawning,
• ringing in the ears,
• decreased sex drive,
• impotence, or
• difficulty having an orgasm.

Zulresso (vortioxetine) tablets are an antidepressant indicated for the treatment of major depressive disorder (MDD).

Lexapro is a prescription medicine used to treat depression. It is important to talk with your healthcare provider about the risks of treating depression and also the risks of not treating it. You should discuss all treatment choices with your healthcare provider. Lexapro is also used to treat:

• Major Depressive Disorder (MDD)
• Generalized Anxiety Disorder (GAD)

Talk to your healthcare provider if you do not think that your condition is getting better with Lexapro treatment.

Zulresso may interact with monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), triptans, buspirone, tramadol, tryptophan products, NSAIDs, aspirin, warfarin, bupropion, fluoxetine, paroxetine, quinidine, rifampicin, carbamazepine, and phenytoin. Tell your doctor all medications and supplements you use.

Do not take Lexapro if you:

• are allergic to escitalopram oxalate or citalopram hydrobromide or any of the ingredients in Lexapro. See the end of this Medication Guide for a complete list of ingredients in Lexapro.
• take a monoamine oxidase inhibitor (MAOI). Ask your healthcare provider or pharmacist if you are not sure if you take an MAOI, including the antibiotic linezolid.
• take the antipsychotic medicine pimozide (Orap®) because taking this drug with Lexapro can cause serious heart problems.

Do not take an MAOI within 2 weeks of stopping Lexapro unless directed to do so by your physician.

Do not start Lexapro if you stopped taking an MAOI in the last 2 weeks unless directed to do so by your physician.

People who take Lexapro close in time to an MAOI may have serious or even life-threatening side effects. Get medical help right away if you have any of these symptoms:

• high fever
• uncontrolled muscle spasms
• stiff muscles
• rapid changes in heart rate or blood pressure
• confusion
• loss of consciousness (pass out)

Before starting Lexapro, tell your healthcare provider if you:

• Are taking certain drugs such as:
• Triptans used to treat migraine headache
• Medicines used to treat mood, anxiety, psychotic or thought disorders, including tricyclics, lithium, SSRIs, SNRIs, amphetamines, or antipsychotics
• Tramadol
• Over-the-counter supplements such as tryptophan or St. John's Wort

• have liver problems
• have kidney problems
• have heart problems
• have or had seizures or convulsions
• have bipolar disorder or mania
• have low sodium levels in your blood
• have a history of a stroke
• have high blood pressure
• have or had bleeding problems
• are pregnant or plan to become pregnant.

It is not known if Lexapro will harm your unborn baby. Talk to your healthcare provider about the benefits and risks of treating depression during pregnancy are breast-feeding or plan to breast-feed. Some Lexapro may pass into your breast milk. Talk to your healthcare provider about the best way to feed your baby while taking Lexapro. Tell your healthcare provider about all the medicines that you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Lexapro and some medicines may interact with each other, may not work as well, or may cause serious side effects.

Your healthcare provider or pharmacist can tell you if it is safe to take Lexapro with your other medicines. Do not start or stop any medicine while taking Lexapro without talking to your healthcare provider first.

If you take Lexapro, you should not take any other medicines that contain escitalopram oxalate or citalopram hydrobromide including: Celexa.

Especially tell your healthcare provider if you take:

• triptans used to treat migraine headache
• medicines used to treat mood, anxiety, psychotic or thought disorders, including tricyclics, lithium, buspirone, SSRIs, SNRIs or MAOIs
• tramadol and fentanyl
• amphetamines
• cimetidine
• the antibiotics ciprofloxacin, enoxacin
• medicine to treat irregular heart rate (like propafenone, flecainide, quinidine)
• theophylline
• the blood thinner warfarin (Coumadin, Jantoven)
• non-steroidal anti-inflammatory drug (NSAID) (like ibuprofen, naproxen or aspirin).
• over-the-counter supplements such as tryptophan or St. John's Wort
• thioridazine (Mellaril). Mellaril together with Lexapro can cause serious heart rhythm problems or sudden death.

Ask your healthcare provider for a list of these medicines if you are not sure.

Do not take Lexapro with any other medicine that contain duloxetine.

The recommended starting dose of Zulresso is 10 mg administered orally once daily without regard to meals. Dosage should then be increased to 20 mg/day, as tolerated.

Take Lexapro exactly as prescribed. Your healthcare provider may need to change the dose of Lexapro until it is the right dose for you.

Lexapro may be taken with or without food.

If you miss a dose of Lexapro, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of Lexapro at the same time.

If you take too much Lexapro, call your healthcare provider or poison control center right away, or get emergency treatment.