How Safe is the Latest SSRI Drug on Children and the Elderly in the Treatment of Depression

SSRI drugs – that is, drugs belonging to the Selective Serotonin Reuptake Inhibitor class of drugs – are used in the treatment of depression and generalized anxiety disorders. The latest such drug to enter the US market is Lexapro, whose active principle is escitalopram oxalate. Available in the US since 2002, Lexapro is superior to older SSRI drugs by way of smaller dosage, quicker onset of action, and milder side-effects in most cases. Yet, it is not without side-effects altogether and therefore requires expert medical attention during the treatment. This is particularly true in the cases of child and elderly patients.

Children and adolescents: Though the potential side-effects of Lexapro on children and adolescents is the same as for adults, the younger patients require special attention because they may not thoroughly understand their medical condition and the effects of the anti-depressants, especially an SSRI, with which they are being medicated.The side-effects manifest in pediatric treatment more quickly than in adults. These side-effects include: panic attacks; agitation; aggressive or irrational behavior; increase in worry, anxiety and/or depression; suicidal thoughts; insomnia; unusual excitation; or any abrupt changes in behavior.

These side-effects arise in the first few days to about three weeks of the start of treatment and taper off thereafter, though exceptions have been noted.Parents must make it a point to report to the doctor every sign of abnormal behavior in their child taking Lexapro. The doctor is the only person to decide the course of action – which may be a reduction in dosage, or administration of an additional medicine to cope with specific side-effects, or a change of medication, or simply an advice to live with the side-effects through the first few weeks. In any event, children and adolescents need constant attention from parents or guardians to ensure that they do not end up doing something drastic as the side-effects run their course.

Elderly patients: The pleasant information concerning Lexapro is that its side-effects on elderly patients are much less than that of other SSRI drugs such as Paxil, Prozac, and Zoloft. The specific side-effect on which Lexapro scores above the other SSRIs is: suicidal tendency. Since elderly patients usually have the thought of death in their mind, aggravation of their depressive or anxiety disorder (as an initial side-effect of SSRI treatment) can be understood to fuel suicidal tendencies.

But a research in Canada has shown that elderly patients taking Paxil, Prozac, and Zoloft are nearly five times more likely to commit suicide in the first month of treatment than those talking Lexapro or other classes of anti-depressants. As for side-effects other than the suicidal thought, they are of the same nature but higher intensity in elderly patients than in younger patients. This is because the body system of the elderly is less adaptable to the physiological changes caused by Lexapro and other anti-depressants, even though these changes are temporary. Therefore, as with children and adolescents, elderly patients too need close medical attention and family care to avoid self-harm in the course of their treatment.