Escitalopram (Lexapro) is an SSRI (selective serotonin reuptake inhibitor). That means it is a lot like fluoxetine (Prozac). We have lost confidence in the FDA’s ability monitor generic drug quality. The continuing reports of carcinogen contamination of ARB (angiotensin receptor blocker) blood pressure medications are a case in point. Even when manufacturers follow the rules, they are allowed to substitute different inactive ingredients compared to the brand name they are presumably copying. This reader reports problems with generic escitalopram because of such substitution.

Hives from Generic Escitalopram (Lexapro):

Q. I originally took Lexapro for depression without problems. When I started the generic escitalopram, I got hives.

I worry about generic drug quality control in foreign countries, so I checked the price of brand name Lexapro. It is nearly $500 a month, which I can’t afford. So, my thought was to get the brand name version from Canada where it is much cheaper. Do you have a list of trustworthy Canadian pharmacies?

A. According to, the average retail price of Lexapro in the U.S. is $419 a month. Even with their coupon, the price is still high, at around $360 a month. In Canada, the price of brand name Lexapro runs anywhere from $60 to $100 for the same amount.

Another reader reported a different kind of problem with generic escitalopram:

“I was taking generic escitalopram (name-brand is called Lexapro) for anxiety and started getting irregular heart beats. The cardiologist said they were benign PVCs, they just happen. Well, I was getting this arrhytmia a dozen times per day and it was very uncomfortable. So I tried eliminating medications one by one for several days each.

“First to go was levothyroxine for thyroid. Nope, condition persisted. So got back on that med.
Knocked out lisinopril for BP. No luck, got back on it. Dropped fenofribrate for high triglycerides. Still had PVCs, so went back on the feno.

“At that point, the only other med was escitalopram and I couldn’t imagine it was doing this to me, so I didn’t bother with it. Well, I got a prescription refill of the escitalopram and noticed that the maker of the generic drug had changed. Bam! Immediately, lots and lots of PVCs. So I quit the escitalopram for a week and the PVCs went away. Took another one and they came back. Got off it and they went away for good. Doc prescribed a week’s worth of name-brand Lexapro and I took one and had only a couple of PVCs, but didn’t want to fool with it anymore. I am sure of two things:

“• Escitalopram may trigger PVCs in me.
 • The generic version triggered literally hundreds of PVCs per day!!

“My belief is that the generic makers have poor quality control, or are deliberately putting inferior ‘carrier’ substances into their tablets to save money. If the heart palpitations ever come back from taking another med, I’ll ask the doctor to get me name-brand, made in the US or Europe, not some back alley in Bangalore, and see if that solves the problem.”

Mary Bell reported a very odd experience with generic escitalopram (Lexapro):

“Here is my ONE of a couple experiences I have had with generic escitalopram (Lexapro). I have been taking this generic, escitalopram, for about 10 years. I started a refill and about 3 weeks later I began smelling phantom cigarette smoke many times a day. This experience was so strange! I would look around me; no one was smoking. At home, when I smelled the smoke, I would ask my daughter (who had quit smoking a yr before) if she was sneaking a smoke. She thought I was going crazy.

“Finally, after about a month and a half of smelling cigarette smoke, having nasty headaches and being so nauseous I could barely eat, I called my PC. He was alarmed and ordered a brain scan. Meanwhile, I explained to the pharmacist what I was experiencing. The pharmacy ‘poo-pooed”’any link between my issues and my escitalopram.

“Long story short, my PC contacted the pharmacy. The Rx manager was on the phone very quickly (within a couple of days apologizing for the treatment I received from his underling. He immediately notated in my file that I was not to take that generic manufacturer’s product again. Within three weeks of stopping the BAD generic I was no longer smelling cigarette smoke, experiencing nausea or headaches.”

Cheryl also had a problem with generic escitaloprm (Lexapro).

“I never realized there were different manufacturers for generic medications. I recently refilled a prescription for escitalopram, which I’ve been taking with great success for a long time. But shortly after I got the refill, I started having really pronounced symptoms. I’ve been joking, ‘who switched my Lexapro for placebos?’

“I called the pharmacy today just to make sure there hadn’t been a mixup. The pharmacist told me they’d switched manufacturers for escitalopram. I asked more questions and found that the generic made by XXX was working just fine, but on the recent refill I got the generic made by YYY. I might as well be taking tic tacs.

“My doctor called every pharmacy in town, and no one has the XXX escitalopram. So now she’s calling in a script for Lexapro name brand only, no generic. It absolutely infuriates me, because the generic has been working so well for such a long time. Now I’m going to have to pay more for brand name. It doesn’t feel fair.”

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  1. JMT

    I too had problems with generic Lexapro. I was excited when it first became available in 2013, but after 6 weeks of using it, my depression had returned, and I had very uncomfortable side effects. My PA was supportive and reported it to the FDA, but it has been a constant battle with my pharmacy to keep the brand name stocked. My insurance company will only reimburse a small part of it, and my doctor’s office folks usually forget to call it in as “dispensed as written”.

    My pharmacy doesn’t take me seriously. They seem to think all generics are as good as the original, won’t call me if the doctor’s office sends the prescription in wrong, and won’t order any other brand of generic for me to try. Unfortunately, I am rural and can’t change pharmacies without driving more than 65 miles. And now I’m finding a difference in two different generic brands of lamotrigine. We really need more oversight on this.

  2. Phyllis

    I’m trying to find out which generic anti-depressant is the most successful in treating depression.

  3. Cari

    I’m frightened of anything generic. Who knows what they are putting in it? As far as the medication in question goes, I gained fifty lbs when taking it. I had always been thin to average until I took that nasty drug. As soon as I weaned off of it, the weight just fell off without having to do anything different with my diet. Also, I was getting severe nosebleeds and required one ER visit and several cauterizations. As far as I’m concerned, it’s a nasty drug.

  4. Mark

    Other than our subjective experience with a generic, which may or may not be reliable, especially if one is taking several medications, how can we determine if a generic medicine contains what it’s supposed to contain?

    Can you recommend any labs that conduct such tests for a reasonable price?

    Thank you!

  5. mjm

    Would it be possible for you to share your research on alternative providers with the rest of us? I’m at the end of my rope trying to get decent prescription drugs.

  6. Nancy
    Parkville MD

    The generic brand for Lexapro didn’t work for me. What a shame that I was doing so well on Lexapro and then had to take the generic. The doctors swear that they are the same, but I know better, my body knows better.

  7. Patricia G.

    Have been having problems with some of the generics as well. They weren’t doing their job.
    Got replacements which did not come from India or China. Had to go online and research it to find other providers. Am now doing better. The new drugs are not more expensive.


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