Does Lexapro improve interstitial cystitis? (+alternatives)

This article will discuss the effectiveness of Lexapro in managing interstitial cystitis-related pain. It will explain the mechanisms by which antidepressants, including Lexapro, may help with interstitial cystitis.

Additionally, the article mentions the potential side effects of using Lexapro for this indication. Finally, this article will discuss other treatment options that are effective in managing interstitial cystitis.

Does Lexapro improve interstitial cystitis?

Lexapro doesn’t improve interstitial cystitis, and it is not approved by the FDA for this condition. There is no available research that assesses or proves its effectiveness in managing interstitial cystitis or its associated pain [1].

However, certain other antidepressants have been studied and demonstrated effectiveness in alleviating pelvic pain associated with interstitial cystitis. Additionally, the mechanism of action of Lexapro can directly lead to pain relief, making it a potentially effective option for people experiencing depression as a result of chronic interstitial cystitis-related pain.

Nevertheless, individual responses to medications can vary, and while some individuals may find relief from using Lexapro for interstitial cystitis-related pain, this outcome is less likely. Therefore, it is advised to consult with a medical professional before considering the use of Lexapro for interstitial cystitis.

How can antidepressants like Lexapro help with interstitial cystitis?

Antidepressants, including Lexapro, can help alleviate pelvic pain associated with interstitial cystitis by directly affecting the neurotransmitters responsible for pain.

Selective serotonin-reuptake inhibitors (SSRIs) specifically target serotonin, but they may also impact other neurotransmitter pathways such as noradrenergic, cholinergic, and histaminergic pathways.

Since these neurotransmitters play a role in pain sensation throughout various areas of the nervous system, antidepressants, including SSRIs like Lexapro, may manage interstitial cystitis-related pelvic pain by blocking acetylcholine and histamine H1 receptors and inhibiting the reuptake of serotonin and norepinephrine [2].

Moreover, it is hypothesized that depression can intensify the severity of chronic pain, including chronic pelvic pain. Researchers have found that people with a genetic predisposition to depression are more susceptible to experiencing depressive symptoms when they have chronic pain [3].

Therefore, managing the depressive symptoms associated with interstitial cystitis pain can enhance the effectiveness of treatment for interstitial cystitis itself. However, there isn’t enough research to recommend antidepressants for patients with interstitial cystitis-related pelvic pain [3].

What does research suggest?

So far, there is no research focused specifically on assessing the effectiveness of escitalopram for managing interstitial cystitis or associated pelvic pain.

However, the scientific literature contains a few studies that examine the efficacy of selective serotonin-reuptake inhibitors (SSRIs), the class of antidepressants to which Lexapro belongs, in managing this condition.

One study found that taking sertraline, which is an SSRI as well, for 6 weeks did not reduce pain in women compared to placebo. Similarly, another investigation was conducted in men with chronic pelvic pain syndrome, and it concluded that sertraline could not improve the pain’s frequency or severity [4,5].

On the other hand, research has found that citalopram can reduce the intensity of pelvic pain. However, it did not lead to significant improvements on the pain disability scale [6].

What to do if Lexapro doesn’t improve interstitial cystitis-related pain?

If Lexapro does not effectively improve chronic pelvic pain associated with interstitial cystitis, it is important to consult with a doctor. They may recommend alternative treatment options or refer you to a urologist.

You should also explore medications and approaches that target interstitial cystitis specifically rather than using antidepressants. For example, consulting with a physical therapist may help with the pain and stiffness in your pelvic floor. 

It is important to consider bladder training, which involves urinating at certain constant times rather than when you need to. This can improve the overall health of your bladder and increase your control over it. It may be helpful if you avoid wearing tight clothes or belts that put pressure on your lower abdomen [7].

Moreover, you should avoid certain foods that are known for irritating the bladder, including carbonated drinks, chili, chocolate, peppers, tomatoes, caffeine, citrus fruits, vitamin C-rich foods, as well as alcohol. If certain other foods irritate your bladder, it is advisable that you avoid them too [7].

Furthermore, you should avoid smoking, as it can increase the risk of bladder cancer, and regularly exercise, as this has been found to improve interstitial cystitis symptoms. Complementary therapies such as acupuncture also showed effectiveness in reducing pelvic pain [7].

What are the side effects of taking Lexapro for interstitial cystitis?

Several side effects can be associated with using Lexapro for interstitial cystitis. Thus, it is important to discuss your condition and risk factors with a doctor to determine if it is safe for you to take Lexapro for this indication.

Common side effects of Lexapro include [1]:

• Tiredness
• Laziness
• Sleepiness 
• Insomnia
• Sweating
• Dry mouth
• Headache 
• Nightmares
• Arrhythmia
• Blurry vision
• Restlessness 

On the other hand, rare side effects include [2]:

• Tinnitus
• Paranoia 
• Migraine 
• Petechiae
• Tremors
• Joint stiffness 

What other drugs are better for interstitial cystitis?

Drugs that are effective in managing interstitial cystitis include [7]:

• Pentosan polysulfate sodium (Elmiron) is the only FDA-approved drug for interstitial cystitis. It works by forming a protective layer on the bladder wall, which helps to reduce irritation and inflammation.

• Amitriptyline, additionally, is a tricyclic antidepressant that is effective in managing interstitial cystitis-related pain. It increases serotonin and norepinephrine in the brain, which can reduce pain signals.

• Hydroxyzine (Vistaril), an antihistamine, is often prescribed to help relieve certain symptoms of interstitial cystitis, including urinary frequency and urgency. It works by decreasing inflammation and irritation in the bladder.

• Oxybutynin (Ditropan) is an anticholinergic drug that works by relaxing the bladder muscles and consequently controlling urinary frequency and urgency, which are common in interstitial cystitis.

• Gabapentin (Neurontin), moreover, is an anticonvulsant that can be used off-label to help manage the pain associated with interstitial cystitis.

• Lidocaine, which is a local anesthetic, can be used to relieve pain and discomfort.

• Baclofen, a muscle relaxant, reduces bladder spasms and improves symptoms of interstitial cystitis.

In conclusion, based on my knowledge, Lexapro does not improve interstitial cystitis or its associated pain in most people. While other antidepressants (like amitriptyline) have shown effectiveness in alleviating pelvic pain, there is no available research specifically assessing Lexapro for this condition. 

According to my research, antidepressants like Lexapro can help with interstitial cystitis by affecting neurotransmitters that are involved in pain sensations. However, I believe that individual responses can vary, so it is recommended to consult with your doctor before using it for interstitial cystitis.

If Lexapro doesn’t improve interstitial cystitis-related pain, I recommend consulting with a doctor. They may recommend other medications or approaches such as physical therapy, bladder training, avoiding certain foods and irritants, quitting smoking, regular exercise, and complementary therapies. 

References