Interaction Between Betaine And Lexapro

In our latest question and answer, the pharmacist discusses the theoretical interaction between Lexapro and betaine.

Question

Hi, Drugbank says, "The therapeutic efficacy of Escitalopram can be decreased when used in combination with Betaine." Is this only the case if I take both at the same time, or is it a general issue? Can I avoid this interaction by taking them at a different time of the day separately? Thanks in advance!

Asked by Alex30 On Mar 30, 2024

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Mar 31, 2024
Last updated Apr 12, 2024

Key points

  • There is a theoretical interaction based on how each drug is classified, but it is likely clinically insignificant.

Answer

Hello and thank you for reaching out!

The interaction you're asking about, between Lexapro (escitalopram) and betaine, is not listed in our own herbal-drug interaction checker. I had to do some research to understand why this interaction is listed in DrugBank.

Why Does DrugBank Show an Interaction Between Betaine and Lexapro?

The interaction is based on how both drugs are classified in DrugBank. Lexapro is categorized as an 'anticholinergic agent,' while betaine is categorized as a 'cholinesterase inhibitor.'

DrugBank Classification

DrugBank displays this interaction based on the theoretical interaction between these two classifications, not necessarily between the two drugs themselves.

While it's true that Lexapro has some mild anticholinergic effects, these effects are not related to its primary function in treating depression and anxiety. Similarly, while betaine can increase choline levels, its main use as a dietary supplement is as a source of hydrochloric acid, to aid digestion, and its cholinergic effects are not significant in this context.

It's also worth noting that the absorption of Lexapro is not significantly affected by stomach acidity, which betaine can increase. Taking Lexapro with food, which can increase stomach acid, is not known to significantly affect its absorption.

In summary, the interaction between Lexapro and betaine listed in DrugBank is based on their classification within the database rather than a direct drug-drug interaction.

In my opinion, taking them together is unlikely to have a clinically significant impact. I'd be more concerned if instead of Lexapro, we were talking about a drug whose primary action was to decrease choline levels, such as Benztropine (which is used to treat Parkinson's Disease). That's just not the case with Lexapro.

Final Thoughts

Thank you once again for reaching out. I hope this answer has been helpful.

References

  • Lexapro Prescribing Information, PubMed
  • Gastric reacidification with betaine HCl in healthy volunteers with rabeprazole-induced hypochlorhydria, PubMed

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 13 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical, program development, and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Dr. Brian Staiger also has herbalist training and educational certificates in the field of medical ethnobotany. Feel free to send him an email at [email protected]! You can also connect with Dr. Brian Staiger on LinkedIn.

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