Table 5.

Worsening symptoms on escitalopram according to consumer-generated and professionally controlled text

Website	Standard Warninga (Professionally Controlled Text)	Consumer Reviewb (Consumer-Generated Text)
RevolutionHealth	Call your doctor at once if you have any new or worsening symptoms such as mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself	A couple of days later I had my first manic experience which lasted about 30 minutes of complete reckless driving, I probably should have gotten arrested. And a few minutes later I came down into deep depression. [Consumer review #258]
WebMD	Tell the doctor immediately if you notice worsening depression/other psychiatric conditions, unusual behavior changes (including possible suicidal thoughts/attempts), or other mental/mood changes (including new/worsening anxiety, panic attacks, trouble sleeping, irritability, hostile/angry feelings, impulsive actions, severe restlessness, very rapid speech)	I have been very hostile and irritable on this med and my panic attacks have been coming more often and they have been much worse! I have no patience with my kids or my fiancé, or basically anyone around me. [Consumer review #364]
AskaPatient		…[a]nd then the worst crippling panic attacks I have ever had to date… [Consumer review #8] I seemed to become more aggressive and assertive. I would just speak my mind whenever I got angry, and had no fear. I seemed to become more “mean” and “mad” and I just didn’t like myself. [Consumer review #41]
CrazyMeds		Had some hypomania then extreme agitation, then suicidality. The agitation was awful, felt like I was going to jump out of my skin— and my mind was racing. [Consumer review #172] …2 hours of alternating panic attacks/crying jags… [Consumer review #130]

^a Complete text is provided.

^b Selected illustrative comments are provided