I read your question carefully and I understand your concern. The efficacy and side effects profile of Venlafaxine and Escitalopram (Lexapro) are very similar to each other. That is because they act both on serotonin levels, while the difference is that Venlafaxine also raises noradrenaline ones. So in theory Venlafaxine could be a little more effective (but very little) but Lexapro shouldn t have the high blood pressure effect due to noradrenaline. So I believe Lexapro to be a very good choice with very similar efficacy (if not the same) and less negative effect on blood pressure. I hope to have been of help.