escitalopram

• Risk factors: Age under 24 years old | History of depression or other mental health conditions

Taking escitalopram (Lexapro) can make your depression worse and cause you to have thoughts of suicide or harming yourself. The risk is highest if you're 24 years of age or younger, during the first few weeks of taking the medication, and when your dose changes. If you or your loved ones notice that you have suicidal thoughts or unusual behavior (e.g., anxiety, panic attacks, difficulty sleeping, feeling angry or irritated, restlessness) while taking escitalopram (Lexapro), get medical help right away.

• Risk factors: Taking other medications that raise serotonin levels in your brain

Some people taking escitalopram (Lexapro) have developed a rare, but potentially life-threatening condition called serotonin syndrome. This condition happens where there's too much serotonin in the brain. Your risk for serotonin syndrome is higher if you take escitalopram (Lexapro) with other medications that can raise your serotonin levels, such as certain antidepressants, mental health medications, pain medications, and migraine medications. Let your psychiatrist know about all the medications you take before starting escitalopram (Lexapro). Also, don't start any new medications without talking to them first. Symptoms of serotonin syndrome include fast heart rate, sweating, muscle stiffness or spasms, fever, and confusion. Get medical help right away if you have any of these symptoms.

• Risk factors: Stopping escitalopram (Lexapro) suddenly

Stopping escitalopram (Lexapro) suddenly can cause withdrawal symptoms such as nausea, anxiety, agitation, flu-like symptoms, trouble sleeping, and dizziness. If you want to or need to stop taking escitalopram (Lexapro), ask your prescriber how to do so safely over time. Never try to stop the medication on your own without the supervision of a healthcare professional.

• Risk factors: Taking blood-thinners or other medications that raise your risk of bleeding

Escitalopram (Lexapro) can raise your risk of severe bleeding or bruising, especially if you're also taking antiplatelets (e.g., aspirin, clopidogrel (Plavix)) or anticoagulants (e.g., warfarin (Coumadin), apixaban (Eliquis), rivaroxaban (Xarelto)). Get medical help if you experience bruising that doesn't improve, black-colored stools, pink or red-colored urine, coughing up or vomiting blood, or unusual bleeding from the nose or gums.

Depression can be the first sign of bipolar disorder. If you're at risk for bipolar disorder, taking antidepressants, like escitalopram (Lexapro), by themselves can trigger a bipolar manic episode. Before starting escitalopram (Lexapro), your mental health provider will check to see if you have or are at risk for bipolar disorder. Escitalopram (Lexapro) isn't used to treat bipolar depression. Talk to your psychiatrist right away if you or your loved ones notice unusual changes in your behavior, such as racing thoughts, restlessness, getting easily distracted, or unusual talkativeness.

• Risk factors: History of angle-closure glaucoma

Escitalopram (Lexapro) can lead to or worsen angle-closure glaucoma. You might need to see your optometrist regularly and get eye exams to check your eyes and make sure your vision isn't worsening. Contact your optometrist or psychiatrist if you notice changes in your vision after starting escitalopram (Lexapro).

• Risk factors: Low blood potassium or magnesium levels | Older age | Kidney problems | History of heart problems, slow heart rate, or other abnormal heart rhythms (arrhythmias) | Personal or family history of long QT syndrome | Taking other medications that cause QT prolongation

Escitalopram (Lexapro) can affect your heart rhythm, which can be serious and life-threatening. One example includes lengthening the time period from when the heart pumps and then relaxes. This is known as QT prolongation. Your risk is higher if you have certain factors, including abnormal electrolyte levels, heart rhythm problems, or are taking other medications that cause heart rhythm problems, such as amiodarone (Pacerone) and ciprofloxacin (Cipro), among others. To lower your risk, your psychiatrist or primary care provider might periodically monitor your heart and perform electrocardiograms (EKGs) to make sure your heart rhythm is normal. If you feel your chest pounding, have shortness of breath, have chest pain, or feel faint or lightheaded while taking escitalopram (Lexapro), call 911 right away.

• Risk factors: Older people | Taking diuretic medications

Escitalopram (Lexapro) can cause low blood sodium levels. Your prescriber might closely monitor your blood sodium levels before and during treatment with escitalopram (Lexapro). Get medical help right away if you experience weakness, confusion, difficulty concentrating, headache, or memory problems because these could be signs of low blood sodium levels, which is a medical emergency.

SSRIs like escitalopram (Lexapro) can cause sexual problems, such as ejaculation problems, low sex drive, trouble having an orgasm, and erectile dysfunction. Speak to your prescriber if these side effects become troublesome.