Escitalopram, also known by its brand name, Lexapro, is a selective serotonin reuptake inhibitor (SSRI). It's a first-choice antidepressant to treat depression and anxiety in adults and children. The medication is available as a tablet and oral solution, in both brand and generic forms. A dose is typically taken by mouth once per day. Some common side effects include nausea, trouble sleeping (insomnia), and dizziness.
Depression in people ages 12 years and older
Generalized anxiety disorder (GAD) in people ages 7 years and older
Escitalopram (Lexapro) is a selective serotonin reuptake inhibitor (SSRI). It works by raising the levels of serotonin, which is an important chemical in your brain that's involved with regulating your mood and anxiety.
Source: DailyMed
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Rare
Coma
confusion
decreased urine output
dizziness
fast or irregular heartbeat
headache
increased thirst
muscle pain or cramps
nausea or vomiting
seizures
swelling of the face, ankles, or hands
trouble breathing
unusual tiredness or weakness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
decreased interest in sexual intercourse
ejaculation delay
gas in the stomach
inability to have or keep an erection
loss in sexual ability, desire, drive, or performance
sleepiness or unusual drowsiness
trouble sleeping
Less common
Bloated or full feeling
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
chills
decreased appetite
excess air or gas in the stomach or bowels
general feeling of discomfort or illness
increased sweating
joint pain
muscle aches and pains
not able to have an orgasm
pain in the neck or shoulders
pain or tenderness around the eyes and cheekbones
passing gas
shivering
tightness of the chest
tooth problems
unusual dreams
unusual drowsiness, dullness, tiredness, weakness or feeling of sluggishness
yawning
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
First-choice medication for anxiety and depression
Only need to take it once a day
Generally has fewer side effects compared to other antidepressants
Can be taken with or without food
Can take up to 2 months before you feel the the full benefits
Risk of certain sexual problems
Can raise your risk for bleeds
Can cause withdrawal symptoms if you suddenly stop taking it
You can take escitalopram (Lexapro) with or without food. But since it often causes nausea, especially when starting or changing doses, taking it with food might help with the upset stomach.
Swallow escitalopram (Lexapro) tablets whole; never crush, chew, or split the tablets. If you're having trouble swallowing the tablets, let your prescriber know. They might switch you to the liquid form of the medication.
Antidepressant medications, like escitalopram (Lexapro), can raise the risk of suicidal thoughts. Contact your psychiatrist right away if you or your loved ones notice any new or worsening changes in your behavior or mood while taking this medication.
Avoid drinking alcohol while taking escitalopram (Lexapro) because it can worsen some side effects like drowsiness and dizziness. It can also worsen your depression or anxiety symptoms.
Don't change your dose or suddenly stop taking escitalopram (Lexapro) without talking to your prescriber first. Doing so can cause withdrawal symptoms, like nausea, headache, and trouble sleeping. Follow your prescriber's instructions to lower your dose slowly over a period of time to stop the medication completely.
Escitalopram (Lexapro) can interact with a lot of common medications. Tell your care team about all of the medications you're taking before starting escitalopram (Lexapro). Also, don't start any new medications without talking to your care team first.
It’s not fully clear if escitalopram (Lexapro) is safe to use while breastfeeding. Talk with your OB-GYN about the risks and benefits of taking this medication during this time.
More tips for escitalopram (Lexapro) liquid:
Make sure to use an oral syringe or medication dosing cup to measure out your escitalopram (Lexapro) dose. Don't use household spoons because they aren't accurate and might cause you to take the wrong dose.
Store the escitalopram (Lexapro) liquid at room temperature in the original bottle it came in from the pharmacy.
Escitalopram (Lexapro) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
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.
In general, your psychiatrist will have you start with a lower dose of escitalopram (Lexapro) and raise it slowly over a few weeks, if needed.
The typical starting dose for both children and adults is 10 mg by mouth once per day. The maximum dose is 20 mg by mouth once per day.
GoodRx has partnered with PatientsLikeMe to provide reviews on the different aspects of Escitalopram (Lexapro).
Learn more about the effectiveness of Escitalopram (Lexapro) based on real life experiences.
Based on 733 people taking this medication
3.1
2.9
3.3
3.2
3.7
2.1
Severity of side effects
Based on 1544 people taking this medication
0%
50%
100%
Decreased sex drive (libido)
8%
Weight gain
7%
Fatigue
4%
Insomnia
3%
Apathy
3%
Reasons people stopped taking Escitalopram (Lexapro)
Based on 1963 people who have taken this medication
Did not seem to work
33%
Doctor's advice
20%
Side effects too severe
19%
Other
14%
Expense
7%
Course of treatment ended
5%
Personal research
4%
Change in health plan coverage
3%
How long people take Escitalopram (Lexapro)
Based on 2534 people taking this medication
0%
50%
100%
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Currently take or have taken an MAOI, linezolid (Zyvox), or methylene blue (ProvayBlue) in the last 14 days
Taking pimozide
Allergy to citalopram
Depression in people ages 12 years and older
Generalized anxiety disorder (GAD) in people ages 7 years and older
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Allergan, Inc. (2023). LEXAPRO- escitalopram tablet, film coated [package insert]. DailyMed.
American College of Obstetricians and Gynecologists. (2023). Depression during pregnancy.
Bellantuono, C., et al. (2012). The safety of escitalopram during pregnancy and breastfeeding: A comprehensive review. Human Psychopharmacology.
Centers for Disease Control and Prevention. (2018). Spoons are for soup / Milliliters (mL) are for medicine.
Kasper, S., et al. (2006). Onset of action of escitalopram compared with other antidepressants: Results of a pooled analysis. International Clinical Psychopharmacology.
Reefhuis, K., et al. (2015). Specific SSRIs and birth defects: Bayesian analysis to interpret new data in the context of previous reports. BMJ: British Medical Journal.
Sanchez, C., et al. (2014). A comparative review of escitalopram, paroxetine, and sertraline: Are they all alike? International Clinical Psychopharmacology.
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