Medication Guide
Escitalopram (Lexapro) Side Effects and Uses
A plain-language guide to Escitalopram, an SSRI antidepressant. Learn how it helps, what it treats, how to take it and which side effects to know about.
Quick answer. Escitalopram (Lexapro) is an SSRI antidepressant. Common escitalopram side effects include nausea, headache, sleepiness or tiredness and trouble sleeping. The rare but serious ones, and when to get help, are listed under escitalopram side effects below. Never stop or change your dose on your own.
How Escitalopram Can Help You
Escitalopram (Lexapro) is a selective serotonin reuptake inhibitor, or SSRI. It works well for many people and is usually well tolerated. So it is often a first choice for depression and generalized anxiety. It slowly raises serotonin activity in the brain.
As it takes effect, it can ease worry, restlessness and low mood. It can calm the feeling of being always on edge. Many people find it easier to focus and sleep. They can enjoy the people and things they care about again.
Like all SSRIs, it works gradually. Early changes may show up within one to two weeks. You may sleep better or feel calmer. The full effect usually builds over four to eight weeks. Your prescriber tracks your progress and adjusts the plan if needed.
Uses for Escitalopram
- Major depressive disorder, in adults and teens 12 and older
- Generalized anxiety disorder
- Panic disorder (off-label)
- Social anxiety disorder (off-label)
- Obsessive-compulsive disorder (off-label)
- Premenstrual dysphoric disorder (off-label)
How to Take Escitalopram
Your prescriber decides your dose and whether it should change. Escitalopram is taken once a day, morning or evening. Food does not matter. If it makes you a little sleepy, the evening may work better. If it makes you feel alert, the morning is usually better.
Take it at the same time each day. This keeps levels steady. Missed a dose? Take it when you remember, unless the next dose is close. Then skip the missed one and do not double up. Do not stop suddenly. That can cause dizziness, irritability and poor sleep. Follow your prescriber's plan for any change.
Escitalopram Side Effects
Common Side Effects
- Nausea, mostly in the first week
- Headache
- Sleepiness or tiredness
- Trouble sleeping
- Dry mouth
- More sweating
- Sexual side effects, such as lower desire or delayed orgasm
Serious: Get Medical Help Promptly
- New or worse suicidal thoughts, mostly in people under 25 (boxed warning)
- Serotonin syndrome, with agitation, fever, fast heartbeat or stiff muscles
- Heart rhythm changes, with fainting or a pounding heartbeat
- Low sodium (hyponatremia), mostly in older adults
- Unusual bleeding or bruising
- Mania, with a very high or irritable mood
How Escitalopram Works
Nerve cells pass messages using chemicals such as serotonin. After a message is sent, the cell pulls serotonin back in. Escitalopram slows that pullback, so more serotonin stays active. Over weeks, the brain adapts. That is when mood and worry tend to ease.
Escitalopram is the active half of the citalopram molecule. The two are closely related but are not the same drug. Some people do better on one than the other. Your prescriber can explain which fits you.
Before You Start Escitalopram
Tell your prescriber about every medicine and supplement you take. Escitalopram must never be taken with an MAOI antidepressant or pimozide. Other drugs that raise serotonin, such as triptans, tramadol and St. John's wort, raise the risk of serotonin syndrome. Aspirin, NSAIDs and blood thinners raise bleeding risk.
Also share any history of bipolar disorder or seizures. Mention heart rhythm problems, liver disease or low sodium too. Like all antidepressants, escitalopram has a boxed warning. It covers suicidal thoughts in young people. If you are thinking about harming yourself, call or text 988, or call 911. Learn about medication management by telehealth in California.
Is Escitalopram Right for You?
Only a full evaluation with a prescriber can tell you if Escitalopram fits your symptoms, history and goals. Harpal Singh, PMHNP-BC offers psychiatric evaluations and ongoing medication management by telehealth anywhere in California.
SCHEDULE AN APPOINTMENT CALL (888) 457-8124
Related Medication Guides
Other guides in the same group, written the same simple way. Being in one group does not mean you can swap one medicine for another.
- Doxepin (Silenor), Tricyclic antidepressant (TCA)
- Duloxetine (Cymbalta), SNRI antidepressant
- Fluoxetine (Prozac), SSRI antidepressant
- Fluvoxamine (Luvox), SSRI antidepressant
- Mirtazapine (Remeron), Atypical antidepressant (noradrenergic and specific serotonergic)
- Nortriptyline (Pamelor), Tricyclic antidepressant (TCA)
FAQ
Questions About Escitalopram
How is escitalopram different from other SSRIs?
Escitalopram often works well with mild side effects. It also has fairly few drug interactions. Many prescribers see it as a first choice for depression and generalized anxiety. Each person responds differently, so finding the right fit is a shared process.
How long does escitalopram take to work?
Better sleep or a calmer baseline may appear within one to two weeks. The full effect on mood and anxiety usually takes four to eight weeks of daily use. Keep taking it during this time, even if you do not feel different yet.
How long will I need to take it?
After a first episode, treatment often goes on for several months after you feel well. This lowers the chance of symptoms coming back. Some people benefit from longer treatment, and your prescriber helps you decide when a taper makes sense.
Does escitalopram cause weight gain?
Most people have little or no weight change. Some gain a modest amount over long-term use. Keep an eye on your weight and talk with your prescriber about any change.
Can I take escitalopram while pregnant or breastfeeding?
This is a personal decision. It weighs the risks of untreated illness against the risks of the medicine. Escitalopram is one of the SSRIs often used in pregnancy. Talk through your own case with your prescriber and your OB provider.
What happens if escitalopram doesn't work for me?
If you have not improved after a fair trial, your prescriber may change the dose, switch medicines or add another treatment. Not responding to one antidepressant does not mean others will fail. Many people do well on a second option.
Is escitalopram the same as citalopram?
No, but they are close relatives. Escitalopram is the active half of the citalopram molecule. Your prescriber chooses between them based on your history, other medicines and how you respond.
Can I stop escitalopram once I feel better?
Talk to your prescriber first. Stopping suddenly can cause dizziness, irritability and sleep problems, and stopping too soon raises the chance of relapse. When the time is right, your prescriber plans a slow taper.