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Medication

Lexapro®

Lexapro is the brand name of the generic drug escitalopram. Lexapro is a selective serotonin reuptake inhibitor (SSRI), a type of antidepressant medication that also can be used to treat anxiety.

by

Ros Lederman

Medically reviewed by

Lloyd Sederer, MD

January 30, 2023

Lexapro®

fast facts.

Pronunciation

lek-suh-prow

Drug class

selective serotonin reuptake inhibitor (SSRI)

Other names

escitalopram

Used for

anxiety, depression, eating disorders, obsessive-compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD), premenstrual dysphoric disorder (PMDD)

About

Lexapro®

What is Lexapro?

Lexapro is the brand name of the generic drug escitalopram. Lexapro is a selective serotonin reuptake inhibitor (SSRI), a type of antidepressant medication that also can be used to treat anxiety. Prescription drugs like Lexapro (escitalopram) are not available over-the-counter.

 

SSRIs, including Celexa (citalopram), Zoloft (sertraline), and Prozac (fluoxetine), are thought to boost the level of serotonin (a neurotransmitter that affects feelings of contentment, optimism, and satisfaction) in your brain by preventing it from being reabsorbed into the brain’s neurons where it was produced.

 

Doctors commonly use Lexapro to treat generalized anxiety disorder (GAD) and major depressive disorder (MDD).

 

In addition to depression and anxiety, Lexapro also may be prescribed for “off-label” uses to treat several other medical conditions. Off-label use means taking a medication to treat a condition other than what the Food and Drug Administration (FDA) has approved it to treat. This is a common and acceptable medical practice.


Off-label Lexapro uses include:

  • Eating disorders (including binge eating disorder or bulimia nervosa)
  • Obsessive-compulsive disorder (OCD)
  • Panic disorder (characterized by frequent panic attacks)
  • Post-traumatic stress disorder (PTSD)
  • Premenstrual dysphoric disorder (PMDD)

Lexapro (escitalopram oxalate) is available in tablet and liquid forms:

Lexapro tablet

  • 5 mg
  • 10 mg
  • 20 mg

Lexapro liquid

  • 1 mg/ml

Whether you are taking this medication for depression or anxiety, a typical starting dose of Lexapro is 10 mg taken once per day. If necessary, your doctor or prescribing nurse may gradually increase your dose of Lexapro over several weeks. While 10 mg is the maximum recommended dose for Lexapro for anxiety, the maximum recommended dose for Lexapro for depression is 20 mg. However, some people might find that a higher dose is needed to experience symptom relief.

 

Lexapro is typically taken one time per day. It can be taken in the morning or the evening, with or without food.

 

If you accidentally miss a dose of Lexapro, you should either go ahead and take your missed dose as soon as you remember or, if it is closer to the time when you would take your next dose, just take your next dose.

 

For more information:

Lexapro side effects, warnings, and drug interactions

Lexapro side effects

Common side effects of Lexapro include:

  • Anxiousness
  • Appetite loss
  • Constipation
  • Difficulty sleeping
  • Dizziness
  • Dry mouth
  • Infections
  • Nausea
  • Sexual problems (such as decreased sex drive or sexual dysfunction)
  • Shaking
  • Sleepiness
  • Sweating
  • Weakness
  • Yawning

Lexapro side effects in men and Lexapro side effects in women tend to be similar. Always let your doctor, prescribing nurse, or Minded healthcare provider know if you experience these (or any other) side effects or if you experience an allergic reaction.

 

Rare or serious side effects of Lexapro include:

  • Angle-closure glaucoma (symptoms include: eye pain, vision changes, or swelling or redness in or around your eye)
  • Low sodium levels in your blood (symptoms include: headaches, feeling weak, or having a hard time concentrating or remembering things)
  • Seizures
  • Serotonin Syndrome (symptoms include: shivering, diarrhea, confusion, severe tightness in your muscles, fever, or seizures. Serotonin Syndrome is very serious and can be fatal if not properly diagnosed and treated.)
  • Teeth grinding
  • High blood pressure

Lexapro (and SSRIs generally) may also potentially increase your risk for life-threatening bleeding problems—particularly in your gums, intestines, nose, or stomach. This risk of bleeding can be even higher if you are also taking certain other medications, including:

  • Anticoagulants (blood thinners, such as Eliquis or Warfarin)
  • Aspirin
  • Nonsteroidal anti-inflammatories (NSAIDs, such as ibuprofen or naproxen)

Immediately seek medical attention from healthcare professionals if you experience any of these (or other) serious side effects.

Lexapro weight loss and Lexapro weight gain

Few studies have looked at Lexapro weight loss. While one 2011 study found that Lexapro may cause weight loss, most studies indicate that weight gain is more common.

 

Even though antidepressant medications themselves may not always be the direct cause of weight gain in people who are taking antidepressants, some studies—including a 2015 study in General Hospital Psychiatry—have found that a number of antidepressant medications, including Lexapro, may, in fact, lead to significant weight gain.

Lexapro drug interactions

Always let your prescribing doctor, nurse, or Minded professional know about any and all medications and/or supplements, like St. John's Wort, you are taking. This is important so that they can determine if Lexapro may have any potential negative interactions.

 

Lexapro may interact with:

  • Amphetamines
  • Coumadin (warfarin)
  • Medications that may cause bleeding, such as Advil (ibuprofen), aspirin, or Motrin (ibuprofen)
  • Migraine medications (triptans)
  • Monoamine oxidase inhibitors (MAOIs—another type of antidepressant medication—such as isocarboxazid, phenelzine and tranylcypromine)
  • Other selective serotonin reuptake inhibitors (SSRIs)
  • Some pain medications, such as Ultram (tramadol)
  • Zyvox (linezolid)

Lexapro and alcohol

You should not drink alcohol if you are taking Lexapro (or any other antidepressant medication).

 

Alcohol can lead to worsening anxiety and depression symptoms in the long term, even if they seem to boost or calm your mood in the short term. And alcohol can increase the negative effects of antidepressant medications—such as sedation—as well as decrease their benefits. There is also a risk of accidentally overdosing on Lexapro if it is taken with alcohol.

 

Symptoms of a Lexapro overdose may include:

  • Convulsions
  • Coma
  • Dizziness
  • Drowsiness/sleepiness
  • Hypotension (low blood pressure), including fainting
  • Insomnia
  • Irregular heartbeat
  • Nausea and/or vomiting

Lexapro warnings

Lexapro comes with an FDA “Black Box” warning, which means that the FDA has identified certain serious safety risks from taking this medication. However, while these are serious safety warnings, the actual risk may be low or even rare.

 

The Lexapro Black Box warning says:

  • Antidepressant medications may increase the risk of suicidal thoughts or behaviors in children, adolescents, and young adults.
  • Lexapro is not approved for use in children under the age of 12.

Lexapro and pregnancy

Discussing your treatment plan with your prescribing doctor, nurse, or Minded provider is important if you are pregnant, breastfeeding or planning to do either. Because Lexapro (and other SSRIs) may harm your baby during pregnancy—and can be passed to your baby through your breast milk as well—you and your provider may need to discuss adjusting your treatment plan with that in mind.

Lexapro withdrawal symptoms

If you need to stop taking Lexapro (or any other SSRI medication), work with your prescribing doctor or nurse to get medical advice and come up with a plan to gradually and carefully taper off of the medication in order to avoid withdrawal symptoms.

Lexapro withdrawal symptoms may include:

  • Dizziness
  • Headache
  • Irritability
  • Nausea
  • Nightmares
  • Paresthesias (a prickling and/or tingling sensation on your skin)
  • Vomiting

For more information:

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Frequently asked questions about Lexapro

What to expect the first week taking Lexapro?

Like many other SSRIs, when you first start taking Lexapro, you may notice your decreased appetite, energy, and/or sleep begin to improve in the first week or two. On the other hand, you may also start to experience side effects during the first week or so of taking Lexapro (or any SSRI).

 

Some of the Lexapro immediate effects that may occur include:

  • Diarrhea
  • Dry mouth
  • Fatigue
  • Headache
  • Increased sweating
  • Insomnia
  • Nausea
  • Nervousness
  • Restlessness

However, most side effects tend to ease up or disappear altogether within the first few weeks of starting treatment.

How long does Lexapro take to work?

Beyond any initial improvement in the first few weeks of starting Lexapro, it can take 6 to 8 weeks (or more) for other common symptoms (such as decreased interest in daily activities or depressed mood) to improve noticeably.


What is the best time of day to take Lexapro for anxiety?

While Lexapro can be taken in the morning or the evening, because it may cause trouble sleeping, some people find it better to take it in the morning.


Does Lexapro make you tired?

Not everyone who takes Lexapro will experience the same side effects. While some people may find that it keeps them up at night (and therefore that taking it in the morning is better for them), other people may experience sleepiness, which is another common side effect of Lexapro. If that is the case, it may be better to take the medication in the evening instead of the morning.


What are some tips for switching Lexapro from night to morning?

If you are looking to switch when you take Lexapro (from night to morning or from morning to night), reach out to your prescribing doctor or nurse to come up with a plan to make the switch safely in order to avoid withdrawal symptoms.


For more information:

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Is Lexapro right for you?

Visit Minded and get a free assessment to find out if Lexapro could work in your treatment for anxiety or depression.

 

Minded offers online appointments with board-certified psychiatrists and nurse practitioners within a week. If you already have a Lexapro prescription, Minded can help you refill or renew it online. Our team of professionals also can assist with adjusting your dose or advising you about other medications that might be a good fit for your needs.


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