Lexapro (Escitalopram) is a popular medication for treating depression, generalized anxiety disorder (GAD), and other mood disorders. It can be an effective tool in managing these conditions, but it’s important to understand the side effects of Lexapro that may come with taking this antidepressant medication. Knowing the potential risks you take when deciding on Lexapro is essential for your safety and well-being.
Keep reading as we explore common and severe side effects of Lexapro and look at possible interactions with other medications or substances. When you’re informed of the risks, you’re able to make the best decisions regarding your mental health care.
Potential Risks & Warnings of Taking Lexapro
Like most medications, Lexapro can have side effects. Children under 12, pregnant or breastfeeding women, and some people with certain allergies should not take Lexapro. Lexapro and pregnancy have their own correlation, and if you’re pregnant while taking Lexapro, reading more about the two will help you make the right decision before Lexapro use.
Additionally, people with an imbalance in their serotonin levels might not be able to take selective serotonin reuptake inhibitors (SSRIs) like Lexapro. The drug has also been associated with low sodium in the blood (hyponatremia) in the elderly who need to monitor their sodium intake.
Side Effects of Lexapro
While research shows that Lexapro can effectively treat symptoms of depression and anxiety, understanding potential side effects is essential before beginning it or any medication. Always discuss the potential risks versus benefits associated with its use and any other health concerns you may have with your doctor. They can help determine if it’s safe for you to take Lexapro long-term based on your individual needs and medical history.
“Common side effects of taking Lexapro are weakness, feeling tired, nausea, issues with sleep, anxiety, or loss of appetite. It can also cause sexual problems, such as decreased sex drive and erectile dysfunction. It is good to be aware of how the medication is impacting you and what side effects you are having. It can vary from person to person. Be sure to discuss it with your psychiatrist to make sure that this is the best medication option for you.”– Talkspace therapist Bisma Anwar, LMHC
Common side effects
Common side effects of Lexapro use can range from mild to severe. Research shows that except for sexual side effects, which typically don’t improve, many of the more common Lexapro side effects tend to lessen over time.
A lot of Lexapro side effects resolve within two weeks of starting the medication. It’s best to begin with a low Lexapro dosage and slowly increase the amount taken over multiple weeks as advised by your doctor.
Common side effects associated with Lexapro include:
- Nausea: Nausea is one of the most common side effects of Lexapro. It typically occurs within the first few weeks after starting treatment. Often it can resolve over time as your body adjusts to the medication. Taking Lexapro with food or at bedtime may help reduce nausea symptoms.
- Change in sex drive: Sexual side effects are another common occurrence when taking Lexapro. These might include things such as decreased libido, difficulty achieving orgasm, delayed ejaculation, and erectile dysfunction for men.
- Menstrual cycle changes and/or vaginal dryness: Women may also experience changes in their menstrual cycle or vaginal dryness while on this medication.
- Insomnia: Insomnia is a potential side effect of Lexapro, although it’s less common than nausea or sexual problems. Insomnia generally begins the first few weeks after starting treatment but should improve over time as your body gets used to the medication’s effects. To minimize insomnia symptoms, try avoiding caffeine late in the day and setting a regular sleep schedule by going to bed at around the same time each night. If insomnia persists, talk with your doctor about adjusting your dose or switching medications.
- Drowsiness: Lexapro is known to cause excessive fatigue and drowsiness in some people.
- Dry mouth: Dry mouth can be a common side effect of Lexapro.
- Diarrhea or constipation: Diarrhea or constipation may occur when using Lexapro.
- Increased sweating: Lexapro can cause some people to experience increased sweating.
- Weight gain: While it will vary from person to person, weight gain may occur when taking Lexapro. Check out our article on Lexapro weight gain to learn about the causes and ways to avoid these weight fluctuations.
While most side effects are mild, some may become more severe if not addressed. If side effects persist for longer than two weeks or begin to interfere with your ability to function daily, you should contact your doctor immediately.
Serious side effects
When taking any medication, it’s vital to be aware of all the potential side effects.
“Lexapro is an effective medication to treat depression and anxiety but it can also have serious side effects. Make sure that you talk to your doctor about any other health issues you have, as well as other medications you might be taking before starting on Lexapro. This can help inform your doctor and reduce the chances of you having side effects.”– Talkspace therapist Bisma Anwar, LMHC
Serious side effects from taking Lexapro may include:
- Suicidal thoughts or behaviors: Suicidal thoughts or behaviors may occur in people taking this medication – especially those under 25 – so you should monitor for signs of increased depression or suicidal behavior while using this drug.
- Changes in behavior: Some people find an increase in aggression or agitation after beginning Lexapro.
- Serotonin syndrome: Serotonin syndrome can occur when too much serotonin builds up in the body — symptoms include confusion, agitation, and fever. This is a known possible side effect of Lexapro to be aware of.
- Mania: Lexapro can trigger manic episodes in some people taking it for bipolar disorder.
- Seizures: More research is needed to determine if Lexapro increases the risk of seizures in people with a seizure disorder. However, the drug can result in some people without a condition having seizures.
- Abnormal bleeding or bruising: Abnormal bleeding or bruising when taking Lexapro can be due to its ability to inhibit platelet aggregation in some people.
- Difficulty breathing or swallowing: Lexapro can cause an allergic reaction. Though rare, the response might sometimes result in difficulty breathing and/or swallowing.
If you experience any of these severe side effects while taking Lexapro, seek medical attention right away.
Certain medications and alcohol can interact with and impact the efficacy of Lexapro treatment. You should be aware of potential interactions when taking this or any drug. Be sure to speak with your doctor or pharmacist and share what other drugs or medicine you’re taking. Grapefruit and grapefruit juice commonly interact with some SSRI medications, so make sure to check with your pharmacist or doctor about that interaction.
Lexapro interactions with other drugs
Some prescription and over-the-counter drugs, vitamins, or supplements can interact with Lexapro. Commonly known interactions can occur with:
- Monoamine oxidase inhibitors (MAOIs)
- Tricyclic antidepressants (TCAs)
- Other SSRIs
- Certain antihistamines such as diphenhydramine (Benadryl)
Certain combinations of drugs and medicine can increase the risk of developing dangerous side effects or reduce the effectiveness of one or both drugs.
For example, combining Lexapro with monoamine oxidase inhibitors (MAOIs) can cause serious reactions, including high blood pressure and seizures. Studies have linked complications to Lexapro and MAOIs when taken within 14 days of each other.
Finally, certain drug interactions with antibiotics — like clarithromycin, which can cause an irregular heart rhythm that can be life-threatening — should not be taken while on Lexapro.
Lexapro interactions with alcohol
Avoid drinking alcohol when taking an SSRI antidepressant like Lexapro. Alcohol’s sedative properties could increase the risk for adverse reactions when combined with the drug’s active ingredients. Learn more about what can happen when Lexapro and alcohol, so you’re fully aware of potential reactions.
Talk with a Doctor About Lexapro
Talk to a doctor or online psychiatrist at Talkspace about the potential side effects of Lexapro — both common and serious — before taking it or any other anxiety or depression medication. Lexapro can effectively treat depression and other mental health conditions, but it isn’t suitable for everyone. Understanding the risks associated with its use and knowing what to look for is crucial.
You don’t have to live with mental health conditions that negatively impact your life. Help is available through therapy, psychiatrist-prescribed medication, and lifestyle changes. If you’re concerned and looking for interventions to help you manage the symptoms of your depression or another mood disorder, talk to your doctor or therapist to find out if Lexapro might be an option for you.
- Jiang K, Li L, Xueyi W, et al. Efficacy and tolerability of Escitalopram in treatment of major depressive disorder with anxiety symptoms: A 24-week, open-label, prospective study in Chinese population. Neuropsychiatric Disease and Treatment. 2017;Volume 13:515-526. doi:10.2147/ndt.s120190. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5322850/. Accessed December 12, 2022.
- Escitalopram (Lexapro). NAMI. https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Escitalopram-(Lexapro). Published 2020. Accessed December 12, 2022.