Escitalopram, also known under its brand name Lexapro, is prescribed for depression and generalized anxiety disorder. However, like any medication, it may cause side effects. While most are mild and temporary, some can be severe and long-lasting. In this article, we explore the common and rare side effects of Lexapro medicine and factors that can intensify or help prevent these reactions.
Common Side Effects
Major side effects of Lexapro include:
- Dry mouth
- Drowsiness
- Nausea
- Headache
- Diarrhea
- Increased sweating
- Fatigue
- Nervousness
- Insomnia
- Restlessness
- Decrease in sexual ability, desire, drive, or performance
- Influenza-like symptoms
Mild and temporary effects don’t typically require medical care. They usually improve after the first week as your body gets used to the medication, and most patients can tolerate them without serious complications. However, if you experience persistent adverse side effects of Lexapro that cause significant concerns, seek guidance from your healthcare provider.
Serious Side Effects and Precautions
Depression medication Lexapro may also cause severe adverse effects. You should look out for them and discuss them with your doctor immediately if they occur. These include:
- Suicidal thoughts and behavior in adolescents and young adults. Lexapro can worsen
suicidal ideation [1*] and lead to self-destructive behaviors in adults up to 24 years old, hence needing close monitoring of treatment in this age group. - Serotonin syndrome. It is a potentially dangerous condition that has been linked to the use of certain classes of antidepressants, including Lexapro. This risk is further increased when Lexapro is combined with other serotonergic agents such as tricyclic antidepressants, fentanyl, triptans, tryptophan, tramadol, buspirone, St. John’s Wort, and amphetamines. If you suspect the symptoms of
serotonin syndrome [2*] (raised temperature, hypertension, increased heart rate, dizziness, flushing) it’s recommended to seek medical attention immediately. - Activation of mania/hypomania. Patients with a mental illness called bipolar disorder should be screened before being prescribed Lexapro to prevent the potential
risk [3*] of mania or hypomania activation. - Seizures. Patients with a history of seizures should be cautiously prescribed Lexapro to avoid the potential risk of seizure activity.
- Abnormal bleeding. Caution should be exercised for patients taking Lexapro who also take warfarin, aspirin, NSAIDs (nonsteroidal anti-inflammatory drugs), or other medications that affect blood clotting.
- Angle-closure glaucoma. Patients with increased eye pressure due to untreated narrow anterior chamber angles are at
risk of angle-closure glaucoma [4*] when treated with Lexapro. - Hyponatremia, or low sodium levels, can occur along with the syndrome of inappropriate antidiuretic hormone (SIADH) secretion, particularly in elderly patients.
- Effects on cognitive and motor performance. Be careful when driving or operating machinery when on Lexapro.
- Having concomitant illness. Patients with certain medical conditions or disorders that can affect metabolism or cardiovascular function should be cautious when using Lexapro.
- Sexual dysfunction. This can occur when the patient is taking Lexapro, for example, a decrease in sexual desire or difficulty having an orgasm.
- Use in pregnancy. Treatment with Lexapro can cause lung problems and feeding difficulties in the newborn, especially when used later in pregnancy.
Side Effects in Specific Groups
Adults
As with other SSRIs (selective serotonin reuptake inhibitors), adults may experience adverse effects when taking Lexapro for anxiety or depression. Typical effects include headaches, nausea, dry mouth, muscle pain, sleeplessness, and sexual dysfunction. As the body gets used to the medicine, these side effects may become less intense and eventually disappear.
Children and Adolescents
For children under the age of twelve, Lexapro is generally not advised. It may be recommended for teenagers (ages 12 to 17) with major depressive disorder. In young adults, careful observation is necessary because escitalopram is linked to an increased risk of suicidal thoughts or actions.
Pregnancy and Breastfeeding/Chestfeeding
It’s essential to weigh the potential risks and benefits of using Lexapro during pregnancy.
Those With Substance Use Disorders
There may be a higher chance of side effects or drug interactions with Lexapro in those with a history of substance use disorders, particularly those involving alcohol or other CNS depressants. In these cases, close observation might be required.
Patients on Other Medications
Antipsychotics, some painkillers, other antidepressant medications, and herbal supplements may interact with Lexapro. Individuals taking other medicines must discuss that with a healthcare provider in advance.
People With Certain Medical Issues
People with other medical conditions may be more vulnerable to specific side effects of Lexapro. For instance, taking SSRIs may increase the risk of unusual bleeding, especially in people with a history of bleeding disorders. In the same way, SSRIs alone may not be enough to manage bipolar disorder, leading to mood swings or manic episodes.
Contraindications
Lexapro should not be used in the following situations:
- Recent use of MAOIs. Avoid using MAOIs with Lexapro or within 14 days before or after stopping Lexapro as it increases the risk of serotonin syndrome. Also, do not start Lexapro if currently using linezolid or intravenous methylene blue.
- Having hypersensitivity to escitalopram, citalopram, or any of the medication’s inactive ingredients.
- Pimozide (an antipsychotic medication). Avoid using it concurrently.
What to Expect After Stopping the Medication?
Stopping Lexapro suddenly might cause withdrawal symptoms, which include agitation, headache, nausea, and flu-like symptoms along with dizziness. The discomfort associated with it is usually brief but sometimes may require medical help. Healthcare professionals generally suggest weaning off the medicine gradually under their supervision to reduce the symptoms of withdrawal.
Factors That Affect the Duration and Intensity of Side Effects
The duration and severity of side effects vary from person to person because of different factors, including:
- Dosage. The dosage of Lexapro can significantly affect the occurrence and severity of adverse reactions. Higher doses may increase the likelihood and intensity of adverse effects.
- Duration of treatment. Long-term use of Lexapro may cause more or different side effects than short-term use.
- Individual differences. Every person is different, so their body may respond differently to medications. Some individuals may be more susceptible to certain side effects than others.
- Age. Age can be a significant factor in the likelihood and intensity of side effects experienced with Lexapro. Older individuals may experience more effects than younger patients.
- Underlying health conditions. Individuals with certain underlying health conditions may experience more uncomfortable effects than others. It is important to discuss your medical history with your healthcare provider before starting Lexapro.
- Other medications. Concurrent use of some other medicines can cause interactions and affect the number or severity of adverse reactions. It is essential to disclose all medications, including over-the-counter ones, to your healthcare provider to avoid harmful effects.
- Withdrawal. Stopping Lexapro abruptly can result in withdrawal symptoms, including dizziness, headache, and nausea. Do not quit taking this medication without professional assistance.
It is crucial to discuss any concerns or negative side effects you experience while taking Lexapro with your doctor or pharmacist so they can determine the appropriate course of action.
When to Contact Healthcare Provider about Side Effects
You should contact your healthcare provider if you experience any persistent or bad side effects from Lexapro. These include:
- Mood side effects, such as worsening depression or anxiety, suicidal thoughts, and unusual changes in mood or behavior.
- Severe physical side effects, such as nausea or seizures, or an unusual or allergic reaction (e.g., rash, itching, swelling, difficulty breathing).
Your healthcare provider can help determine the best course of action, including adjusting your medication dosage, exploring alternative treatments, or providing supportive care. Open communication with your healthcare provider is essential for managing side effects.
Preventing Side Effects
Preventing adverse effects from Lexapro (escitalopram) can involve several strategies:
- Follow Your Dosage: Take Lexapro exactly as directed by your physician.
- Adjusting Dosage Gradually: Your doctor may initially prescribe a low dose and then gradually raise it.
- Taking With Food: Some people find that taking Lexapro with food reduces its adverse impact on the gastrointestinal system.
- Drink Plenty of Water: Make sure you stay hydrated, especially if you have a dry mouth as a side effect.
- Regular Monitoring: Contact your healthcare provider regularly to monitor any adverse effects and make necessary adjustments to your treatment.
- Avoid Alcohol: Alcohol may interact with Lexapro and raise the possibility of negative consequences. It is better to minimize or stay away from drinking alcohol.
- Talk About Your Concerns: Speak with your doctor if any of the side effects are troublesome.
- Discuss Possible Interactions: To prevent possible interactions, let your doctor know about all other prescription and over-the-counter medications as well as any herbal supplements you take.
- Seek Medical Help if Necessary: Get help right away if you have serious side effects like serotonin syndrome, unusual or allergic reaction, or suicidal thoughts.
Conclusion
While Lexapro can be an effective treatment for anxiety and depression, it may cause side effects. By being informed about the potential risks, you can better understand what to expect and what steps to take to manage them. If you experience significant discomfort or have other concerns about taking Lexapro, discuss them with your provider.
If you seek treatment for depression or anxiety, schedule a video appointment with our qualified healthcare providers at MEDvidi. They will assess your condition and offer you an individualized treatment plan. You will be provided with an online prescription for Lexapro or another appropriate medication if deemed necessary.
Frequently Asked Questions
What to avoid when taking this medication?
Who should avoid this antidepressant?
How long do the side effects last?
Is it better to take it in the morning or at night?
Does it make you feel bad at first?
When using Lexapro, some people may first feel headaches, nausea, or anxiety attacks. They are typically temporary and fade away as your body becomes used to the medication.
Do the side effects go away?
As your body gets used to the medication, side effects from Lexapro frequently get better or go away over time. However, each person will react differently to medication, and some adverse effects might not go away or require medical attention.
How long does it take to adjust to Lexapro?
Some people can see improvements in their symptoms in a few weeks, while others might need several weeks or more to get the full effects. It’s critical to closely monitor any changes in symptoms and to be patient and persistent with your treatment plan.
