Lexapro has a boxed warning, the most serious type of warning from the Food and Drug Administration (FDA). Lexapro’s active ingredient escitalopram has an increased risk of suicidal thoughts in young adult patients. Remember to discuss the risks with your healthcare provider.
Highlights
- Lexapro (escitalopram) is commonly prescribed for depression and generalized anxiety disorder and has proven effective but may still cause side effects.
- Common side effects of Lexapro include nausea, headaches, dry mouth, etc., most of which subside over time. Serious effects like serotonin syndrome, abnormal heart rhythms, and increased suicidal thoughts require immediate medical attention.
- Lexapro has several contraindications and potential for drug interactions, so it’s essential to discuss your health history with a medical provider before starting the medication.
- Stopping Lexapro abruptly can lead to withdrawal symptoms such as dizziness, brain zaps, mood swings, and insomnia. Tapering off under medical supervision is recommended.
Lexapro (escitalopram) is one of the most common medications used to help with depression and generalized anxiety disorder. It works by
According to the WHO,
Common Side Effects of Lexapro
Many people starting Lexapro don’t experience significant improvement in their symptoms for at least a week or two (main effects occur in 6 to 8 weeks) — but they may experience side effects during this period. Some common and most frequently reported ones are:
- Nausea
- Diarrhea
- Headaches
- Dry mouth
- Increased sweating
- Insomnia
- Excessive sleepiness
- Feeling tired or weak
- Nervousness
- Sexual dysfunction
- Flu-like symptoms
Most of these side effects are short-lived and tend to resolve within a few weeks as your body becomes accustomed to the medication. However, if adverse side effects of Lexapro continue or interfere with quality of life, consult your healthcare provider.
Serious Side Effects and Precautions
Aside from the common side effects of escitalopram, some individuals may also face serious, major side effects. These include:
Quick loss or gain of weight[3] .- Patients with untreated narrow anterior chamber angles are at
risk for angle closure glaucoma[4] because of increased eye pressure. - Headaches accompanied by confusion, weakness, and muscle cramps.
- Changes in the menstrual cycle, which may include spotting or bleeding between periods.
- Increased body temperature, agitation, or confusion and twitching. This may be a symptom of
serotonin syndrome[5] . - Abnormal cardiac rhythm.
Nasal bleeding[6] .- Bruising or bleeding from gums.
If you experience any of the above or other serious negative side effects, get medical help immediately. It is important to always be transparent with your healthcare provider: inform them about your diagnosis and the medications you are taking to help them find an appropriate solution faster.
Seek professional guidance on the treatment of depression or anxiety and receive a prescription online, if deemed necessary.
Side Effects of Lexapro in Specific Groups
Adults
Adults commonly experience side effects such as nausea, headache, dry mouth, sleeplessness, muscle aches, and sexual dysfunction. These may be mild to moderate and subside as the body gets accustomed to the medication.
Children and Adolescents
If you’re experiencing suicidal or self-harming thoughts and require immediate assistance, contact crisis hotlines, such as 911, 988 Suicide & Crisis Lifeline (toll-free), or Samaritans (116-123 or via chat).
Pregnancy and Breastfeeding
Escitalopram is classified as a
Individuals With Substance Use Disorders
Escitalopram can lower the seizure threshold. If an individual has a history of substance abuse, caution is advised when prescribing escitalopram.
Patients Taking Other Medications
Other antidepressant medications (such as SSRIs and SNRIs), some painkillers, herbal supplements, and antipsychotics interact with Lexapro. Patients taking other medications must discuss that with the healthcare provider beforehand and refer to the official
People With Certain Medical Issues
Certain medical conditions may make individuals more susceptible to some side effects of Lexapro. In
Contraindications
The key contraindications to taking Lexapro are the following:
- The Use of Monoamine Oxidase Inhibitors (MAOIs): The use of escitalopram with MAOIs, or within 14 days after stopping them, is contraindicated because it can lead to serotonin syndrome. As serotonin is not reabsorbed and accumulates in the synaptic cleft in our brain, it may cause symptoms ranging from shivering and diarrhea to more serious ones such as muscle rigidity, fever, and seizures.
- The Use of Pimozide: Using pimozide along with Lexapro could increase the risk of irregular heart rhythm (arrhythmia) and palpitations. Patients with prior cardiac issues should be cautioned further. Remember to inform your healthcare provider about any medications you are taking before starting Lexapro.
- Liver or Renal Problems: Since escitalopram breaks down in the liver, patients with kidney or liver impairment may require dose adjustment and continuous monitoring to prevent the medication’s buildup in the body.
- Hypersensitivity to Escitalopram: Individuals sensitive to escitalopram or other Lexapro ingredients should be cautious before taking this medication and inform a medical provider in advance.
Factors That Affect the Duration and Intensity of Side Effects
The duration and severity of Lexapro side effects vary significantly from one individual to another. Knowing the factors can help adjust your expectations and provide you with an insight into the occurrence of side effects and how to deal with them. Some factors include:
- Age: Younger adults may experience specific bad side effects, like suicidal thoughts, more intensely due to higher serotonin sensitivity. However, side effects like hyponatremia or dizziness may last longer in older adults due to slower medication clearance.
- Dosage: A higher dose may be linked with a higher risk of side effects and withdrawal symptoms. It should be kept in mind that the dosage is based on each individual’s history.
- Abrupt Discontinuation: Discontinuing the medicine suddenly without slowly tapering off the dose increases the likelihood as well as the severity of withdrawal symptoms.
- Prolonged Use: Individuals taking escitalopram for a prolonged period may be more likely to experience withdrawal symptoms.
What to Expect After Stopping Lexapro?
Lexapro is not advised to be stopped abruptly as this may cause withdrawal symptoms, such as:
- Brain zaps, dizziness, and nausea.
- Flu-like symptoms, such as fatigue, muscle pain, chills, and headaches.
- Mood fluctuations like irritation, anxiety attacks, sadness, mood swings, and increased depression.
- Insomnia, inability to get deep sleep, and vivid dreams.
- Sensory disturbances, such as tingling sensations in feet, hands, or face.
- Random episodes of night flashes or sweating.
- Difficulty concentrating and “brain fog”.
Symptoms may be short-term or long-term depending on the individual, dose, and duration of treatment. Short-term symptoms tend to subside within 1-2 weeks after discontinuation while long-term symptoms may persist for several weeks.
Is Taking Lexapro Worth It?
Whether Lexapro is worth it depends on an individual’s needs, health history, and the body’s response to the medication. Like any medication, Lexapro can have both benefits and potential side effects. Also, its effectiveness may vary from one individual to another.
|
Potential benefits |
Potential drawbacks |
|
Shown effectiveness for depression and anxiety. |
Potential side effects, including stomach issues, weight changes, drowsiness, and sexual dysfunction. |
|
Better tolerance compared to some other antidepressants. |
Risk of |
|
Fewer side effects as compared to older antidepressants as well as safer long-term use. |
After starting the treatment, some people may face an initial worsening of symptoms of depression and anxiety. |
|
Improved mood as well as better sleep and concentration. |
Effectiveness may vary from one person to another. |
Lexapro can be helpful for many struggling with anxiety or depression; often, the potential for symptom relief outweighs manageable side effects. Also, rather than being used alone, antidepressants like Lexapro are usually a part of a comprehensive treatment plan, including lifestyle adjustments, therapy, and self-care to
When to Contact Healthcare Provider About Side Effects
If you notice any irregular changes in your health status, or the side effects become severe and don’t resolve gradually, it is important to inform your healthcare practitioner. Reach out to your provider in the following cases:
- Severe side effects, such as cardiac issues, dizziness, confusion, tremors, and muscle rigidity.
- Increased initial worsening symptoms of depression and anxiety; agitation, extreme mood swings, and suicidal thoughts.
- Symptoms of bipolar disorder, such as mania or hypomania, more energy than usual, impulsive behaviors, racing thoughts, and reduced need for sleep.
- Rash, itching, seizures, swelling, or difficulty breathing may be symptoms of an unusual or allergic reaction to Lexapro and require medical attention.
- Severe sexual dysfunction.
- Severe withdrawal symptoms; it is important to contact your healthcare provider so they can tell you how to taper off the medication.
Preventing Side Effects
While it may not always be possible to completely avoid side effects, with careful strategies, the likelihood of side effects can be reduced. Some of the ways are the following:
- Follow the prescribed dose; typically, your medical provider will start by prescribing the lowest effective dose and may increase it gradually when needed, according to your response to the medication.
- Take Lexapro at the same time every day: it helps maintain the levels of the medication in your body consistent, minimizing side effects.
- Communicate with your healthcare practitioner if you experience side effects; some of them, such as sleep disturbance, can be managed by adjusting the time you take the medication.
- Avoid discontinuing the medicine abruptly to lower the risk of withdrawal symptoms.
- Taking Lexapro with food may help reduce gastrointestinal side effects.
- Supplement Lexapro with lifestyle changes, such as proper hydration, a balanced diet, as well as regular exercise.
- Avoid alcohol to prevent interactions.
- Inform your healthcare provider regarding any other medications and over-the-counter supplements.
Conclusion
Knowing the risks and potential side effects of Lexapro will make you more aware of what to expect and how to better handle the situation. If you’re experiencing discomfort or have concerns about taking Lexapro, discuss them with your healthcare provider.
If you are seeking online treatment for depression or anxiety, schedule a video appointment with our licensed healthcare providers at MEDvidi. They will evaluate your symptoms and provide you with an individualized treatment plan, including an online prescription if deemed clinically appropriate.
FAQs
What to avoid when taking Lexapro?
Who should avoid Lexapro?
Lexapro (escitalopram) may not be suitable for individuals with severe liver or kidney impairments, hypersensitivity to the medication, epilepsy, a history of QT interval prolongation, and more. For pregnant or breastfeeding women, it should be prescribed with caution and under certain conditions. Remember to discuss your health history with a healthcare provider to find the most suitable medication for depression or anxiety.
How long do the side effects of Lexapro last?
Is it better to take Lexapro in the morning or at night?
Does Lexapro make you feel bad at first?
Do the side effects of Lexapro go away?
How long does it take to adjust to Lexapro?
Typically, it takes two to four weeks to adjust to Lexapro, during which time initial side effects tend to resolve. Complete therapeutic benefits can take four to six weeks to develop. Remember to follow-up with your healthcare provider to monitor your health dynamics and adjust your treatment plan timely if needed.
