Can you overdose on lexapro?
Lexapro (escitalopram) is an SSRI used to treat depression, anxiety, and related disorders. An overdose is rare but can occur if you take more than prescribed or combine it with other serotonergic drugs.
What is Lexapro?
Lexapro is a selective serotonin reuptake inhibitor (SSRI) approved for major depressive disorder and generalized anxiety disorder. It increases serotonin levels in the brain to improve mood and can also be used off‑label for OCD, panic disorder, and PTSD.
Common side effects
- Nausea
- Diarrhea
- Sweating
- Tremors
- Trouble sleeping
- Headache
- Fatigue
- Sexual side effects (low libido, difficulty reaching orgasm)
Overdose symptoms
- Headache
- Drowsiness
- Blurred vision
- Fever
- Convulsions
- Slow or fast heart rate
- Coma
- Insomnia
- Nausea and vomiting
- Confusion
Serious overdose symptoms
- Seizures
- Hallucinations
- Cardiovascular toxicity
- Suicidal thoughts
- Kidney failure
Serotonin syndrome
An SSRI overdose can trigger serotonin syndrome, a potentially fatal buildup of serotonin. Risk increases with overdose or combining SSRIs with MAOIs, TCAs, triptans, SNRIs, lithium, tramadol, St. John’s Wort, and other serotonergic agents.
- Increased heart rate
- Dizziness
- High body temperature
- High blood pressure
- Flushing
- Nausea, vomiting, diarrhea
- Tremor, muscle stiffness
- Loss of coordination
- Hallucinations, agitation
- Coma
How is overdose treated?
Immediate medical attention is required. Emergency responders will monitor vital signs, perform ECG, and may administer activated charcoal if ingestion was recent. Ongoing monitoring and supportive care, including mental health follow‑up, are essential.
How to prevent overdose
- Take only the prescribed dose; do not increase without consulting your provider
- Avoid contraindicated combinations, especially MAOIs (phenelzine, isocarboxazid, methylene blue, rasagiline) within 2 weeks of stopping Lexapro
- Do not use with other serotonergic drugs (lithium, fentanyl, tramadol, TCAs, triptans, SNRIs, amphetamines, buspirone, St. John’s Wort, other SSRIs)
- Inform your provider of all medications and supplements before starting Lexapro
Missed dose
If you miss a dose, take it as soon as you remember unless it’s almost time for the next dose. Do not double doses to catch up.
Alcohol and Lexapro
Avoid alcohol while taking Lexapro, as it can increase side effects, reduce medication efficacy, and heighten overdose risk.
Sources
- Physician’s Digital Reference. Escitalopram oxalate – drug summary. Accessed Jan 28, 2025.
- U.S. National Library of Medicine. Escitalopram. Accessed Jan 28, 2025.
- MedlinePlus. Serotonin syndrome. Accessed Jan 28, 2025.
- van Gorp GFWM et al. Clinical and ECG effects of escitalopram overdose. Ann Emerg Med. Accessed Jan 28, 2025.