What is Lexapro?

Lexapro (escitalopram) is a brand-name antidepressant medication that is used to treat a variety of mental health conditions such as anxiety and depression. It is a selective serotonin reuptake inhibitor (SSRI) that was approved by the U.S. Food and Drug Administration (FDA) in 2002. It works by increasing serotonin levels, a natural substance in your brain that helps regulate your mood.

SSRIs like Lexapro are generally safe and effective and cause fewer side effects than older antidepressants, such as monoamine oxidase inhibitors (MAOIs). Lexapro is not addicting like Xanax (alprazolam) or other benzodiazepines, which can be used to treat anxiety. It can, however, cause withdrawal symptoms if you suddenly stop taking this medication. It can cause some common side effects that include headache, nausea, ejaculation problems or decreased sex drive, drowsiness, and dry mouth.

While Lexapro does have drug interactions, it has fewer when compared to other SSRIs. But, there are still some potentially serious ones you should be aware of, which we will discuss later in this blog. Keep reading and we will also discuss details on how it works, possible side effects, warnings, and other important information you should know.

How does Lexapro work?

Lexapro contains the active ingredient escitalopram. It is in a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). Lexapro works by increasing the levels of serotonin, a chemical in your brain that is involved with regulating your mood and anxiety.

What is Lexapro used for?

Lexapro is FDA-approved to treat adults with major depressive disorder (depression) and general anxiety disorder (GAD). It is also approved to treat depression in children 12 to 17 years of age. Your healthcare provider may also use it to treat panic disorder or panic attacks, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD).

What are the side effects of Lexapro?

The most common side effects of Lexapro seen in clinical trials include:

  • Headache
  • Nausea
  • Ejaculation problems
  • Sleepiness
  • Trouble sleeping
  • Dry mouth
  • Diarrhea
  • Fatigue or tiredness

Some other less serious side effects that may occur include:

  • Dizziness
  • Sweating
  • Low appetite or weight loss (most commonly in children)
  • Indigestion
  • Constipation
  • Lower sexual drive
  • Flu-like symptoms

Rarely, Lexapro may cause some more serious side effects such as:

Serious, life-threatening allergic reactions.

Seek immediate medical attention if you experience hives, swelling of your tongue, face, or throat, or trouble breathing.

Worsening depression and suicidal thoughts.

Taking Lexapro can worsen your depression and cause you to have thoughts of suicide or harming yourself. You are at an increased risk of this during the first few weeks of taking the medication, during any change in dose, or if you are a young adult 24 years of age or younger. If you or your loved ones notice that you are having suicidal thoughts or behavioral changes such as anxiety, panic attacks, trouble sleeping, feeling angry or irritated, or restlessness, seek medical attention right away.

Serotonin syndrome.

Lexapro can rarely cause a potentially life-threatening condition called serotonin syndrome. This happens when there is too much serotonin in your brain. This risk is higher if you use Lexapro with other medications that can raise your serotonin levels, such as certain medications for depression, pain, and migraines. Talk with your healthcare provider about any medications you are taking before starting Lexapro. Seek medical attention right away if you experience symptoms of serotonin syndrome such as increased heart rate, sweating, muscle spasms or stiffness, fever, and confusion.

Increased risk of bleeding.

Lexapro can increase your risk of severe bruising or bleeding, especially if you take other medications that affect clotting. This includes Coumadin (warfarin), aspirin, Plavix (clopidogrel), and Eloquis (apixaban). Seek medical attention if you have bruising that won’t go away, black-colored stools, red or pink-colored urine, coughing up or vomiting blood, or unusual bleeding from your nose or gums.

Glaucoma.

Lexapro can cause or worsen angle-closure glaucoma. Let your healthcare provider know if you develop sudden eye pain or changes in your vision such as blurry vision, seeing halos around lights, or vision loss.

Heart rhythm problems.

Lexapro can affect your heart rhythm, which can be serious and life-threatening. You are at an increased risk of this if you have abnormal electrolyte levels, heart rhythm problems, or are taking other medications that cause heart rhythm problems. If you feel your chest pounding, have shortness of breath, have chest pain, or feel faint or lightheaded while taking Lexapro, seek immediate medical attention.

Low sodium levels.

Lexapro can cause low blood sodium levels. Your healthcare provider may monitor your sodium levels before starting Lexapro and while you are on it. Seek medical attention right away if you develop weakness, confusion, trouble concentrating, headache, or memory problems.

These are not all of the possible side effects of Lexapro. Contact your healthcare provider for medical advice about any possible adverse effects you experience while taking this medication. You can report your adverse effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

What drug interactions are there with Lexapro?

When you take Lexapro with other medications, it can change how they work or make some side effects like CNS depression more likely or severe. You should ask your healthcare provider if any of the prescription drugs, over-the-counter (OTC) medications, vitamins, or supplements you take may interact with Lexapro, including:

Other medications that increase serotonin levels such as:

  • Other SSRIs such as Celexa (citalopram) and Zoloft (sertraline)
  • SNRIs such as Cymbalta (duloxetine) and Effexor (venlafaxine)
  • Monoamine oxidase inhibitors (MAOIs): isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine
  • Tricyclic antidepressants (TCAs) such as Pamelor (nortriptyline)
  • Triptans for migraines such as Imitrex (sumatriptan)
  • Opioids such as fentanyl and tramadol
  • Tryptophan
  • St. John’s Wort
  • Amphetamines

Drugs that affect blood clotting such as:

  • NSAIDs such as ibuprofen and naproxen
  • Aspirin
  • Coumadin (warfarin)
  • Plavix (clopidogrel)

Medications that affect the heart rhythm (QT prolongation):

  • Amiodarone
  • Pimozide
  • Procainamide
  • Quinidine
  • Sotalol

Drugs that cause drowsiness including alcohol, marijuana, antihistamines, medications for sleep or anxiety, and muscle relaxants

What does your healthcare provider need to know before you start Lexapro?

You should not take Lexapro if you are allergic to escitalopram, citalopram, or any of the inactive ingredients in the product. You should also not take an MAOI within 2 weeks of stopping Lexapro or start Lexapro if you stopped taking an MAOI in the last 2 weeks unless directed to do so by your healthcare provider. Taking these medications too close together can cause serious, possibly life-threatening adverse effects such as:

  • High fever
  • Muscle stiffness
  • Uncontrolled muscle spasms
  • Rapid changes in your blood pressure or heart rate
  • Confusion
  • Passing out

Seek immediate medical attention if you develop any of these symptoms.

Also before taking this medication, be sure your healthcare provider knows all of your other medical conditions, including:

  • Liver, heart, or kidney problems
  • History of seizures or convulsions
  • Bipolar disorder or mania
  • Low blood sodium levels
  • History of a stroke
  • High blood pressure
  • History of bleeding problems
  • If you are pregnant or breastfeeding

How should you store Lexapro?

Store Lexapro in a tightly closed container at room temperature, away from heat, moisture, and direct light. It may be stored between 59°F to 86°F (15°C to 30°C) for short periods of time if needed. As with all medications, keep out of the reach of children.

What should you do if you miss a dose of Lexapro?

If you miss a dose of Lexapro, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose. Take the next dose at its regular time. Do not double the dose to catch up.

Related Medications

  • Zoloft (sertraline)
  • Prozac (fluoxetine)
  • Paxil (paroxetine)
  • Celexa (citalopram)
  • Pristiq (desvenlafaxine)
  • Effexor XR (venlafaxine ER)

Sources

  • Escitalopram oxalate – drug summary. Physician’s Digital Reference. Accessed July 5, 2024.
  • Escitalopram. U.S. National Library of Medicine. Accessed July 5, 2024.
  • Landy, K., Rosani, A., & Estevez, R. (2024). Escitalopram. In StatPearls. StatPearls Publishing. Accessed July 5, 2024.
  • Information for healthcare professionals: Escitalopram (marketed as Lexapro). U.S. Food & Drug Administration. Accessed July 5, 2024.
  • Escitalopram (Lexapro). National Alliance on Mental Illness. Accessed July 5, 2024.
  • Degeorge K. C., et al. (2022). Generalized anxiety disorder and panic disorder in adults. Accessed July 5, 2024.