Escitalopram is a selective serotonin reuptake inhibitor (SSRI) antidepressant known by the brand name Lexapro. Because of Lexapro’s safety and effectiveness in relieving symptoms and elevating a patient’s mood, it’s one of the most commonly prescribed drugs for treating depression and anxiety. However, before you talk to a doctor about getting a prescription, it’s important to learn how escitalopram works, research the conditions treated with Lexapro and discover the potential side effects and risks.
Conditions Treated With Lexapro
The U.S. Food and Drug Administration (FDA) has approved Lexapro for treating major depressive disorder (MDD) in adults and adolescents 12 and older and generalized anxiety disorder (GAD) in adults and children 7 and older. Some psychiatrists use Lexapro off-label to treat panic disorder, social anxiety, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), premenstrual dysphoric disorder (PMDD) and menopause.
Before prescribing Lexapro, your psychiatrist may evaluate your symptoms to see if you’re a good candidate. Common signs of MDD include:
- Depressed mood
- Fatigue
- Feelings of guilt
- Difficulty concentrating
- Poor appetite
- Slow movements
- Reduced sleep quality
- Suicidal thoughts
You might have GAD if you experience any of these symptoms:
- Excessive worrying
- Restlessness
- Irritability
- Poor concentration
- Trembling
- Body aches
- Sleep disturbances
Depression and anxiety tend to have high comorbidity levels. Fortunately, for some patients, Lexapro can treat both disorders at once.
How Lexapro Works in the Brain
As an SSRI, Lexapro increases the levels of serotonin released into the brain by blocking its reuptake into nerve endings. Serotonin is a naturally occurring neurotransmitter known to influence a person’s mood, sleep, memory, impulse control and sex drive. When you’re living with depression or anxiety, serotonin levels may be insufficient, which causes low mood.
What Lexapro does to your brain may help you feel more focused, increase your energy levels and relieve feelings of worthlessness and guilt. This medication can also help improve your mood and your sleep quality. If you’re living with anxiety, it can help lessen your feelings of nervousness, irritability and restlessness. For most people, Lexapro is effective when combined with talk therapies and other evidence-based mental health treatments.
How Long Does Lexapro Take to Work?
So, when does Lexapro start working? While some people experience the benefits from treatment with Lexapro within the first couple of weeks after starting treatment, it can take up to 8 weeks for others to feel the full effects. If you don’t start seeing improvements within the first few weeks, your doctor might increase your dose or even change your antidepressant medication. It’s important to keep taking the medication as prescribed until your doctor can evaluate your symptoms.
How Do You Know Lexapro Is Working?
Some signs indicate Lexapro is working. These include:
- Sleep improvement
- Increased energy
- Better appetite
- Mood improvement (relief from depressed mood)
- Renewed interest in enjoyable activities
It is important to note that some may occur in one to two weeks, while some psychological improvements may take six to eight weeks.
What Can Influence Lexapro’s Effectiveness?
Several factors can influence how escitalopram works. It’s important to take this medication as your health care provider indicates, and you should let them know of any previous health conditions or medications you’ve taken. Some factors that may affect how well escitalopram works in relieving depression or negatively interact with it include:
- Medications, such as other SSRIs, antianxiety medication, antipsychotic medications, blood thinners and nonsteroidal anti-inflammatory drugs
- Supplements, such as Saint-John’s-wort
- Health conditions that include seizures, glaucoma, liver or kidney disease and some heart conditions
For some people, Lexapro is more efficient when taken at night, while other patients experience better outcomes if they take it in the morning. However, it’s best to take it at around the same time each day and speak to your health care provider if you wish to change your dosage.
Doctors generally start new patients on a lower dose before upping it. In some cases, it will take a while before you’re on the correct dosage. However, people respond differently to antidepressants. If Lexapro doesn’t work for you, your prescriber might need to consider different treatment options. Don’t be discouraged if that happens. There’s often a trial-and-error process when it comes to any type of psychiatric treatment.
Lexapro Dosage and Administration
Lexapro dosage is typically 10 mg daily, taken by mouth with food or without. As for timing, it can be taken in the morning or at night.
If sleeplessness becomes problematic when taking Lexapro, take it in the morning. However, if it makes you sleepy when you take it in the morning, try taking it nightly. As for night sweats, switch to taking Lexapro in the morning. Although sweats may still occur, many people say they’re more manageable in the daytime.
For Generalized Anxiety Disorder
The usual dose for adults diagnosed with generalized anxiety disorder (GAD) is initially 10 mg orally once daily. The doctor may increase the dose after a week of treatment to 20 mg once daily. For maintenance of GAD, the usual adult dose is 10 to 20 mg orally once daily. The maximum Lexapro adult dose is 20 mg once a day.
For Depression
For adults diagnosed with depression, the usual dose of Lexapro is 10 mg once daily, taken by mouth. After one week of treatment, the doctor may increase the dose to 20 mg once daily. The maintenance dose for adults is 10 to 20 mg once daily. Lexapro’s maximum daily dose is 20 mg.
Potential Side Effects and Risks
For most people, Lexapro acts as prescribed with minimal to no side effects. However, like all medications, it can cause unpleasant symptoms ranging from mild to severe. Most side effects usually subside after an adjustment period of 1 or 2 weeks, but those experiencing some of the more severe reactions should contact a health care professional as soon as possible. Your doctor might reduce your dose or, in some cases, change your medication entirely.
Some of the most common side effects that usually go away within the first week of treatment include:
- Nausea and diarrhea
- Difficulty falling asleep
- Feeling unusually tired
- Dry mouth
- Changes in appetite
- Muscle and joint aches
- Cold and flu-like symptoms
- Loss of interest in sex
- Inability to orgasm
You should contact your prescriber immediately if you experience any more serious adverse effects, such as confusion, seizures, severe headaches or trouble breathing. While rare, some of the more severe side effects might require medical attention and, in some cases, even hospitalization.
Lexapro Side Effects in the First Week
You may wonder about Lexapro’s side effects in the first week—a common concern. During the first week of taking Lexapro, you may have trouble sleeping, feel drowsy during the day, and experience diarrhea or nausea. Side effects will decrease after your body acclimatizes to Lexapro’s active ingredient, escitalopram. Usually, this occurs after about two weeks.
Serious Side Effects
Let your doctor know immediately if you experience any serious side effects, such as:
- Increased bleeding and bruising
- Lack of interest in sex
- Noticeable changes in sexual abilities
Extremely serious side effects requiring immediate medical attention include:
- Allergic reaction (rash, itching and swelling, severe dizziness, and trouble breathing)
- Black/bloody/tarry stools
- Changes in vision
- Eye pain, including swelling and redness
- Fainting
- Irregular/rapid heartbeat
- Seizures
- Vomit (resembling coffee grounds or with blood)
- Wide pupils
Weight Gain
Taking Lexapro may result in weight gain for some people. The medication blocks serotonin transport, which increases brain levels of serotonin but also increases appetite and decreases metabolism. However, reported Lexapro weight gain is much less than with other antidepressants but more than with fluoxetine.
Lexapro Precautions and Considerations
Several factors influence Lexapro side effects, both in the first week and after, including the person’s age and whether they take other medications.
- Pregnant women should talk with their doctor about taking Lexapro or other SSRIs during the second half of pregnancy. Doing so can slightly increase the infant’s risk of developing persistent pulmonary hypertension. Pregnancy complications may also be a risk.
- Lexapro has an FDA-boxed warning, meaning suicidal behavior and thoughts may be a risk for children, teens, and young adults.
- Severe allergic reactions, though rare, may occur.
- Those with bipolar disorder taking Lexapro have an increased likelihood of experiencing a manic episode.
- Low blood sodium levels are a greater risk, particularly for older individuals.
- Serious heart problems may result when taking Lexapro and pimozide, an antipsychotic.
Serotonin Syndrome Toxicity
One extremely serious condition that may occur with Lexapro is serotonin syndrome/toxicity. The risk is magnified if you also take another drug that increases serotonin. Seek medical attention right away if you experience some of the following:
- Coordination difficulties
- Extreme dizziness
- Hallucinations
- Inexplicable fever
- Muscle twitches
- Rapid heartbeat
- Severe diarrhea, nausea, vomiting
- Unusual restlessness or agitation
Is Lexapro Addictive?
Lexapro isn’t considered a controlled substance in the United States, and the potential for misuse is very low. While you’re unlikely to experience Lexapro euphoria, there’s a risk of developing a physical dependence with long-term use. You should never stop taking this medication suddenly, as it increases the risk of withdrawal.
Symptoms of discontinuing SSRI medications are uncomfortable and can sometimes mimic a relapse of depression or anxiety. Some of the possible discontinuation symptoms include:
- Nausea, vomiting and heartburn
- Feeling dizzy
- Irritability
- Brain zaps (sensory disturbances that feel like an electric shock)
- Trouble sleeping and strange dreams
- Low mood
- Feelings of restlessness
It’s crucial to speak to your prescriber before you stop taking your medication. Coming off Lexapro should be a gradual process of lowering your dose, and it should be done under medical supervision to help minimize the risk of unpleasant withdrawal.
How Long Can You Take Lexapro?
Those taking this medication for acute depressive episodes may require several months of Lexapro treatment after the initial acute episode response. The doctor may prescribe it for a specified period, such as six months or a year. Research shows Lexapro (or other antidepressants) may benefit those with depression, likely combined with therapy.
However, individuals should be assessed periodically to gauge whether they need maintenance Lexapro treatment. Some who have persistent depression may require many years of treatment with Lexapro. Notably, long-term Lexapro treatment isn’t known to cause problems.
What Should I Discuss With My Doctor Before Taking Lexapro?
When your doctor prescribes this medication, it would be good to ask how long Lexapro takes to work. Bring your current medication list, including over-the-counter medicines, vitamins, and supplements. It is essential to mention any medications that increase bleeding risk, such as aspirin, prescription blood thinners (Eliquis, Coumadin, Warfarin), NSAIDs, and other anticoagulant or antiplatelet drugs.
While your doctor reviews your medications list, ask about any potential drug interactions and if you should take Lexapro at a different time.
Get Support at Restore
Medication could be one of the first steps on your road to recovery. If you’re experiencing struggles with your mental health and feel the need for support, the team of counselors and psychiatrists at Restore Mental Health in Deerfield Beach can help you lead a better life. Call (877) 810-2074 or get in touch with us today and take the first step toward recovery.
Contact Restore Mental Health