Millions of Americans seek treatment for anxiety and depression each year, and many of them are prescribed the antidepressant Lexapro. If you’re among them and your doctor has recommended Lexapro, you may have some questions. The sections that follow contain what to know about taking Lexapro.
What Is Lexapro and What Is It Used For?
Lexapro, a brand name for escitalopram, is one of the medications doctors prescribe to treat and manage several psychiatric conditions. It is a selective-serotonin reuptake inhibitor (an SSRI) medication commonly prescribed for certain types of anxiety and depression.
How It Works
Serotonin, a chemical produced in the body, helps stabilize mood and produces a sense of well-being. Lexapro slows the reabsorption of serotonin back into the nerve cells, helping maintain higher levels of serotonin in the brain.
Understanding Lexapro
How long does Lexapro take to work? The opinions are mixed here. Some say it starts working the first day they take it. Most report that it takes several weeks to two months to really start working.
Lexapro Uses and Benefits
Doctors prescribe Lexapro to help individuals manage psychological conditions. These may include various anxiety disorders, such as generalized anxiety disorder (GAD) and social anxiety disorder. Lexapro is also used to treat major depressive disorder, obsessive-compulsive disorder (OCD), and panic disorder.
Lexapro may also be prescribed as an off-label treatment for seasonal affective disorder (SAD) and premenstrual syndrome (PMS).
Lexapro Risks and Side Effects
As with any prescription medication, there are always risks and side effects. Lexapro is no different, although some side effects may be less than with other similar antidepressants. While many side effects may improve within a couple of weeks of taking Lexapro, often, the sexual side effects do not.
What Are the Common Side Effects of Taking Lexapro?
Common Lexapro side effects include:
- Anorexia
- Abdominal pain (cramps)
- Constipation
- Diarrhea
- Difficulties/problems with sexual functions
- Dizziness
- Drowsiness
- Dry mouth
- Fatigue
- Heartburn
- Insomnia
- Runny nose
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
Immediate Effects of Lexapro
Are Lexapro’s effects immediate? How long does Lexapro take to work?
Most of the time, the effects won’t be immediately discernible. Serotonin levels in the brain can increase in a few hours, yet the medication may take several weeks to kick in. You may feel more energetic or have side effects like constipation, decreased appetite, drowsiness, dry mouth, or nausea. However, they will likely disappear as your body becomes accustomed to Lexapro and the increased serotonin levels in the brain.
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.
How Do You Know Lexapro Is Working?
Some signs indicate Lexapo 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.
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 not take Lexapro or other SSRIs during their second-half 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
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. Research shows that about 40 percent of those taking antidepressant medications like Lexapro will experience some weight gain. However, reported Lexapro weight gain is much less than with other antidepressants but more than with fluoxetine.
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.
Treatment Duration and Withdrawal
Lexapro can provide significant relief of anxiety and depression symptoms. Still, after the initial concern about how long Lexapro takes to work, there’s eventually a need to discuss treatment duration and withdrawal.
Individuals taking Lexapro for acute GAD should be periodically reassessed by their doctor to determine if they require continuing treatment. Lexapro’s efficacy after eight weeks hasn’t been studied systematically.
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.
Of course, when discussing Lexapro, how long to work is often the top question. You’ll also want to go through the Lexapro immediate effects, and Lexapro side effects first week. However, Lexapro and how long it takes to work are almost always the primary concerns.
Discontinuing Lexapro
Never stop taking Lexapro without your doctor’s guidance. Stopping suddenly can worsen drug withdrawal symptoms. Also, fatigue, headache, mood swings, disturbed sleep, and brief tingling, electric-shock-type feelings may occur. Your doctor will likely gradually reduce dosage while you are discontinuing treatment with the drug.
Making the Decision
It can be extraordinarily debilitating to experience untreated anxiety or depression. Medication can help you manage symptoms, while counseling can provide effective coping strategies and tools to feel better. Ultimately, though, the decision to proceed with medication or counseling is entirely yours.
If you have questions about Lexapro or treatment for anxiety or depression, our experts at Restore-Mental Health are always available. Contact us for a free and confidential consultation about our programs.
