Escitalopram oxalate (Lexapro) is a generic prescription medication used to treat:

Escitalopram comes as an oral tablet. It also comes as an oral solution. This article will only cover the side effects of the oral tablet form. For more information about escitalopram oral solution, talk with your doctor.

If you and your doctor decide that escitalopram is working well for you, your doctor may prescribe the drug long term. As with other drugs, escitalopram can cause side effects.

Read on to learn about potential common, mild, and serious side effects. For a general overview of escitalopram, refer to this article. Your doctor can also tell you more about escitalopram.

Escitalopram can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

These are just a few of the more common side effects reported by people who took escitalopram in clinical trials:

  • fatigue
  • somnolence (tiredness or drowsiness)
  • insomnia
  • sweating more than usual
  • sexual side effects*
  • nausea*

* For more information about this side effect, see the “Escitalopram: Side effect specifics” section below.

Mild side effects can occur when taking escitalopram. This list does not include all possible mild side effects of the drug. For more information, you can refer to escitalopram’s prescribing information.

Mild side effects that have been reported with escitalopram include:

  • fatigue
  • somnolence (tiredness or drowsiness)
  • insomnia
  • sweating more than usual
  • dry mouth
  • constipation
  • sexual side effects*
  • nausea*
  • diarrhea*
  • headache*
  • mild allergic reaction*

These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you develop a side effect while taking escitalopram and want to tell the FDA about it, visit MedWatch.

* For more information about this side effect, see the “Escitalopram: Side effect specifics” section below.

Escitalopram may cause serious side effects. The list below may not include all possible serious side effects of the drug. For more information, you can refer to escitalopram’s prescribing information.

If you develop serious side effects while taking escitalopram, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Serious side effects that have been reported and their symptoms include:

  • Serotonin syndrome (a condition caused by high levels of the chemical serotonin). Symptoms can include:
    • fever
    • rapid heart rate
    • dizziness
    • seizure
    • blood pressure changes
  • Hyponatremia (low sodium levels). Symptoms may include:
    • confusion
    • weakness
    • trouble concentrating
    • headache
    • memory problems
    • unsteadiness and falling
  • Mania or hypomania, which are periods of unusually high levels of energy. Symptoms may include:
    • racing thoughts
    • talking more or speaking faster than usual
    • reckless or impulsive behaviors, such as excessive spending
  • Seizure. Symptoms may include:
    • staring into space or blinking quickly
    • loss of consciousness
    • jerking or repetitive body movements
  • Increased bleeding and bruising. Symptoms may include:
    • bleeding or bruising more often than usual
    • bleeding that takes a long time to stop, such as nosebleeds or bleeding gums
    • bloody urine, stool, or vomit
  • Suicidal thoughts and behaviors in young people.*
  • Severe allergic reaction.†

* Escitalopram has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “Escitalopram: Side effect specifics” section below.
† An allergic reaction is possible after using escitalopram. However, this side effect wasn’t reported in clinical trials. It was seen after the drug became available for use. To learn more, see the “Escitalopram: Side effect specifics” section below.

Escitalopram is approved to treat major depressive disorder (MDD) in children ages 12 and older. In clinical trials, children experienced similar side effects as adults. They also experienced back pain, nasal congestion, and vomiting.

It is important to note that these side effects were reported in children ages 6 to 17 years old who were taking the drug for MDD. So, it is unknown whether these side effects specifically occurred in children over 12 years old. Escitalopram is not approved for use in children under 12 years old. The safety of escitalopram for this age group is unknown.

If you have questions about how escitalopram will affect your child, talk with their doctor.

Escitalopram may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.

How do side effects of escitalopram 5-mg, 10-mg, and 20-mg tablets compare?

Typically, side effects of escitalopram can be more severe with higher doses. In clinical trials, the most common mild side effects of escitalopram occurred more often in people taking 20-mg tablets than in those taking 10-mg tablets. (To learn more about these common side effects, see the “Escitalopram: Mild side effects” section above.)

Also, higher doses of the drug can increase the risk of severe side effects in people with liver or kidney problems. This is because escitalopram is broken down in the body by the liver. Some of the drug then leaves the body in urine through the kidneys. So, if these organs are not working correctly, the drug can build up in your body and increase the risk of severe side effects.

Side effects of escitalopram, such as hyponatremia (low sodium levels), may also be more severe in older adults. This is because older adults can be more sensitive to the effects of medications, including escitalopram.

If you have questions about what side effects you might experience with your escitalopram dosage, talk with your doctor or pharmacist.

Is weight gain or weight loss a side effect of escitalopram?

It’s possible for escitalopram to cause weight loss or weight gain as a side effect. People in clinical trials of escitalopram did not report weight loss. However, there have been reports of weight loss since the drug became available for use. Weight gain was rarely reported as a side effect in clinical trials. It is unknown if escitalopram directly causes weight changes or how often it does.

Children taking selective serotonin reuptake inhibitors (SSRIs) may lose weight during escitalopram treatment. (Escitalopram is a type of SSRI.) This weight loss can also occur with delayed growth. For this reason, your child’s doctor will closely monitor your child’s weight and growth during escitalopram treatment.

Weight loss or weight gain can also be a symptom of major depressive disorder (MDD) or generalized anxiety disorder. Changes in weight can occur due to symptoms of these conditions, such as changes in appetite or physical activity level.

If you are concerned about weight changes while taking escitalopram, talk with your doctor. They can suggest ways to maintain a weight that’s healthy for you.

What escitalopram side effects can I expect in the first week of treatment and long term?

In the first week of escitalopram treatment, you may experience side effects more often than in the later weeks. These side effects are typically mild.* The frequency of these side effects may decrease over time as your body adjusts to the medication.

If you’re taking escitalopram to treat MDD, your depression may worsen† at the start of treatment. This is more likely to occur in children and young adults up to 24 years old. If you have side effects that are bothersome or do not go away, talk with your doctor. They can discuss with you whether there are ways to ease these side effects. They can also help determine if other treatment options would be better for you.

* To learn more about mild side effects, see the “Escitalopram: Mild side effects” section above.
Escitalopram has a boxed warning for suicidal thoughts and behaviors in young people. This can occur due to worsening depression. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “Escitalopram: Side effect specifics” section below.

Learn more about some of the side effects that escitalopram may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for escitalopram.

Suicidal thoughts and behaviors in young people

Escitalopram has a boxed warning for suicidal thoughts and behaviors in young people. This is a serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

Signs of suicidal thoughts or behaviors include:

  • worsening depression or anxiety
  • thoughts of harming oneself
  • aggressiveness
  • feeling agitated or irritable (easily frustrated or upset)
  • behaviors and feelings that aren’t typical for you

In short-term studies, people ages 24 years and younger who were taking antidepressants had an increased risk of suicidal thoughts and behaviors. (Escitalopram is a type of antidepressant.) It is unclear if the antidepressants caused the increased risk or if there were other factors. For example, depression and certain other mental health conditions also increase the risk of suicidal thoughts and behaviors.

What you can do

If you have thoughts of harming yourself while taking escitalopram, call 911 or your local emergency number. Or tell your doctor right away.

It’s important to watch for signs of worsening depression, such as those listed above. It can take several weeks to notice whether escitalopram is easing your symptoms. So, it’s important to have support during this time. Those close to you can also help you watch for these signs.

Before starting escitalopram treatment, talk with your doctor about your medical history, including if you’ve ever had suicidal thoughts or behaviors. If you are under 24 years old or if your child is prescribed escitalopram, the doctor will discuss the risks and benefits of taking the drug.

Sexual side effects

Sexual side effects were commonly reported in clinical trials of people taking escitalopram. These side effects can lead to sexual frustration, stress, and anxiety for both males* and females.*

Sexual side effects in males can include:

Sexual side effects in females can include:

What you can do

If you are experiencing sexual side effects while taking escitalopram, talk with your doctor. Medical conditions, treatments, and lifestyle behaviors can also cause sexual side effects. So your doctor can help determine if escitalopram is the cause of the side effects. Your doctor may also suggest ways to reduce these side effects and improve your sexual satisfaction.

* Sex and gender exist on spectrums. Use of the terms “males” and “females” in this article refers to sex assigned at birth.

Nausea

Nausea is a common side effect of escitalopram. It was reported in clinical trials for both major depressive disorder (MDD) and generalized anxiety disorder (GAD). Also, people taking 20-mg escitalopram doses reported nausea more often than people taking 10-mg doses in clinical trials. Most people tolerated this side effect. However, some people chose to stop taking the drug because of it.

Nausea can also be a symptom of a more serious side effect of escitalopram called serotonin syndrome. Serotonin syndrome can occur when the levels of the chemical serotonin become too high in your body. This is a dangerous side effect that can be fatal if left untreated. To learn more, see the “Escitalopram: Serious side effects” section above.

What you can do

Talk with your doctor if you are experiencing nausea that bothers you or does not go away. They can determine whether escitalopram is the cause. If so, they may recommend a lower dose of escitalopram. Or they may recommend a different treatment option for you.

Diarrhea

Diarrhea is one of the more common side effects of escitalopram. This side effect was reported in clinical trials for both MDD and GAD. People taking 20-mg escitalopram doses reported this side effect more often than those taking 10-mg doses.

Diarrhea can also be a symptom of serotonin syndrome, which is a serious side effect that can be fatal. To learn more, see the “Escitalopram: Serious side effects” section above.

What you can do

If you’re experiencing diarrhea that is intolerable or does not go away, talk with your doctor. They can determine the cause of your diarrhea. If escitalopram is causing your diarrhea, your doctor may recommend reducing your dose. They may also suggest different treatment options for you.

Headache

Headache is a common side effect reported in clinical trials of escitalopram for people with GAD. However, it wasn’t reported in clinical trials of the drug for MDD. Headache with escitalopram is typically considered mild.

However, headache may also be a symptom of a more serious side effect called hyponatremia (low sodium levels in your body). This side effect is more common in older adults than younger people. To learn more about the other symptoms of hyponatremia, see the “Escitalopram: Serious side effects” section above.

What you can do

Tell your doctor if you have headaches that are bothersome or do not go away. They’ll help determine whether the headaches are a sign of hyponatremia or other conditions. They can also recommend ways to relieve your headaches. This may include using over-the-counter drugs, such as ibuprofen (Advil, Motrin, others).

Allergic reaction

As with most drugs, escitalopram can cause an allergic reaction in some people. However, this side effect wasn’t reported in clinical trials. It was seen after the drug became available for use, and it is unclear how common they were.

Symptoms can be mild or serious and can include:

  • skin rash
  • itching
  • flushing
  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What you can do

For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep taking escitalopram. However, if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Click here for more links and local resources.

Escitalopram has several precautions. Read below to learn more.

Boxed warning: Increased risk of suicidal thoughts and behaviors in young people

This drug has a boxed warning for the increased risk of suicidal thoughts and behaviors in young people. This is a serious warning from the Food and Drug Administration (FDA). For details, see the “Escitalopram: Side effect specifics” section above.

Other precautions

Be sure to talk with your doctor about your health history before you take escitalopram. This drug may not be the right treatment for you if you have certain medical conditions or other factors that affect your health. These are considered drug-condition or drug-factor interactions. The conditions and factors to consider include:

Angle closure glaucoma. Tell your doctor if you have glaucoma before starting escitalopram treatment. This medication can increase the risk of a sudden worsening of glaucoma. This can cause blurry vision and severe eye pain. Your doctor will advise whether escitalopram is right for you.

Liver or kidney problems. If you have liver or kidney problems, tell your doctor before you start taking escitalopram. They may lower your dose or suggest a different treatment option. They will also monitor you more closely for side effects.

Seizures. If you’ve ever had seizures, escitalopram may increase your risk for seizures occurring during treatment. Tell your doctor if you’ve ever had seizures. They will help determine whether escitalopram is right for you.

Bipolar depression or mania. Before starting escitalopram, tell your doctor if you have bipolar disorder. If you have this condition, escitalopram can increase your risk for mania or hypomania. Your doctor can help determine if escitalopram is safe for you to take.

Low blood pressure. Tell your doctor if you have low blood pressure or take blood pressure medications called diuretics. Escitalopram can cause hyponatremia which can worsen due to certain factors. These include if you have low blood pressure or take a diuretic.

Drug interactions. Escitalopram can interact with many drugs. (To learn more, see this article.) This can increase your risk of side effects or make side effects more severe. Talk with your doctor about all prescription drugs and over-the-counter products you take before starting escitalopram treatment.

Allergic reaction. If you’ve had an allergic reaction to escitalopram, citalopram, or any of their ingredients, your doctor will likely not prescribe escitalopram. Taking Escitalopram could cause you to have another allergic reaction. Ask your doctor what other medications may be better options for you.

Alcohol with escitalopram

There are no known interactions between escitalopram and alcohol. However, the drug manufacturer recommends avoiding alcohol while you’re taking escitalopram. This is because both escitalopram and alcohol can cause similar side effects, including:

  • drowsiness
  • insomnia
  • nausea
  • fatigue
  • trouble thinking and coordinating your movements

Drinking alcohol while taking escitalopram can make these side effects more severe.

If you’d like to drink alcohol, talk with your doctor about whether it’s safe to do so while taking escitalopram.

Pregnancy and breastfeeding while taking escitalopram

It’s unknown if it’s safe to take escitalopram during pregnancy. However, certain selective serotonin reuptake inhibitors (SSRIs) have been studied during pregnancy. (Escitalopram is an SSRI.)

Studies found that children born to people taking an SSRI during pregnancy had more complications after birth than those without exposure to an SSRI before birth. These complications were more common when a person took an SSRI during the third trimester of pregnancy than in earlier trimesters.

Complications include:

  • breathing problems
  • muscle tone changes
  • tremor (shakiness) or jitteriness
  • trouble eating
  • pulmonary hypertension (a lung condition that causes low oxygen levels in the body)

If you’re taking escitalopram during pregnancy, consider enrolling in the National Registry for Antidepressants. This is a pregnancy registry that collects information about a drug’s effects when used during pregnancy. It helps researchers learn more about the safety of escitalopram and other antidepressants during pregnancy. You can report any side effects or complications of taking escitalopram during pregnancy at the registry’s website or by calling 844-405-6185.

It’s not known for certain if escitalopram is safe to take while breastfeeding. Escitalopram passes into breast milk. There have been rare reports of unwanted side effects in breastfed children. These include poor feeding, poor weight gain, extreme sleepiness, and agitation.

If you are pregnant, breastfeeding, or considering either, talk with your doctor about whether taking escitalopram is right for you. They can discuss the risks and benefits with you.

It’s unlikely that taking escitalopram will lead to misuse. Misuse refers to taking a drug in a way or for a purpose not prescribed by your doctor.

However, taking too much escitalopram can cause serious side effects. These include nausea, vomiting, dizziness, seizure, and changes in heart rate or heart rhythm. Sometimes, these effects can be fatal.

If you or someone you know has taken more escitalopram than prescribed, watch closely for the above symptoms. And call 911 or your local emergency number if you think there’s a medical emergency.

If you have questions about escitalopram and misuse, talk with your doctor.

Side effects of escitalopram are usually mild. However, some rare side effects can be severe and require medical attention. Talk with your doctor about how to prevent or lower your risk of mild and serious side effects.

Before starting escitalopram treatment, talk with your doctor about any history of suicidal thoughts or behaviors. Escitalopram has a boxed warning for the increased risk of suicidal thoughts and behaviors in young people. This is a serious warning from the Food and Drug Administration (FDA). To learn more, see the “Escitalopram: Side effect specifics” section above.

If you’d like to learn more about escitalopram, talk with your doctor or pharmacist. They can help answer any questions you have about side effects from taking the drug. You can also ask them about Lexapro, the brand-name version of escitalopram.

A generic drug and its brand-name version contain the same active ingredient, so they’re expected to have the same side effects. Referring to the following articles about escitalopram and Lexapro can provide you with additional information:

  • More information about escitalopram. For details about other aspects of escitalopram, refer to this article.
  • Dosage. For information about the dosage of Lexapro, see this article.
  • Drug comparison. Learn how escitalopram compares with citalopram and sertraline.
  • A look at your condition. For details about your condition, refer to our anxiety hub or depression hub.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.