Lexapro, the brand name of escitalopram, is an antidepressant. It may cause side effects ranging from mild to severe. Several factors can influence these side effects, such as age and taking other medications.

Lexapro is a selective serotonin reuptake inhibitor (SSRI). SSRIs work by slowing the reabsorption of serotonin back into nerve cells to maintain higher serotonin levels in the brain.

Serotonin is a chemical your body produces. Doctors believe that it helps stabilize mood and causes happiness and a sense of well-being.

Doctors prescribe Lexapro to treat major depressive disorder (MDD) and generalized anxiety disorder (GAD).

People should take Lexapro as follows:

For MDD, adults and adolescents aged 12⁠–17 ⁠years should take 10 milligrams (mg) of Lexapro daily, with or without food. The dosage may increase to 20 mg daily following a doctor’s recommendation.

For GAD, adults should take 10 mg of Lexapro daily, with or without food. If necessary, a doctor can recommend increasing the daily amount to 20 mg after a minimum of one week.

This article provides information on the side effects of Lexapro, including interactions with different drugs and when to see a doctor.

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Lexapro side effects may vary among different people. Many common side effects can improve within the first 2 weeks after use.

Adults

In adults, common side effects of Lexapro include:

According to the National Alliance on Mental Illness (NAMI), many common side effects of Lexapro may improve within 2 weeks of taking the medication. However, the sexual side effects of taking Lexapro often do not improve.

Children

Doctors do not recommend Lexapro for children under the age of 12 years. A 2014 study of its effects on children aged 7–11 years found half experienced side effects such as:

  • abdominal pain
  • diarrhea
  • nausea
  • vomiting
  • increased appetite
  • common cold
  • dizziness
  • headache
  • insomnia
  • stuffy nose (nasal congestion)

In the above study, one participant also experienced mania, while another had suicidal ideation.

Doctors may prescribe Lexapro to adolescents between the ages of 12⁠–17 for the treatment of MDD. Side effects for this age group are similar to those for adults. Side effects that may be more common among people aged 12–17 include:

Pregnancy

According to NAMI, pregnant people who take SSRIs in their second and third trimesters have a risk of their baby being born before 37 weeks, before it is fully developed.

NAMI also notes that taking SSRIs during the second half of pregnancy slightly increases the risk of the infant developing the serious condition known as persistent pulmonary hypertension. The overall risk remains very small, though. The condition happens in less than 1% of pregnancies with SSRI treatment.

The evidence on certain pregnancy complications is mixed. For example, a large 2015 study found that people who take SSRIs in pregnancy have a lower risk of birth before 37 weeks and cesarean section than people who have depression or other mental health conditions but do not take SSRIs.

This means that while there are risks linked to SSRI use during pregnancy, untreated depression during pregnancy may also come with an increased risk of certain complications.

People who are pregnant or trying to conceive should consult their doctor when considering Lexapro treatment before or during pregnancy. It is important to discuss a person’s specific medical history and the possible risks and benefits before deciding whether to take this medication.

Breastfeeding and chestfeeding

People who are breastfeeding or chestfeeding can pass Lexapro to babies via their breast milk. Usually, this does not cause side effects for infants. However, in rare cases, babies may become restless, irritable, or sick.

If a person notices these changes in their baby, it is important to talk with a doctor or pharmacist right away.

A boxed warning is the strongest warning the Food and Drug Administration (FDA) can require a drug to have.

The boxed warning for Lexapro indicates that it may carry a risk of suicidal thoughts and behavior in children, adolescents, and young adults. The boxed warning also notes that the FDA has not approved Lexapro for children younger than 12 years old.

Suicidal thoughts or behaviors may be more likely to occur in the first few months of taking the drug or if the dose changes. It is important to look out for new or worsening thoughts or behaviors related to self-harm or suicide.

If a person’s depression gets worse, or they experience thoughts or behaviors related to suicide, they should contact their doctor immediately.

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.

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Lexapro may produce other side effects that can be serious or life threatening. If a person suspects they are experiencing a serious side effect, they should seek immediate medical attention.

Some serious side effects of Lexapro include:

Serotonin syndrome

Serotonin syndrome, or serotonin toxicity, is a potentially life threatening condition that occurs due to an excess of serotonin in the body.

This condition can cause changes to a person’s mental state, such as agitation, hallucinations, and delirium.

Other symptoms of serotonin syndrome include:

To reduce the risk of serotonin syndrome with Lexapro, it is important to talk with a doctor about any other drugs a person may be taking.

Allergies

Although it is rare, Lexapro may cause severe allergic reactions, which can result in:

  • trouble breathing
  • wheezing
  • swelling of the face, tongue, mouth, or throat
  • itching
  • rash, hives, or blisters on the skin

If a person is having a serious allergic reaction, get emergency medical help.

Mania or hypomania

In people with bipolar disorder, Lexapro can increase the likelihood of a manic episode.

Symptoms of a manic episode include:

  • very elevated mood, such as feeling extremely happy
  • very high self-esteem or overconfidence
  • irritability
  • racing thoughts
  • reckless behavior
  • talking more or faster than usual
  • being easily distracted
  • needing less sleep than usual

People with a personal or family history of manic episodes or bipolar disorder should discuss this with their doctor before taking Lexapro.

Low sodium levels in the blood

People who take Lexapro may be at a greater risk of experiencing low sodium levels in the blood. This is more common for older adults.

Symptoms of this condition include:

  • headache
  • weakness
  • feeling unsteady or having falls
  • confusion
  • memory problems
  • trouble concentrating

In serious cases, low blood sodium levels can lead to symptoms such as hallucinations, fainting, seizures, and coma. If a person does not receive treatment, the condition can be life threatening.

Lexapro can trigger adverse reactions when taken with other medications.

According to NAMI, people should not have this medication within 2 weeks of taking monoamine oxidase inhibitors (MAOIs), another type of antidepressant.

The antipsychotic medication pimozide can also cause serious heart problems when taken with Lexapro.

Lexapro may increase a person’s chances of experiencing abnormal bleeding or bruising, especially when taken with aspirin, blood thinners, or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. People who take these drugs with Lexapro may experience:

  • unusual bruising
  • gastrointestinal bleeding
  • nosebleeds
  • broken capillaries
  • life threatening bleeding

Lexapro may also interact with drugs and supplements such as:

People should talk with their doctor about any other medications or supplements they take before using Lexapro. A person should avoid consuming alcohol while taking Lexapro.

Lexapro can cause issues in people with the following health conditions:

  • Bipolar disorder: A person with bipolar disorder is at risk of experiencing a manic episode when taking Lexapro.
  • Angle-closure glaucoma: People who are at risk of angle-closure glaucoma may experience a glaucoma episode due to the pupil dilation that occurs when taking Lexapro.
  • Seizures: Doctors do not know whether Lexapro increases seizure risk for people who have seizure conditions. However, the medication itself can cause seizures in some people.
  • Heart problems: Lexapro can cause the heart to beat too fast or irregularly, so it may not be appropriate for people with heart problems.

A person who wishes to stop taking Lexapro should speak with their doctor first. Stopping Lexapro too quickly may cause:

  • anxiety
  • irritability
  • high or low mood
  • changes in sleeping habits
  • inability to control one’s emotions (emotional lability)
  • headache
  • dizziness
  • agitation
  • confusion
  • feelings of electric shock

Slowly stopping treatment with a doctor’s supervision can help to lower the risk of these side effects.

A 2017 study in China found that 87% of people taking Lexapro for MDD showed good or excellent improvement after 6 weeks. People with milder depression at the start of the study had a greater reduction in symptoms than people with more severe depression.

Clinical trials have shown Lexapro to be effective. A 2019 research review and meta-analysis found that escitalopram, the active ingredient in Lexapro, was 68% more likely to improve MDD than a placebo medication.

In the same 2019 study, researchers found escitalopram to be more effective than some other antidepressant medications, such as fluoxetine. However, the authors note that their research does not address individual factors that help a doctor decide which medication is right for a particular person.

Is taking Lexapro worth it?

Lexapro may help adolescents and adults with MDD, and adults with GAD, find relief from the symptoms of these conditions.

Like other medications, it can cause some side effects and drug interactions. However, for some people, the benefits may outweigh the possible adverse effects.

Depression and anxiety may have major effects on a person’s quality of life. While it can be difficult to take the first steps to reach out for help, treatments are available that can help a person feel better.

It is important for a person to talk with a doctor to determine whether Lexapro is the right treatment for their specific needs.

A person who takes Lexapro should contact their doctor if they have any symptoms that cause discomfort or do not clear up.

If a person notices any serious side effects or sudden changes in their mood or thinking, they should seek immediate medical help.

Generally, common side effects from Lexapro may improve within 2 weeks of taking the drug.

Although some side effects can be serious, these reactions are rare. If a person has concerns about Lexapro, they should speak with their doctor.

Many medications come with side effects, so they may be impossible to avoid entirely. However, people should make sure they do not take any medications that could interfere with Lexapro to minimize possible side effects.

Certain health conditions may also increase the chance of side effects, so a person should discuss their health history with a doctor before starting Lexapro.

A person can also speak with a doctor about lowering their Lexapro dosage to help reduce adverse effects.

Lexapro can trigger side effects in some people. These can range from mild to severe, although more severe side effects are rare.

A person should discuss other medications they take before starting Lexapro. They should also tell their doctor about any other health conditions they may have.

If a person experiences serious adverse effects when taking Lexapro, they should seek medical attention immediately.