What to Know Before Taking Lexapro (2024)

Lexapro is the trademark name for the generic drug escitalopram, an antidepressant medication. Like Zoloft (sertraline), it is a selective serotonin reuptake inhibitor (SSRI) that was introduced in the late 1980s. Available in pill or liquid form, it's prescribed to treat a variety of mental health conditions, such as depression and anxiety.

SSRIs like Lexapro are generally effective and have fewer side effects than older antidepressants, such as monoamine oxidase inhibitors (MAOIs). They also lack the addictive potential of Xanax (alprozolam) and other benzodiazepines.

Uses of Lexapro

Escitalopram, the generic form of Lexapro, is primarily used to treat depression and generalized anxiety disorder (GAD). Initially, it was used only to treat depression, but research has shown that it is effective for treating both mood disorders and anxiety disorders.

A doctor may prescribe Lexapro for other uses if they believe it might be of benefit. For example, they might prescribe Lexapro for conditions such as obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), social anxiety disorder, and even migraines.

How Lexapro Works

Scientists are still learning how Lexapro works, but there is a general neurological understanding.

According to an article in the journal National Library of Medicine, "SSRIs exert their mechanism of action by binding to the sodium-dependent serotonin transporter protein (SERT) in the presynaptic neuron. SERT is responsible for reuptaking serotonin from the synaptic cleft into the presynaptic neuron. Inactivation of SERT by escitalopram leads to an elevation in synaptic serotonin levels."

In other words, Lexapro helps raise or balance serotonin levels in the brain, which can reduce anxiety and enhance mood. Serotonin is a neurotransmitter involved in mood, sleep, and other functions.

Before Taking Lexapro

Lexapro is prescribed for the treatment ofanxiety disorder, depressive disorders, and other mood disorders, sometimesin combination with other medications. Therefore, you generally need amental health diagnosisbefore a doctor prescribes Lexapro for you.

Your primary care physician can write a prescription for Lexapro. But a mental health professional can prescribe medications and handle other your treatment needs, such as by combining medication with psychotherapy.

Prior to starting Lexapro for anxiety or depression, tell your doctor if you are allergic or hypersensitive to escitalopram or if you are pregnant or breastfeeding. Also alert your doctor if you have a history of any of these medical conditions, which may be exacerbated by Lexapro:

• Bipolar disorder
• Glaucoma
• Low salt levels (hyponatremia)
• Seizures
• Suicidal thoughts or behaviors

Tell your doctor about all medications, supplements, and vitamins that you currently take. While some drugs pose minor interaction risks, others may cause outright harm or prompt more careful consideration as to whether the pros of treatment outweigh the cons in your case.

Precautions and Contradictions for Lexapro

There are many precautions involved when taking Lexapro. You can reduce your risks by being aware of who should not take this medication and understanding the black box warning.

Who Should Not Take Lexapro

Lexapro is not safe for everyone. Certain people should either not take Lexapro at all or take it with caution, including:

• People with escitalopram allergies: You should not take Lexapro if you're hypersensitive to escitalopram oxalate. This means that you have a known allergy to the medication and experience symptoms of allergic reaction when taking it, such as difficulty breathing or swelling of the face, mouth, or tongue.
• Children: The safety and effectiveness of Lexapro for children under 12 years of age have not been well-established. Some smaller studies have found that this drug may be helpful for young children with anxiety disorders, and with minimal side effects, but more research is needed to know for sure.
• People who are pregnant or breastfeeding: Use Lexapro with caution if you're pregnant or breastfeeding, as the medication can be passed to your child. The FDA also reports that SSRIs taken after the 20th week of pregnancy have been found to increase the risk of persistent pulmonary hypertension in infants by six times. Your doctor should discuss this with you; if not, be sure to ask about potential risks.
• Older adults: Side effects of this medication can be more severe in older adults, such as by causing blood sodium levels to lower to dangerous levels. Your doctor should monitor your dose and adjust as necessary to reduce the severity of its effects.

Lexapro Black Box Warning

A boxed warning, also referred to as a black box warning, is the strictestwarningfor prescription drugs. It is issued by the Food and Drug Administration (FDA) to help draw consumers' attention to serious or life-threatening risks of taking that medication.

Lexapro has a black box warning as taking it can result in an increased risk of suicidal thoughts and behaviors—particularly in children, adolescents, and young adults. Close monitoring by your psychiatrist or doctor is important when taking Lexapro, particularly if you are a younger person.

Lexapro Dosage

Lexapro tablets are available in 5 milligram (mg), 10mg, and 20mg strengths. The 10mg and 20mg tablets are scored and can be cut in half. The oral solution comes in a strength of 1 mg per milliliter (mL).

The usual recommended daily dosage of Lexapro is 10mg, but you may begin at a lower dose that is increased slowly if needed. The manufacturer recommended doses for Lexapro based on condition and age are:

• Major depressive disorder, ages 12 to 18:10mg per day; can increase dosage to 20mg per day after three weeks if necessary
• Major depressive disorder, over age 18:10mg per day; can increase dosage to 20mg per day after one week if necessary
• Generalized anxiety disorder, adults only:10mg per day; can increase dosage to 20mg per day after one week if necessary

If you are experiencing your first episode of depression or anxiety, you may take Lexapro for a defined period—such as between six months and one year. For individuals with a chronic mental health condition, it may be necessary to take Lexapro for an extended period (over many years).

Modifications

Dosage modifications may be required in people with severe kidney impairment. Your doctor can provide guidance in these situations to help you take this drug safely.

How to Take and Store Lexapro

Taking and storing Lexapro properly helps keep the medication both safe and effective. Lexapro is typically taken as a tablet or oral solution once daily, in the morning or evening, with or without food.

If you miss a dose, take your prescribed dose as soon as you remember unless it is very close to your next dose. In that case, take your regular dose instead. Never take two or more doses of Lexapro at the same time.

Doses higher than 20 mg are not approved by the FDA. Staying within the recommended dose helps to reduce the risk of side effects or adverse reactions.

It's important to recognize that you will not experience immediate relief from taking Lexapro. It can take anywhere from one to four weeks to feel better once you start taking this drug.

You might notice improvements in your sleep, energy levels, and appetite within the first week or two. But you may not experience the full benefits of the medication until you've been following a recommended treatment plan for a couple of months.

Storage

Lexapro should be stored at room temperature, away from light and moisture. Do not store it in the bathroom. If you're traveling with Lexapro, be sure to carry your medication in its original packaging in your carry-on luggage and have your prescription with you.

Lexapro Side Effects

Lexapro is generally well-tolerated and effective. As your body adjusts to taking the medication, the side effects should gradually go away.

If you notice that side effects are getting worse or interfering with your quality of life, talk to your doctor. Side effects can be minimized by carefully following the dosage directions given by your doctor and reporting any negative effects.

Common

The most common side effects of Lexapro or escitalopram are:

• Sleep disturbances
• Nausea
• Headaches
• Blurred vision
• Dry mouth
• Diarrhea
• Stomach pain
• Constipation
• Heartburn
• Lightheaded and faintness
• Irritability and nervousness
• Dizziness
• Changes in weight and appetite
• Fatigue
• Excessive sweating
• Flu-like symptoms
• Sexual side effects

Severe

Seek immediate help if you experience any of the following unusual but severe side effects of Lexapro:

• Difficulty breathing or swallowing
• Swelling of the face, mouth, or tongue
• Fever
• Stiff muscles
• Fast heartbeat
• Vomiting
• Seizures
• Rash
• Confusion
• Hallucinations
• Suicidal thoughts or behaviors

Lexapro Warnings and Interactions

Caution should be used when taking Lexapro along with other medications. The following serotonergic medications should not be used at all or only with significant caution and close monitoring when combined with Lexapro due to the increased risk of serotonin syndrome:

• Other SSRIs, such as Celexa (citalopram)
• Monoamine oxidase inhibitors (MAOIs), which are used to treat psychiatric disorders (you should not use MAOIs within 14 days of using escitalopram)
• Tricyclic antidepressants, such as Pamelor (nortriptyline)
• Triptans,used for treating migraines, such assumatriptan
• St. John's wort

Other drugs that can negatively interact with Lexapro include blood thinners; taking NSAIDs, aspirin, and warfarin can increase the risk of bleeding in people taking Lexapro. While rare, there have been reports of people developing a life-threatening reaction after combining escitalopram with linezolid, a drug used to treat infections like pneumonia.

To help avoid any possible drug interactions, let your doctor know about any other prescription and over-the-counter medications you are currently taking. Avoid drinking alcohol when taking Lexapro as well since it can reduce the effectiveness of the medication and also may increase its toxicity.

Discontinuing Lexapro Use

You should only discontinue taking Lexapro under the guidance of your doctor at an appropriate time—such as when symptoms have been stable for a certain period. Your doctor will help you to taper off the medication to minimize any withdrawal effects.

If you stop taking escitalopram suddenly, you may experience withdrawal symptoms, including:

• Dizziness
• Muscle tension
• Chills
• Confusion
• Trouble concentrating
• Trouble remembering things
• Crying

If you are discontinuing Lexapro to try another SSRI, it is recommended that your dosage be reduced over a 4-week period when making the switch.

Keep in Mind

This overview of the use of Lexapro for mental health conditions does not cover every possible outcome of taking this medication. If you have been prescribed this medication, be sure to follow the instructions carefully. If you have additional questions, speak to a healthcare provider.