Pronunciation: leks-a-pro
Generic name: escitalopram
Dosage form: tablets, oral solution
Drug class: Selective serotonin reuptake inhibitors

Medically reviewed by Carmen Pope, BPharm. Last updated on Jul 1, 2024.

What is Lexapro?

Lexapro (escitalopram) is an antidepressant from the group of drugs called selective serotonin reuptake inhibitors (SSRIs) and is used to treat certain types of depression and anxiety. It is not known how Lexapro works, but it is thought to block the reuptake of serotonin by nerves. This results in an increase in serotonin concentrations in the nerve synapse (the space between two nerves).

Lexapro was FDA-approved on August 14, 2002.

Lexapro side effects

Common side effects of Lexapro may include:

• painful urination;
• dizziness, drowsiness, tiredness, weakness;
• feeling anxious or agitated;
• increased muscle movements, feeling shaky;
• sleep problems (insomnia);
• sweating, dry mouth, increased thirst, loss of appetite;
• nausea, constipation;
• yawning;
• nosebleed, heavy menstrual periods; or
• decreased sex drive, impotence, or difficulty having an orgasm.

Serious side effects

Get emergency medical help if you have signs of an allergic reaction to Lexapro: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Lexapro may cause serious side effects. Call your doctor at once if you have:

• blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;

• racing thoughts, unusual risk-taking behavior, feelings of extreme happiness or sadness;

• pain or burning when you urinate;

• (in a child taking Lexapro) slow growth or weight gain;

• low levels of sodium in the body - headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady; or

• severe nervous system reaction - very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Warnings

You should not use Lexapro if you also take pimozide or citalopram (Celexa).

Do not use Lexapro within 14 days before or 14 days after you have used an MAO inhibitor, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Young adults are at higher risk of having thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Parents or caregivers should report any new or worsening mood symptoms in their child to their doctor. Also, be alert for signs of mania (excessively happy or active behavior).

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

SSRIs, including Lexapro, may cause sexual problems. Symptoms in males may include delayed ejaculation or inability to have an ejaculation, decreased sex drive, and problems getting or keeping an erection. Symptoms in females may include decreased sex drive, delayed orgasm, or inability to have an orgasm. Talk to your healthcare provider if you develop any changes in your sexual function or if you have any questions or concerns about sexual problems during treatment with Lexapro. There may be treatments your healthcare provider can suggest.

Do not give Lexapro to anyone under 12 years old.

Do not stop using Lexapro without first asking your doctor.

Before taking this medicine

You should not use Lexapro if you are allergic to escitalopram or citalopram (Celexa), or if:

• you also take pimozide.

Do not use Lexapro within 14 days before or 14 days after you have used an MAO inhibitor. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine.

Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. These medicines may interact with escitalopram and cause a serious condition called serotonin syndrome.

To make sure Lexapro is safe for you, tell your doctor if you have ever had:

• liver or kidney disease;

• seizures;

• low levels of sodium in your blood;

• heart disease, high blood pressure;

• a stroke;

• bleeding problems;

• sexual problems;

• bipolar disorder (manic depression); or

• drug addiction or suicidal thoughts.

Tell your healthcare provider if you are pregnant, intending to become pregnant, or breastfeeding.

Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.

Lexapro is not approved for use by anyone younger than 12 years old.

Pregnancy

Ask your doctor about taking this medicine if you are pregnant. Taking an SSRI antidepressant during late pregnancy may cause serious medical complications in the baby. However, you may have a relapse of depression if you stop taking your antidepressant. Tell your doctor right away if you become pregnant. Do not start or stop taking Lexapro without your doctor's advice.

If you are pregnant, there is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to antidepressants during pregnancy. You can register by calling the National Pregnancy Registry for Antidepressants at 1-844-405-6185 or visiting online at https://womensmentalhealth.org/research/pregnancyregistry/antidepressants.

There is a less than 2-fold increased risk for severe bleeding after delivery (postpartum hemorrhage) in mothers exposed to SSRIs, particularly in the month before delivery.

Breastfeeding

If you are breastfeeding, tell your doctor if you notice drowsiness, agitation, feeding problems, or poor weight gain in the nursing baby.

How should I take Lexapro?

Take Lexapro exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Take the medicine at the same time each day, with or without food.

Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

It may take up to 4 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve.

Your doctor will need to check your progress on a regular basis. A child taking Lexapro should be checked for height and weight gain.

Tell your doctor if you have any changes in sexual function, such as loss of interest in sex, trouble having an orgasm, or (in men) problems with erections or ejaculation. Some sexual problems can be treated.

Do not stop using Lexapro suddenly, or you could have unpleasant withdrawal symptoms. Follow your doctor's instructions about tapering your dose.

Store Lexapro at room temperature away from moisture and heat.

Dosing information

Usual Adult Dose for Generalized Anxiety Disorder:

Initial dose: 10 mg orally once a day; increase if necessary after at least 1 week of treatment to 20 mg once a day
Maintenance dose: 10 to 20 mg orally once a day
Maximum dose: 20 mg orally once a day

Comment: Treatment should be periodically reassessed to determine the need for ongoing treatment; efficacy beyond 8 weeks has not been systematically studied.

Use: Acute treatment of generalized anxiety disorder

Usual Adult Dose for Depression:

Initial dose: 10 mg orally once a day; increase if necessary after at least 1 week of treatment to 20 mg once a day
Maintenance dose: 10 to 20 mg orally once a day
Maximum dose: 20 mg orally once a day

Comments:
-Acute episodes may require several months or longer of sustained pharmacological therapy beyond response to the acute episode.
-Patients should be periodically reassessed to determine the need for maintenance treatment.

Use: Acute and maintenance treatment of major depressive disorder

Usual Geriatric Dose for Depression:

Recommended dose: 10 mg orally once a day

Use: Acute and maintenance treatment of major depressive disorder

Usual Pediatric Dose for Depression:

12 years and older:
-Initial dose: 10 mg orally once a day; increase if necessary after at least 3 weeks of treatment to 20 mg once a day
-Maintenance dose: 10 to 20 mg orally once a day
-Maximum dose: 20 mg orally once a day

Comments:
-Acute episodes may require several months or longer of sustained pharmacological therapy beyond response to the acute episode.
-Patients should be periodically reassessed to determine the need for maintenance treatment.

Use: Acute and maintenance treatment of major depressive disorder

Related/similar drugs

Trintellix, Rexulti, Vraylar, trazodone, sertraline, duloxetine, alprazolam, escitalopram, buspirone, venlafaxine

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What to avoid

Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, and others. Using an NSAID with Lexapro may cause you to bruise or bleed easily.

Avoid alcohol.

Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.

What other drugs will affect Lexapro?

Using Lexapro with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.

Tell your doctor about all your current medicines, including ones you buy over the counter. Especially tell them about medications that increase your risk of bleeding such as warfarin, Coumadin, Jantoven, NSAIDs, aspirin, or other antiplatelet or other anticoagulants.

SSRIs, including Lexapro, can precipitate serotonin syndrome, a potentially life-threatening condition. The risk is increased with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, meperidine, methadone, tryptophan, buspirone, amphetamines, and St. John’s Wort) and with drugs that impair metabolism of serotonin, such as MAOIs. Serotonin syndrome can also occur when these drugs are used alone.

Many drugs may interact with escitalopram, and some drugs should not be used at the same time. Tell your doctor about all your current medicines and any medicine you start or stop using. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here.

Storage

• Store Lexapro at 68°F to 77°F (20°C to 25°C); excursions permitted to 59°F to 86°F (15°C to 30°C).
• Keep the Lexapro bottle closed tightly.
• Keep Lexapro and all medicines out of the reach of children.

What are the ingredients in Lexapro?

Active ingredient: escitalopram oxalate

Inactive ingredients:

• Tablets: talc, croscarmellose sodium, microcrystalline cellulose/colloidal silicon dioxide, and magnesium stearate. The film coating contains hypromellose, titanium dioxide, and polyethylene glycol.
• Oral Solution: sorbitol, purified water, citric acid, sodium citrate, malic acid, glycerin, propylene glycol, methylparaben, propylparaben, and natural peppermint flavor (oral solution is not currently being marketed).

Manufacturer

Allergan USA, Inc.
Madison, NJ 07940

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Further information

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