*An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.
Lexapro increases serotonin, which can enhance your ability to sleep or make you more active.1 It can also affect your sleep by decreasing the amount of serotonin in your brain due to the brain compensating for this change in serotonin.2 However, this side effect should wear off and Lexapro should help you get better quality sleep.
If you are considering Lexapro or want to discuss your current medication treatment with a provider, online psychiatry platforms, such as Talkiatry and Brightside Health are a good place to start. Their providers offer assessments and prescription consultation, and can answer any questions you have about medication side effects of Lexapro, such as insomnia.
Boxed Warning: Escitalopram (Lexapro) - Risk of suicidal thoughts and behaviors in certain people
Escitalopram, the active ingredient in Lexapro, has a black box warning. These are the most serious types of warnings from the Food and Drug Administration (FDA). Escitalopram can increase the risk of suicidal thoughts and behaviors in children, adolescents, and young adults. Regardless of your age, you should talk with your doctor about serious risks with escitalopram and any other medications before starting treatment.
What is Lexapro (Escitalopram)?
Lexapro (escitalopram) is a selective serotonin reuptake inhibitor (SSRI) used to treat anxiety and depression.3 It works in the brain by slowly increasing the amount of serotonin over time.2 As a result, your mood, stress response, appetite, sleep, and energy levels may improve. Serotonin also affects your ability to learn and memorize, your sex drive, and your ability to regulate your body’s temperature.
Online Psychiatry and Medication Management Covered by Insurance Talkiatry can match you with a real psychiatrist who takes your insurance and is seeing new patients. They’re in-network with major insurers and offer medication management. Get started with a short online assessment
What Is the Link Between Lexapro & Insomnia?
Insomnia is a common side effect in Lexapro, occurring in 9-14% of people vs 4-6% in placebo groups.2 When taking an SSRI, you may regain your energy as your symptoms improve, which may result in insomnia. Other factors that could impact your sleep may include that you are getting more exercise, which can keep you awake at night if done too late in the day.
However, extreme tiredness is another common side effect of Lexapro (5-8% vs 2% in placebo groups).2 Insomnia is a common symptom of anxiety and depression, so Lexapro may help this symptom improve. Also, Lexapro may cause tiredness because serotonin can influence the action of melatonin, a naturally-occurring hormone that helps us fall asleep.4
The Role of Serotonin in Insomnia
Serotonin helps improve your mood, which can increase your ability to function or enhance your quality of sleep. However, serotonin may induce wakefulness.4
Best Time to Take Lexapro to Avoid Insomnia
It is best to take Lexapro in the morning to prevent it from keeping you up at night. If you find that Lexapro instead can help you sleep or causes drowsiness, try taking it in the evening or at bedtime. Factors that may contribute to the timing of your medication include when you take other medications or the amount of time you’ve been taking Lexapro.
8 Tips for Managing Insomnia From Lexapro
Changing some of your lifestyle and sleep habits can help improve insomnia associated with taking Lexapro. You can start by avoiding drinking too much alcohol or drinking late in the day. In addition, your doctor may consider switching your antidepressant to one that is less likely to cause insomnia. Also, having a healthy sleep routine, diet, and getting enough exercise can contribute to a better night’s sleep.
Avoid Drinking Alcohol
The combination of alcohol and sleep problems has been shown in studies.5 While it may help you fall asleep quicker, it decreases your quality of sleep. You may also sleep less while having more sleep disturbances because alcohol affects sleep stages.
Consider Switching Antidepressants
If you can’t sleep from your Lexapro, your doctor may switch antidepressants to one less likely to cause insomnia. Other SSRIs also commonly cause insomnia, but since medications work differently for everyone, other antidepressants may be less likely to cause insomnia. Your doctor may also try decreasing your dose to maintain some benefits while preventing side effects.
Avoid Stimulants Such as Caffeine
Caffeine can make it harder for you to sleep if you drink too much, too late in the day, or combine it with other substances, including Lexapro. Stimulants can also increase the amount of time it takes for your body to adjust to Lexapro and can prolong insomnia. Try to stick to 1-2 cups per day at most in the morning or early afternoon.
Avoid Napping for Too Long or Too Late
Naps can be very beneficial for mental health and recharging. However, research shows they should be limited to 30 minutes and taken before 3 pm to help improve work efficiency and prevent insomnia.6 The benefits of naps have been shown to last about 2 hours.
Maintain Proper Sleep Hygiene
When preparing to sleep, there are a few guidelines you should follow to ensure you get optimal sleep. Have a dark and quiet place where you can rest. Also, it is best to keep your room a little cooler than normal. Not eating a large meal before bed can help as well.
Have a Sleep Routine
Going to sleep and waking up at the same time every day can be very helpful for teaching your mind when it is time to sleep. You can also add to this routine by doing relaxing things each night, such as taking a bath, lighting a candle, or reading a book. Avoiding screen time before bed can also help prevent insomnia.
Get Enough Exercise
Exercise has been shown to have many mental health benefits, including aiding in sleep onset and quality. You should aim to do 30 minutes of strenuous exercise most days of the week. Strenuous exercises include jogging, swimming, cycling, or weight training.
Eat a Healthy Diet
A healthy diet is another way to maintain good mental health and sleep quality. The nutrients you get from food provide you with fuel to maintain energy. They keep your body functioning properly throughout the day to prevent the need for naps. Staying hydrated can also keep you going during the day as well.
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Will the Insomnia Go Away?
Insomnia from taking Lexapro may last for the first 1-2 weeks and then go away. However, each person will have a unique experience when taking the medication. Determining other potential causes of insomnia may be necessary. Side effects from other medications you are taking may also contribute to insomnia.
How Long Does Insomnia Last With Lexapro?
Lexapro may cause insomnia for 1-2 weeks or it may last for the duration of time you take the medication. If the symptoms are very troubling, let your doctor know right away. They may try switching you to another medication or a lower dose. Otherwise, they may advise you to try to wait a couple of weeks and see if it gets better.
Additional Side Effects of Lexapro
People taking Lexapro may experience other common side effects. These usually do not require medical attention. However, if you are experiencing severe nausea or headaches, you should tell your doctor immediately. Not everyone experiences Lexapro side effects, but you should talk to your prescriber for guidance on managing any side effects that persist or are distressing, as some may require medical care.
Some other common side effects of taking Lexapro include:*2
- Headache
- Sexual issues
- Nausea
- Increased sweating
- Excessive tiredness
*All medications, including Lexapro, can cause side effects that can be mild or serious. This is not a comprehensive list of all possible side effects. Some people also report vivid dreams or night terrors, episodes of intense fear during sleep that can accompany changes in medication. You should talk with your doctor about any questions you have and understand the potential side effects and benefits of any medication.
Questions to Ask Your Healthcare Provider About Lexapro & Insomnia
You may want to ask your doctor, psychiatrist, or therapist about the effects of Lexapro before starting it. Questions you may want to ask include if there are supplements or medications you can take in the meantime and if there are alternative options if insomnia does not wear off. Online psychiatry services may also be a good option if you need to change prescribers.
Questions to ask your care team about insomnia while taking Lexapro:
- How long will it take for me to adjust to taking Lexapro?
- Am I at greater risk for insomnia if I am already taking other anxiety /depression medications?
- What is the best dosage to reduce the risk of insomnia?
- When should I reach out to you if I am experiencing insomnia?
- Is there anything I should tell my therapist about taking Lexapro?
- What medications should I expect to be switched to in place of Lexapro if I have insomnia?
- Do other medications have lower rates of insomnia?
- What can I do to prevent insomnia?
- How should I take Lexapro to prevent insomnia?
- Can I take an over-the-counter supplement or medication if I’m having insomnia?
- How bothersome is insomnia from Lexapro usually?
- Who is most likely to experience insomnia from Lexapro?
In My Experience
Lexapro is a common medication prescribed for anxiety or depression and is generally well tolerated. If you experience insomnia, try changes in your daily routine. It’s important to talk to your doctor about this topic and follow their guidance because Lexapro can have serious side effects if combined with other substances or not taken as directed.
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Online Anxiety Test A few questions from Talkiatry can help you understand your symptoms and give you a recommendation for what to do next. Best Online Psychiatry Services Online psychiatry, sometimes called telepsychiatry, platforms offer medication management by phone, video, or secure messaging for a variety of mental health conditions. In some cases, online psychiatry may be more affordable than seeing an in-person provider. Mental health treatment has expanded to include many online psychiatry and therapy services. With so many choices, it can feel overwhelming to find the one that is right for you.
