Lexapro (escitalopram) is an antidepressant medication that can be prescribed to relieve symptoms of depression and anxiety. This medication is only available through a prescription from a licensed healthcare practitioner. Your doctor will consider several factors, including age and health history, when considering Lexapro as a treatment option for you.
Warnings of Suicidal Thoughts and Behaviors
The Food and Drug Administration (FDA) warns of increased risks of suicidal thoughts and behaviors associated with Lexapro to pediatric and young adults. Before starting your medication, talk with your doctor to understand the benefits and risks associated with the medication. 1
What is Lexapro (Escitalopram) & How Does it Work?
Lexapro, the brand name for the generic version of escitalopram, is an FDA-approved medication for treating symptoms of major depressive disorder and generalized anxiety disorder (GAD).1 Antidepressants make some people feel better, though not everyone has a complete response to the medication. Lexapro use may relieve depression symptoms, leading to more energy and an improved mood. The medication brand name and generic version are dosed equally, with a starting dose of 10 mg daily.
Lexapro is a selective serotonin reuptake inhibitor (SSRI) that regulates the amount of serotonin in the brain. Lexapro leads to increased levels in the brain which helps to reduce symptoms of depression. Serotonin and norepinephrine reuptake inhibitors (SNRIs) work similarly to SSRIs, though their action mechanisms differ. While SSRIs affect serotonin only, SNRIs affect serotonin and norepinephrine. Your doctor may consider prescribing Lexapro over other medications based on its efficacy, side effects, tolerability, and side effects.
Lexapro is FDA-approved for the treatment of multiple mental health disorders such as:1
Lexapro may be prescribed by practitioners for off-label uses (not FDA approved) for treating:2
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Side Effects of Lexapro
It can take some time for antidepressants to work, so you may not start noticing symptom improvement for a few weeks. You may start feeling your depression improve after starting your medication, but it can you may also experience some side effects from Lexapro, such as vomiting and nausea, associated with the medication within the first two weeks.3 These side effects are generally mild (less severe) and do not require immediate medical attention. However, if the side effects worsen and become intolerable, seek immediate medical help.
Side effects of Lexapro may include:1,2
- Headache
- Vomiting
- Nausea
- Diarrhea
- Sleeping problems
- Appetite issues
- Weight changes
- Dizziness
- Dry mouth
- Constipation
- Sexual dysfunction
Drug Interactions With Lexapro
Like other antidepressants, escitalopram has a unique chemical structure contributing to its side effects. Lexapro’s chemical structure can negatively interact with medications, substances, or dietary supplements. Therefore, before starting the medication, you should provide your medication history to your doctor to improve safety while taking the antidepressant.
Patients should not combine Lexapro with certain other medications unless directed by a doctor:1,2
- St. John’s Wort: The interaction between Lexapro and St. John’s Wort can increase the risk of high levels of serotonin accumulation in the body, resulting in serotonin syndrome.4
- Non-steroidal anti-inflammatory drugs (NSAIDs): The interaction Lexapro with NSAIDs can cause you to bruise or bleed easily.
- Monoamine oxidase inhibitors (MAOIs): Taking Lexapro at the same time or within 14 days of stopping MAOIs medication puts you at risk of serotonin syndrome.
- Pimozide: The interaction between these two substances increases the risk of serotonin syndrome.
- Alcohol: The interaction between Lexapro and alcohol can trigger individual side effects of each substance.
- Other antidepressant medications – Using Lexapro with other antidepressant medications may worsen your depression as both substances will trigger individual side effects.
- Thioridazine: Combining Lexapro with thioridazine puts you at increased risk of serotonin syndrome.
- Blood thinners: Using blood thinners while on Lexapro medications increases the risk of excessive bleeding as Lexapro interferes with the blood clotting process.
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Do I Need a Lexapro Prescription?
Lexapro is an FDA-approved medication for treating depression, and it’s only available through a prescription. For this reason, it’s important to talk to your doctor to ensure the medication is suitable for your condition.
Therefore, if you believe Lexapro is the right medication for you, talk with your doctor. Discuss your condition, medical history, or over-the-counter medication you are currently taking with your doctor and herbal supplements like St John’s Wort if you use them. Your doctor will then make an informed decision and may prescribe Lexapro for depression. You will then buy the medication from licensed pharmacies or online retailers. Also, your doctor may recommend Lexapro in addition to psychotherapy, depression medications, or anxiety medication based on the drug’s efficacy or if other medications do not work for you.5
Some signs that you may benefit from a Lexapro prescription include:
- Feelings that something terrible will happen.
- Frequent panic attacks
- Physical symptoms such as sweating, chest pains, and dizziness.
- Difficulty concentrating
- Treatment-resistant mental health condition
- Sleeping problems
Who Shouldn’t Be Prescribed Lexapro
Lexapro can only be prescribed in specific situations since the medication can have adverse side effects. Children and young adults are at increased risk of suicidal thoughts and behaviors due to taking the medication.1 Also, taking antidepressants during pregnancy or while breastfeeding requires careful consideration due to potential risks. Lexapro use can lead to harmful outcomes in pregnant women, increasing the risk of preterm birth and congenital malformations.6
Also, infant exposure to the medication during breastfeeding can make breastfed babies have signs of irritability.6 If the medication does not work for you, your doctor may consider another alternative that works the same way as Lexapro but with a side effect profile that might be safer for you. People with binge eating disorder or bulimia nervosa might also have depression, anxiety, or other mental illness. Taking SSRIs for those with such conditions can worsen their condition.
How to Get a Lexapro Prescription
Lexapro is only available by prescription. Your doctor will ask for your medical history or other medications you are currently taking. After understanding your condition, your doctor will determine whether Lexapro is the right medication for you.
When looking to receive a Lexapro prescription, be sure to follow these steps:
- Book an appointment: Book an appointment with your doctor, leaving enough time to discuss your concerns and ask questions.
- Talk to your doctor about your anxiety: Describe your anxiety condition and how the condition has impacted your life.
- Describe your symptoms thoroughly: Let your doctor know your symptoms in detail, including the timing and triggers. This will help you understand your condition so your doctor can consider an appropriate medication.
- Consider costs and insurance coverage: The cost of Lexapro can be significant, especially if you are not covered by mental health insurance. You can get the medication at a reduced price through coupons or if Medicare plans cover you.
Who Can Prescribe Lexapro?
Lexapro, like other antidepressants, is approved by the FDA for safety, effectiveness, and quality. This is because the medication can have serious side effects on a person’s mental health and well-being. Any healthcare provider who is licensed to prescribe medications is allowed to prescribe Lexapro.
Healthcare providers who can prescribe Lexapro include:
- Licensed physician assistants
- Licensed nurse practitioners
- Psychiatrists
- Primary care providers
How to Get a Lexapro Prescription Online
With the availability of telehealth, you can get your Lexapro prescription through available online psychiatry platforms. Online psychiatry (telepsychiatry) is a form of telemedicine that allows you to get mental health care over the internet without physically visiting your doctor.7 Like in-person therapy, online psychiatry provides screening, assessments, ongoing counseling and therapy, medication refills, and crisis support. There are several online psychiatry platforms across the country where your provider might determine that prescribing Lexapro is right for you.
Telepsychiatry can help you save transportation money, as you don’t need to visit your doctor physically. Instead, use your computer to connect with your doctor. This form of telemedicine is also an effective and convenient option for people in rural areas far from hospital facilities.
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 If I Can’t Get Prescribed Lexapro?
If your doctor does not think Lexapro is right for you, talk to your doctor about other alternatives that can treat your symptoms. Your doctor will determine the suitable medication that will help relieve your depression or anxiety symptoms. It’s important to avoid doctor shopping or seeking medication from several providers. Also, you should never get your medication from your friends or family as this may not be physically suitable for the dosage they have.
Some of the antidepressant alternatives that may be more suitable for you include:
- Citalopram (escitalopram)
- Duloxetine (Cymbalta)
- Paroxetine (Paxil)
- Sertraline (Zoloft)
Do Over-the-Counter Alternatives Exist?
Several over-the-counter (OTC) alternatives can help with depression or anxiety. However, these OTC medications can only be effective at relieving mild symptoms of depression or anxiety. Exercise caution when taking OTC medications for anxiety or depression. Natural remedies for anxiety and depression, like kava or St. John’s Wort. can be found in drugstores.
OTC medications include:8
- St John’s Wort
- Omega-3 fatty acids
- 5-HTP
Questions to Ask Your Health Team About How to Get Lexapro
Before starting your medication, talk with your doctor to understand the risks associated with Lexapro and improve your safety on medication. You can ask your doctor questions like if it’s possible to use Lexapro with other antidepressant medications or the side effects of Lexapro, which you should be aware of.
Questions to ask your care team about getting a how-to-get Lexapro to include:
- What are the best online psychiatry platforms to get prescribed Lexapro?
- Can I use Lexapro with other depression medications?
- Is my medication covered?
- How often should I come for checkups?
- What should I do if the drug does not work for me?
- Is it advisable to take alcohol while on Lexapro medication?
- For how long will Lexapro’s side effects last?
- Is it safe to use over-the-counter alternatives to Lexapro?
How to Get Help Immediately
Lexapro can have serious side effects, which can be life-threatening. If you are in a crisis and struggling to manage symptoms and need help immediately, call the 9-1-1 hotline. You can also visit the nearest hospital facility for immediate medical assistance.
Final Thoughts
While Lexapro is an effective medication for treating symptoms of depression or anxiety, it can also have far-reaching side effects that can be life-threatening. Therefore, before getting a prescription for Lexapro, you and your care team must determine how severe your symptoms are and how you would benefit most.
Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.
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DailyMed. (2021). DailyMed – LEXAPRO- escitalopram tablet, film coated LEXAPRO- escitalopram solution. Dailymed.nlm.nih.gov. Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm
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Landy, K., & Estevez, R. (2020). Escitalopram. PubMed; StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK557734/
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NHS. (2021, February 5). Overview – Antidepressants. Nhs.uk. Retrieved from https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/medicines-and-psychiatry/antidepressants/overview/
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Mayo Clinic. (2017). St. John’s wort. Mayo Clinic. Retrieved from https://www.mayoclinic.org/drugs-supplements-st-johns-wort/art-20362212
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Cuijpers, P., Sijbrandij, M., Koole, S. L., Andersson, G., Beekman, A. T., & Reynolds, C. F. (2014). Adding psychotherapy to antidepressant medication in depression and anxiety disorders: a meta-analysis. World Psychiatry, 13(1), 56–67. Retrieved from https://doi.org/10.1002/wps.20089
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NHS. (2022, February 25). Pregnancy, breastfeeding and fertility while taking escitalopram. Nhs.uk. Retrieved from https://www.nhs.uk/medicines/escitalopram/pregnancy-breastfeeding-and-fertility-while-taking-escitalopram/
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American Psychiatric Association. (n.d.). Telepsychiatry. Www.psychiatry.org. https://www.psychiatry.org/psychiatrists/practice/telepsychiatry
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MayoClinic. (2018). Natural remedies for depression: Are they effective? Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/natural-remedies-for-depression/faq-20058026
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For Further Reading
- Lexapro & Weight Gain: Everything You Need to Know
- Lexapro vs. Zoloft: Choosing Which Is Right for You
- Lexapro vs. Prozac: Choosing Which Is Right for You
- Celexa vs. Lexapro: Choosing Which Is Right for You
- Lexapro & Alcohol: Understanding the Risks
- Lexapro (Escitalopram) Sexual Side Effects: What They Are & How to Manage Them
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