Lexapro (Escitalopram) Dosage Guide: Forms, Strengths, & How To Take It

Lexapro Forms & Strengths

Lexapro is currently only available as an oral tablet in 5 mg, 10 mg, and 20 mg. Lexapro is also available as an equivalent generic form that is much more affordable than the brand name version. Previously the medication was available as a liquid solution, but it is currently not available in the United States. If a liquid version is necessary, working with a local compounding pharmacy may be an option.

Lexapro is available in the following forms:

• Oral tablet

Lead in sentence: Lexapro is available in the following strengths:

• 5 milligrams (mg)
• 10 milligrams (mg)
• 20 milligrams (mg)

Lexapro is safest and most effective when taken exactly as prescribed. Tablets should be taken just once per day at close to the same time each day. Skipping doses or doubling up can be dangerous and cause unwanted side effects. Always communicate with your doctor if you feel you need to change how you take Lexapro.

If you miss a dose of Lexapro, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of Lexapro at the same time.¹

Lexapro Dosages for FDA-approved Treatment

The Food and Drug Administration (FDA) of the US government reviews and approves medications as treatments for many health conditions. This means that the benefits of a medication outweigh the potential risks. Lexapro is an FDA-approved medication, and dosages may vary according to a person’s disorder, health history, and other factors.

Lexapro Dosage for Adults

Lexapro is used in adults to treat depression (MDD) and anxiety (GAD). The most common dose is 10 mg taken once daily. Some people may take a lower dose for one week to start, and others may increase the dose after some time at 10 mg if needed.¹

Lexapro Dosage for Adults with Major Depressive Disorder (MDD)

Lexapro is FDA-approved to treat major depressive disorder in adults and can take 4 – 6 weeks to start improving depression symptoms. Taking Lexapro every day at the same time is the best way to take the medication.¹

Here is Lexapro dosage information for depression in adults:¹

• Typical starting dosage: 10 mg taken once daily with or without food. Some may start with a half dose taken once daily for 1 – 2 weeks before increasing to the normal dose.
• Dosage increases: If your doctor determines you require a dose increase, this will happen only after taking Lexapro for at least 1 week.
• Maximum dosage: The maximum dose of Lexapro is 20 mg once daily.

Lexapro Dosage for Adults with Generalized Anxiety Disorder (GAD)

Lexapro is FDA-approved to treat generalized anxiety disorder (GAD) in adults. It can take 4-6 weeks of taking Lexapro to fully feel the effects and improve anxiety symptoms. The recommendation for taking Lexapro it choose a time that works for you to take it every day.¹ It is not an as-needed treatment and should be taken consistently, even if you do not feel anxious.

Here is Lexapro dosage information for anxiety in adults:

• Typical starting dosage: 10 mg taken once daily with or without food. Some may start with a half dose taken once daily for 1 – 2 weeks before increasing to the normal dose.
• Dosage increases: If your doctor determines you require a dose increase, this will happen only after taking Lexapro for at least 1 week.
• Maximum dosage: The maximum dose of Lexapro is 20 mg once daily.

Lexapro Dosage for Older Adults

Lexapro can also be used to treat anxiety and depression in older adults. It can be a good option for this population since the medication dosage is minimally affected by renal or hepatic impairment, two conditions that are more common in older adulthood.¹ If a patient has severe renal impairment, caution should be taken when using Lexapro. Otherwise, the recommended dose for elderly patients is 10 mg taken once daily.

Lexapro Dosage for Older Adults with Major Depressive Disorder (MDD)

Lexapro is FDA-approved to treat major depressive disorder in older adults. It can take 4 – 6 weeks of taking Lexapro to feel symptom improvement. This means it must be taken consistently, even if you do not feel depressed.¹

Here is Lexapro dosage information for depression in older adults:

• Typical starting dosage: 10 mg taken once daily with or without food. Some may start with a half dose taken once daily for 1 – 2 weeks before increasing to the normal dose.
• Dosage increases: It is not recommended to increase the dose above 10 mg for patients older than 65 years.
• Maximum dosage: The maximum dose of Lexapro for elderly patients is 10 mg once daily.

Lexapro Dosage for Older Adults with Generalized Anxiety Disorder

Lexapro is FDA-approved to treat generalized anxiety disorder in adults. Taking Lexapro every day at the same time is the best way to take the medication, and it can take between 4-6 weeks to start working.¹ Lexapro is not an as-needed treatment and should be taken consistently to treat anxiety symptoms.

Here is Lexapro dosage information for anxiety in older adults:¹

• Typical starting dosage: 10 mg taken once daily with or without food. Some may start with a half dose taken once daily for 1 – 2 weeks before increasing to the normal dose.
• Dosage increases: It is not recommended to increase the dose above 10 mg for patients older than 65 years.
• Maximum dosage: The maximum dose of Lexapro for elderly patients is 10 mg once daily.

Lexapro Dosage for Children & Adolescents

Lexapro is currently approved for the treatment of major depressive disorder (MDD) in adolescents aged 12 to 17. The dosages are the same for adolescents as they are for adults. ¹ Only in special cases may a doctor decide that Lexapro may be safe and effective for someone under 12 years of age. This would be an off-label use of Lexapro.

Lexapro Dosage for Children & Adolescents with Major Depressive Disorder

Lexapro is approved as a treatment for depression in adolescents aged 12 to 17. It can take up to 4-6 weeks for the full effects of the medication to be felt. If your doctor decides that an increase to 20mg daily is needed, you must take the starting dose for at least 3 weeks.¹

Here is Lexapro dosage information for depression in children ages 12 and up with depression:¹

• Typical starting dosage: 10 mg taken once daily with or without food. Some may start with a half dose taken once daily for 1 – 2 weeks before increasing to the normal dose.
• Dosage increases: If your doctor determines you require a dose increase, this will happen only after taking Lexapro for at least 3 weeks.
• Maximum dosage: The maximum dose of Lexapro is 20 mg once daily.

Lexapro Dosage for Off-Label (Non-FDA Approved) Uses

Lexapro can also be used to treat other things besides depression and anxiety. These off-label uses are not FDA-approved. Your health provider will discuss reasons to use Lexapro and should also acknowledge the risks and limits of use.

Possible off-label uses for Lexapro include:

• Depression in children
• Insomnia
• (OCD)
• (PTSD)

If you are interested in using Lexapro for off-label use, you should talk with your healthcare professional. They can help to determine if it is safe for you to use Lexapro and what dose you should take.

Lexapro Dosing Considerations

Lexapro, while well tolerated by many, requires extra caution if used by people with certain pre-existing conditions. It is important to share all of your health history with your doctor to reduce the risk of serious side effects.

Conditions that require special Lexapro dosing considerations include:¹

• Bipolar disorder: Taking Lexapro can cause manic episodes in those with bipolar disorder. It is important to review personal and family history for bipolar disorder.
• Kidney problems: Lexapro can cause a dangerous electrolyte imbalance called hyponatremia. Those with pre-existing kidney problems or those taking medications that work in the kidney may be at a higher risk.
• Bleeding disorders: Lexapro, like other SSRIs and SNRIs, can increase the risk of bleeding. If you take other medications that affect bleeding or have a bleeding disorder you may be at a higher risk.
• Glaucoma: If you have untreated narrow-angle glaucoma, taking Lexapro can cause a medical emergency called a narrow-angle attack. Symptoms include eye pain, pressure, and blurred vision, and require immediate medical attention.
• Seizures: If you have a history of seizures, consider using Lexapro with extreme care and specialized supervision.

What to Expect When Increasing Lexapro Dosage

After starting Lexapro, your doctor may decide whether an increase in dose is right for you. This should only happen after taking Lexapro for at least a week and maybe more depending on your diagnosis.¹ When increasing Lexapro there is an increased risk of experiencing side effects. These side effects can happen with the first higher dose and last for several weeks depending on the person.

As with all side effects, it is important to monitor and contact your doctor if any side effects seem alarming. Going over possible side effects before the dose increase is also helpful.

What if I Miss a Dose of Lexapro?

If you miss one dose of Lexapro you should take the missed dose as soon as you remember. If it is almost time for your next dose you should skip the missed dose and just take the next dose. Do not double up on doses. It is important to take Lexapro every day as prescribed even when symptoms of anxiety or depression are reduced.^{1, 3}

Missing more than one day can cause withdrawal effects that may include rebound anxiety or depression. This and other side effects are called antidepressant discontinuation syndrome. If you have stopped taking Lexapro for a prolonged amount of time, you should work with your doctor to restart Lexapro safely. You may need to begin at a low dose and increase slowly to reduce the risk of side effects.

Can You Overdose on Lexapro?

Overdose with Lexapro is possible and can be dangerous. The major risks of overdose include seizures, heart problems, hypertension, and serotonin syndrome. Signs of these conditions include irregular heartbeat, extreme sweating, confusion, high blood pressure, and loss of muscle coordination. It is important to know these symptoms and go to an emergency room or call 911 immediately if an overdose is suspected.¹

What Should You Do If You Take Too Much Lexapro?

If you take too much Lexapro you should alert someone right away. This is important in case you lose consciousness. Then you should call your doctor, 911, or the poison control center at 1-800-222-1222. They may instruct you to seek further help. It is important to seek help right away. Depending on how much Lexapro you have taken it may be recommended to undergo activated charcoal decontamination. In any situation, it will be important to be monitored by a healthcare team to detect and treat dangerous side effects right away.¹

Can You Become Addicted to Lexapro?

Lexapro is not known to carry a high risk of dependency. However, over time your body will become used to the medication. This can pose a risk of Lexapro withdrawal symptoms if the medication is stopped too quickly. If stopping Lexapro is the goal, your doctor will develop a plan to slowly stop Lexapro over time.^{1, 2}

Questions to Ask Your Health Team About Lexapro Dosage

Staying well-informed is an important part of taking Lexapro. There are many questions you should ask your healthcare team before you start taking the medication. It should also be discussed when to contact your doctor during treatment and for what reasons. As with any medication, in an emergency, you should call 911 or the poison control hotline at 1-800-222-1222.

Questions to ask your care team about Lexapro dosages include:

• Is it safe to take Lexapro with my other medications?
• Will Lexapro or escitalopram be covered by my insurance?
• Does my medical history indicate a need to adjust my dosage?
• How long will it take before my symptoms improve?
• Should I let my therapist know I am taking this medication?
• What should I do if I want to stop taking Lexapro?
• What if I have thoughts of suicide or harming myself?
• Can I drink alcohol or use other drugs with Lexapro?
• What if I want to become pregnant while taking Lexapro?

How to Get A Lexapro Prescription

Lexapro is a medication only available by prescription. You may only get a Lexapro prescription when recommended by a licensed healthcare professional. A doctor may prescribe Lexapro if symptoms of anxiety or depression are frequent and prolonged. Even if your doctor is prescribing Lexapro for off-label use, they will discuss the reasoning and studies to back up their decision with you. Also, online psychiatry services may be a helpful option to consider if it is difficult for you to find a doctor in your area.

In My Experience

Lexapro is a commonly used medication that can be used to treat many different conditions. It is important to understand why your doctor is recommending Lexapro for you. Knowing what dose you will take and for how long, is an important part of successful treatment with Lexapro. It is crucial that any dose changes are discussed with your doctor first. This reduces the risk of unwanted side effects and improves treatment overall.

For Further Reading

• Lexapro & Alcohol: Understanding the Risks
• Lexapro & Weight Gain: Everything You Need to Know
• Lexapro For Anxiety: Effectiveness, Dosage, & More
• How to Get a Lexapro Prescription: Everything You Need to Know
• How Long Does It Take for Antidepressants to Work?
• Medication for Depression: Types, Side Effects, and Management