*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, with the active ingredient escitalopram, is an antidepressant used to treat depression and anxiety in adults and children. It is sometimes used to treat other disorders, such as panic disorder, OCD, and PTSD.
Because of its safety and effectiveness, Lexapro is usually the first-line treatment for depression and anxiety. However, Lexapro also carries risks, such as increased suicidal thoughts (for patients under 25 years old), seizures, and the activation of manic episodes.1
If you’re considering Lexapro, online psychiatry platforms such as Talkiatry and Brightside Health can connect you with a provider quickly. They offer assessments and can provide a prescription if they determine Lexapro or another medication may help your symptoms.
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.
Key Takeaways
Lexapro is a prescription antidepressant medication used to treat major depression and anxiety disorders in adults and children.
Lexapro, with the active ingredient escitalopram, is a selective serotonin reuptake inhibitor (SSRI).
If you are considering Lexapro, a good place to start is with an evaluation from a medical provider. Many online psychiatry platforms offer online assessments and medication management, such as Talkiatry, or Circle Medical.
What Is Lexapro (Escitalopram)?
Lexapro is an antidepressant used to treat depression and anxiety in adults and children. It is in the selective serotonin reuptake inhibitor (SSRI) drug class. Like other SSRI drugs, Lexapro may help improve symptoms like sleep, appetite, and energy and reduce fear and anxiety.
Lexapro is the brand name for the active drug escitalopram, which is also a generic medication with the same uses and risks as Lexapro.
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How Does Lexapro Work?
Lexapro is thought to work by increasing serotonin levels in the brain. Serotonin is a body chemical involved in mood regulation.1
What Is Lexapro Used to Treat?
Lexapro is FDA-approved to treat the following conditions:
- Major depressive disorder in children 12 years and older and adults
- Generalized anxiety disorder in children 7 years and older and adults
Off-Label (Non-FDA-approved) Uses of Lexapro
Lexapro may be used off-label to treat certain conditions. An off-label use of a medication is one 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 is sometimes also used off-label to treat:2
- Obsessive-compulsive disorder (OCD)
- Panic disorder
- Post-traumatic stress disorder (PTSD)
- Premenstrual dysphoric disorder (PMDD)
- Social anxiety disorder
How Effective Is Lexapro?
Lexapro has been studied extensively for use in patients with major depressive disorder and generalized anxiety disorder. In multiple studies comparing Lexapro to placebo, patients taking Lexapro felt their depression symptoms improved significantly.
These results were also seen in a long-term study of hundreds of patients over 36 weeks. This study found that patients taking Lexapro had a significantly longer time before their symptoms relapsed, or came back, compared to patients receiving a placebo. One study using Lexapro to treat anxiety showed significantly improved anxiety symptoms when compared to a placebo.1 Other studies showed that doses as low as 10 mg were effective in treating both anxiety and depression.1
Studies were also completed to test the safety and effectiveness of Lexapro use in pediatric patients. Studies found Lexapro to be safe and effective as depression treatment for patients 12 years and older. It was also effective for treating anxiety in patients 7 years and older.1 Mental health treatment for children and teens should always be considered carefully and directed by a licensed healthcare provider.
How Long Does it Take for Lexapro to Work?
You may not notice symptom improvement until after a few weeks of consistent use. It may take from 4 to 6 weeks to feel the full therapeutic effect of Lexapro.
How Long Do I Need to Keep Taking Lexapro?
The length of treatment time with Lexapro varies from patient to patient. It can take 4 to 8 weeks for Lexapro to start working, and some people continue treatment anywhere from months to years. The length of treatment will ultimately be decided by you and your prescriber together. Factors that can affect the length of treatment can include your response to Lexapro, Lexapro side effects, changes in health, or being prescribed other medications.
Common Lexapro Side Effects
Side effects from Lexapro may occur for some who take it, especially in the first several weeks. They often go away on their own or may be resolved through dose changes. Your provider may start you with a low dose for a few weeks, increasing your dosage as needed. While this may help you avoid common Lexapro side effects, they may still occur even when taking the medication correctly.
Common side effects of Lexapro for adults include:1
- Nausea
- Sexual problems in males (i.e., decreased sex drive, erectile dysfunction, or delayed or absent ejaculation)
- Sexual problems in females (i.e., reduced sex drive, delayed orgasm, or unable to have an orgasm)
- Drowsiness
- Insomnia
- Increased sweating
*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. You should talk with your doctor about any questions you have and understand the potential side effects and benefits of any medication.
Serious Lexapro Side Effects
Serious side effects from Lexapro are possible and require immediate attention. Some may even become life-threatening. If you experience any of the following serious side effects, call 9-1-1 or seek emergency medical care.
Serious side effects of Lexapro for adults include:1
- Serotonin syndrome
- Abnormal bleeding
- Seizures
- Vision changes
- Manic episodes
- Low salt levels (hyponatremia)
- Suicidal thoughts
- Allergic reactions
- Irregular heartbeat
- Muscle rigidity, tremors, fever, and/or seizures (Could be a sign of serotonin syndrome)
*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. You should talk with your doctor about any questions you have and understand the potential side effects and benefits of any medication.
What Are The Long-term Effects of Taking Lexapro?
Taking any medication long term can increase the risk for experiencing side effects, especially serious ones. If you are taking Lexapro for an extended period, your healthcare provider will continue to monitor for new side effects and follow up with your prescriber with any new side effects.
Lexapro has been shown to be relatively safe when used long term. A large-scale long-term study found most patients did not experience any new types of side effects after 8 weeks of treatment. The most commonly experienced side effects experienced long term from this study were headache, pain, nausea and respiratory infections.3
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What Are the Risks & Warnings for Lexapro?
Suicidal Thoughts & Behaviors
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.
Triggering Manic Episodes
Lexapro can increase the chances of mania in people without bipolar disorder, making mood swings even higher for those with bipolar disorder. Prior to starting treatment with an antidepressant like Lexapro, patients with depressive symptoms should be screened to determine if they are at risk for bipolar disorder.
Seizures
SSRI medications such as Lexapro can cause seizures when taken in high doses or with other similar drugs. It is crucial to alert your doctor if you have a history of seizures.
Allergic Reactions
For some people taking Lexapro, an allergic reaction may occur which may be dangerous.
Severe allergic reactions to Lexapro can include:
- Breathing problems
- Swelling
- Rash/hives
If you experience wheezing, difficulty breathing, or swelling in the throat, seek immediate medical help.
Serotonin Syndrome
Taking Lexapro may increase the risk of a serotonin syndrome, a potentially life-threatening condition resulting from high levels of serotonin in the body. Symptoms include fever, sweating, confusion, fast or irregular heartbeat, severe muscle stiffness or twitching, agitation, hallucinations, loss of coordination, nausea, vomiting, or diarrhea.
Pregnancy Risks
Lexapro may have risks in newborns when taken by mothers in the last few months of pregnancy. Also excreted in breast milk, Lexapro can negatively impact a nursing newborn.
Breastfeeding Risks
Lexapro is excreted in breast milk, which may carry some risk for a nursing newborn.
Irregular Heart Rhythms (Arrythmias)
For some people, taking Lexapro may cause an irregular heart rhythm. If you have any previous heart or heart-related conditions, your doctor may perform an EKG test before taking Lexapro.
Liver Problems
Some people have low levels of specific liver enzymes that can worsen Lexapro’s side effects, so ask your doctor if you need to test your liver enzymes.
Hyponatremia (Low Sodium Levels)
For some people, taking Lexapro may increase the risk of hyponatremia, a condition where salt levels in the blood are too low. This condition can be life-threatening if not appropriately addressed. Headaches, problems with thinking, concentration, or memory, and difficulty urinating are all signs of low salt in the body.
Angle-closure Glaucoma (Serious Eye Condition)
Lexapro may cause angle-closure glaucoma, which can develop suddenly and lead to vision loss. If you have eye problems or a family history of glaucoma, your doctor may recommend an eye exam before taking Lexapro.
Abnormal Bleeding
Taking Lexapro may increase the risk of abnormal bleeding. This can include bruising under the skin, a cut that does not stop bleeding, discolored stool, nose bleedings, or vomiting blood.
Antidepressant Discontinuation Syndrome
People discontinuing Lexapro abruptly may have symptoms of Lexapro withdrawal, also called antidepressant discontinuation syndrome. Because of this, it is always recommended to taper the dose of medication as instructed by your provider. Do not stop taking Lexapro or adjust your dosage on your own.
Here are common symptoms of Lexapro withdrawal:
- Dizziness
- Nausea
- Fatigue
- Anxiety
- Shaking
- Sweating
- Agitation
- Sleep problems
- Seizures
- Electric shock sensations
If you experience any of these symptoms, seek medical care as soon as possible.
Drug Interactions
Taking certain medications, herbs, or supplements alongside Lexapro can change how Lexapro works in your body or increase the risk for serious side effects. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.
Substances you should avoid using while taking Lexapro include:
- Additional SSRI or SNRI medications
- Monoamine oxidase inhibitors (MAOIs)
- Tricyclic antidepressants (TCAs)
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Buspirone
- Alcohol
This is not a comprehensive list of medications that interact with Lexapro. Be sure to talk with your doctor or pharmacist about any prescription or over the counter medications you take, as well as supplements, herbs, and teas.
Who Should Not Take Lexapro?
Some who take Lexapro have a higher chance of experiencing side effects. While it’s not always possible to know whether or not side effects will occur, specific patient populations should be cautious with Lexapro.
Patients taking other SSRIs, SNRIs, or medications that increase serotonin in the brain should avoid Lexapro due to the risk of serotonin syndrome. Adolescent patients and their parents should be aware of the risk of increased suicidal thoughts and behaviors when starting Lexapro. Discuss your health conditions with your provider to select the medication that is the most suitable for you.
People who may need to avoid taking Lexapro include:1
- Kidney problems
- Liver problems
- Heart problems
- Bipolar disorder or mania
- Prior allergic reactions to escitalopram
- Prior vision issues such as glaucoma
- A history of seizures
- Low sodium levels in the blood
- Bleeding problems
Drug Interactions With Lexapro
Taking certain medications, herbs, or supplements alongside Lexapro can change how Lexapro works in your body or increase the risk for serious side effects. Always talk with your prescriber about what to avoid while using Lexapro.
Substances you should avoid using while taking Lexapro include:1
- Additional SSRI or SNRI medications
- Monoamine oxidase inhibitors (MAOIs)
- Tricyclic antidepressants (TCAs)
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Buspirone
- Alcohol
This is not a comprehensive list of the possible interactions with Lexapro. You should talk with your provider and your pharmacist about all prescription and over-the-counter medications, herbs, and supplements you take before starting Lexapro.
Lexapro Withdrawal
If you stop taking Lexapro abruptly, you may develop symptoms of Lexapro withdrawal, also called antidepressant discontinuation syndrome. It may also lead to a relapse of your symptoms. Because of this, it is always recommended to taper the dose of medication as instructed by your provider. Do not stop taking Lexapro or adjust your dosage on your own.
Here are common symptoms of Lexapro withdrawal:1
- Dizziness
- Nausea
- Fatigue
- Anxiety
- Shaking
- Sweating
- Agitation
- Sleep problems
- Seizures
- Electric shock sensations
If you experience any of these symptoms, seek medical care as soon as possible.
Lexapro Dosages for FDA-Approved Treatment
The most common Lexapro dose for adults and children is 10 mg, taken once daily. Depending on the condition Lexapro is used to treat and your response to the medication, your provider may increase the dose after at least one week. This process gives your body time to adjust to the medication and helps reduce any side effects from starting with too high of a dose.
How Should I Take Lexapro?
Take your Lexapro dose as prescribed every day at the same time. You may take it with or without food. Lexapro is available as a tablet or a liquid solution, with the liquid being offered when a lower dose is needed or if someone cannot swallow pills.
What Happens If I Miss a Dose of Lexapro?
If you miss a dose, take the missed dose as soon as you remember. If a whole day or more has passed, do not take a double amount. Instead, skip the missed dose and continue taking Lexapro as prescribed. Do not stop taking Lexapro unless your provider has instructed you to do so.
Can You Overdose on Lexapro?
Lexapro overdose can happen when too much Lexapro is taken in a short time. It can also occur if too much Lexapro is taken with other antidepressants or SSRI medications.
Symptoms of overdose can include:
- Serotonin syndrome
- Excessive sweating
- Chills
- Confusion
- Hallucinations
- Loss of coordination
- Seizures
- Irregular heartbeat
What Should You Do If You Take Too Much Lexapro?
If you notice any symptoms of overdose, get help immediately by calling 9-1-1 or going to the nearest emergency room. You should also contact your provider and can contact poison control for additional assistance at 800-222-1222.
How to Get a Prescription for Lexapro
To get a prescription for Lexapro in person, start with an evaluation for your symptoms. Your primary care provider, who may be a physician, nurse practitioner, or physician assistant, can help you get the process started. They may make a referral to a psychiatrist or specialist to determine if a prescription or Lexapro should be included in your treatment plan.
Can I Get Lexapro Prescribed Online?
To get an online prescription for Lexapro, you will also start by getting evaluated by an online psychiatric provider. We have thoroughly reviewed platforms like Talkiatry or Circle Medical that prescribe non-controlled substances such as antidepressants and some anti-anxiety medications.
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
Questions to Ask Your Provider
It is important to discuss the potential side effects of Lexapro with your doctor, psychiatrist, or therapist you may experience immediately after starting the treatment. Ask them whether these side effects will go away on their own or if any intervention is needed.
Also, many online psychiatry services are available with convenient access to mental health care for depression and anxiety problems. Individuals may even change prescribers and get a mental health evaluation, diagnosis, and personalized treatment plan.
Questions to ask your care team about Lexapro include:
- How long will it take for me to adjust to taking Lexapro?
- How quickly can Lexapro cause side effects?
- What are the first days of Lexapro side effects like?
- What is the best dosage to ensure fewer side effects, especially in the first week?
- Is it safe to take Lexapro with my other medications?
- Will my insurance cover Lexapro or escitalopram?
- How often should I see you for checkups while taking Lexapro?
- Should I let my therapist know I am taking this medication?
- What should I do if I want to stop taking Lexapro?
- How long can I expect to be taking Lexapro?
- How long does Lexapro take to work?
- What should I do if I have thoughts of suicide or harming myself?
- Are there any other medications that I should not take with Lexapro?
Prescriber’s Tips
Your prescriber will share important information about your Lexapro prescription. They will explain how to take and store your medication, what to avoid when taking it, and what to do about side effects. Follow these tips for safe and effective use of Lexapro.
- Take your medication as prescribed, do not change your dose or stop taking it unless your prescriber tells you to. Keeping a consistent dosing schedule reduces the chance of unwanted side effects. When taking antidepressants, this approach can prevent withdrawal symptoms such as dizziness, brain zaps, and flu-like symptoms.1
- Take your medication at the same time each day. Doing so can help you remember to take it, making it as effective as possible. Your healthcare provider can help determine the optimal timing based on your sleep patterns and initial medication response.
- Tell your prescriber right away if you or your child have any worsening mental health symptoms. Antidepressants have a boxed warning for increased risk of suicidal thoughts and behaviors in children under age 18 and young adults.
- You should take your first dose while you are home and not needing to drive. Lexapro has been known to cause drowsiness in some patients, and you should avoid driving after taking Lexapro until you know how it affects you.1
- Do not drink alcohol while taking Lexapro.
- Tell your prescriber about all medications and supplements you take, including over-the-counter treatments. Many over-the-counter medications and supplements can interact with prescription medications.
Frequently Asked Questions
Can Lexapro Be Used During Pregnancy?
Taking Lexapro during pregnancy is generally not recommended. Lexapro may increase the risk of complications for the fetus, especially if Lexapro is taken during the third trimester.1 However, untreated depression or anxiety can negatively impact both the pregnant parent and the fetus. Speak to your provider about the risks and benefits of using Lexapro during pregnancy.
Can Lexapro Be Used While Breastfeeding?
It may depend. Lexapro is excreted in breast milk, which may carry some risk for a nursing newborn. Talk with your provider about the best way to feed your baby while taking Lexapro.
Is It OK to Drink Alcohol While Taking Lexapro?
No, drinking alcohol while taking Lexapro is not recommended. Alcohol significantly affects the brain and can worsen side effects, such as drowsiness, dizziness and other possible dangerous health complications.
What Are Common Side Effects of Lexapro?
Common Lexapro side effects include nausea, fatigue, changes in sleep, and sexual dysfunction.1
How Long Will Lexapro Side Effects Last?
Common Lexapro side effects usually last for a few weeks after the initial dose but may last longer in some people.
Should I Stop Taking Lexapro If I Start Feeling Side Effects?
Do not stop taking Lexapro unless you have been advised to do so by your provider. Doing so can cause uncomfortable symptoms, including dizziness, fatigue, irritability, and nausea. If you are experiencing side effects from your medication, tell your provider. They will help you determine the best course for continued treatment.
What’s the Number One Side Effect of Lexapro?
In the clinical trials for Lexapro, the most commonly reported side effect was a headache.1
ChoosingTherapy.com 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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Lexapro – escitalopram tablet, film coated. (October 1, 2023). DailyMed.nlm.nih.gov. Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm
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Landy K, Rosani A, Estevez R. Escitalopram. [Updated 2023 Nov 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557734/
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Wade, A., Despiegel, N., & Heldbo Reines, E. (2006). Escitalopram in the long-term treatment of major depressive disorder. Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists, 18(2), 83–89. Retrieved from https://doi.org/10.1080/10401230600614447
We regularly update the articles on ChoosingTherapy.com to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.
Author: No Change
Reviewer: No Change
Primary updates: Added “Key Takeaways” feature. Edited for clarity and reorganized. Removed “History of Lexapro”. Revised and retitled content in “What is Lexapro (Escitalopram) & How Is It Used?”, to include “How Does Lexapro Work?” “What Is Lexapro Used to Treat?” Added sections titled “How Effective Is Lexapro?”, “How Long Does it Take Lexapro to Work?” “How Long Do I Need to Keep Taking Lexapro?”, “What Are the Long-term Effects of Lexapro?”. Consolidated “Severe Allergic Reactions to Lexapro” and “Lexapro Warnings & Associated Risks” into new “Risks” feature. Added “Who Should Not Take Lexapro?”, “Lexapro Withdrawal”, “How Should I Take Lexapro?”, “How to Get a Prescription for Lexapro”. Retitled “Questions to Ask Your Health Team About Lexapro” to “Questions to Ask Your Provider”. Removed “For Further Reading” section, added FAQs. Replaced “Final Thoughts” with “Prescriber’s Tips” feature.
Author: Zachary Reale, PharmD
Medical Reviewer: Dena Westphalen, PharmD
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