Lexapro (Escitalopram) is used to treat depression and generalized anxiety disorder (GAD). It is an antidepressant that belongs to a group of medicines known as selective serotonin reuptake inhibitors (SSRIs). These medicines work by increasing the activity of the chemical serotonin in the brain. It’s often used to treat depression and is sometimes used for anxiety, obsessive compulsive disorder (OCD) or panic attacks.
Side Effects:
What are the most common side effects of escitalopram?
The most common side effects of escitalopram are listed below. Tell your healthcare provider if you have any of these side effects that bother you.
- Trouble sleeping
- Sexual problems (see below)
- Nausea
- Sweating
- Tiredness
- Sleepiness
There may be other side effects of escitalopram that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine.
What are the serious side effects of escitalopram?
While less common, the most serious side effects of escitalopram are described below, along with what to do if they happen.
Severe Allergic Reactions. Escitalopram may cause allergic reactions, which can be serious. Stop taking escitalopram and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Suicidal Thoughts or Actions. Escitalopram or other antidepressants may increase the risk of suicidal thoughts or actions in a small number of children, teenagers, or young adults in the first few months of taking the medicine or when the dose is changed. Depression or other serious mental health conditions are the most important causes of suicidal thoughts or actions. If you or your child is about to harm themselves, call 911 or call or text 988, the Suicide & Crisis Lifeline. Call your healthcare provider right away if you have any of the following symptoms.
- New or increased thoughts of suicide or death
- Suicide attempt
- New or increased feelings of anxiety, depression, or other unusual changes in your mood or behavior
Serotonin Syndrome. Serotonin syndrome is when there is too much of a substance called serotonin in your body. Escitalopram can cause serotonin syndrome when it is taken alone or with other medicines that affect serotonin. This condition can be life-threatening. Get emergency help if you have any of the following symptoms of serotonin syndrome.
- Sweating, fever, or flushing
- Confusion
- Feeling agitated or restless
- Seeing or hearing unusual things
- Dizziness
- Fast or racing heartbeat
- Nausea, vomiting, or diarrhea
- Muscle twitching, stiffness, or tremor
- Seizures
Discontinuation Syndrome. If you stop taking escitalopram suddenly, it could lead to discontinuation syndrome, which may be life-threatening. Do not stop taking escitalopram without talking with your healthcare provider. Your healthcare provider will tell you how to stop escitalopram to reduce the risk of withdrawal reactions. Call your healthcare provider right away or go to the nearest emergency room if you have any of the following serious symptoms.
- Anxiety, irritability, or high or low mood
- Feeling restless
- Dizziness
- Confusion
- Headache
- Sweating or shaking
- Changes in sleep habits
- Nausea
- Electric-shock like feelings
Seizures. Some people who have taken escitalopram have reported having seizures. There are many different types of seizures and some of them are not easy to recognize. Stop taking escitalopram and call your healthcare provider if you have any of the following signs that a seizure is happening or could happen.
- Muscle twitching, jerking, spasms, tremors, or other uncontrolled movements
- Stiffening of your arms and legs
- Feeling anxious, nervous, confused, or a sense of dread
- Feeling dizzy or lightheaded
- Falling or losing consciousness
Low Sodium Level (Hyponatremia). Escitalopram may cause low sodium levels. Call your healthcare provider if you have any of the following symptoms of a low sodium level.
- Headache
- Drowsiness
- Muscle weakness or cramps
- Nausea, vomiting, or loss of appetite
- Tiredness or sleepiness
- Dizziness
- Weight gain
- Restlessness or irritability
- Change in your mental condition such as hallucinations, confusion, decreased awareness, or alertness
- Seizures
Sexual Problems. Taking escitalopram or another selective serotonin reuptake inhibitor (SSRI) may cause sexual problems. Tell your healthcare provider if you have any of the following sexual problems.
- Decreased sex drive
- Delayed ejaculation or unable to have an ejaculation
- Problems getting or keeping an erection
- Delayed orgasm or inability to have an orgasm
Heart Rhythm Changes. Escitalopram may cause a rare, dangerous heart rhythm problem called QT prolongation and torsade de pointes. Some people have a higher risk of this, including people who are older, have other people in their family who have had these conditions, have low potassium or magnesium levels, or who take some medicines for other heart rhythm problems. Tell your healthcare provider right away if you faint or have changes in your heart rate or rhythm, such as a fast or skipping heartbeat.
Extremely Elevated Mood (Mania). People with bipolar disorder can have severe high and low moods. The first symptom of bipolar disorder may be depression. People with bipolar disorder who take an antidepressant, such as escitalopram, may have a higher risk of having mania or a manic episode. Call your healthcare provider right away if you have any of the following symptoms of a manic episode.
- Very increased energy
- Significant trouble sleeping
- Racing, fast-paced thoughts
- Reckless behavior
- Unusually grand ideas
- Excessive happiness or irritability
- Talking more or faster than usual
Glaucoma. Escitalopram may increase pressure inside the eye and cause or worsen narrow-angle glaucoma, which can lead to blindness. Tell your healthcare provider right away if you have any of the following symptoms of glaucoma.
- Loss of vision
- Eye pain or redness
- Severe headache or vomiting
- Seeing bright, colorful circles around lights (vision halos)
Abnormal Bleeding. People taking escitalopram or other antidepressants may have an increased risk of bleeding or bruising. You may be at higher risk if you are also taking aspirin, a nonsteroidal anti-inflammatory drug (NSAID), like ibuprofen or naproxen, or a blood thinner such as warfarin, apixaban (Eliquis), or rivaroxaban (Xarelto). Tell your healthcare provider if you notice any changes in how easily you bruise or bleed.
Warnings & Precautions:
Who should not use escitalopram?
Allergies to Ingredients. People who are allergic to any of the following should not take escitalopram. Your pharmacist can tell you all the ingredients in the specific escitalopram products they stock.
Drug Interactions. Escitalopram should not be taken while you are using certain other medicines. Before taking escitalopram, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using or have recently taken. See the Interactions section for more details.
What should I know about escitalopram before using it?
Do not take escitalopram unless it has been prescribed to you by a healthcare provider. Take it as prescribed. Do not share escitalopram with other people, even if they have the same condition as you. It may harm them. Keep escitalopram out of the reach of children.
Escitalopram can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how escitalopram affects you.
Do not stop taking escitalopram without talking to your healthcare provider. Stopping too quickly may cause serious side effects. See the Side Effects section for details.
What should I tell my healthcare provider before using escitalopram?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if escitalopram is right for you.
In particular, make sure that you discuss any of the following.
Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.
- Seizures or convulsions
- Bipolar disorder, mania, or hypomania or a family history of any of these
- Suicidal thoughts or actions
- Low blood sodium levels
- Bleeding problems
- High pressure in the eye (glaucoma)
- Heart problems, including heart attack, heart failure, abnormal heart rhythm, or long QT syndrome
- Liver problems
- Kidney problems
Pregnancy. Taking escitalopram later in pregnancy may lead to an increased risk of certain problems in your unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should take escitalopram while you are pregnant or trying to get pregnant.
If you become pregnant while taking escitalopram, you can register with the National Pregnancy Registry for Antidepressants by calling 844-405-6185 or at womensmentalhealth.org/research/pregnancy registry/antidepressants. This registry collects safety information about the use of antidepressant medicines during pregnancy.
Breastfeeding. Escitalopram passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take escitalopram while breastfeeding. If you breastfeed while taking escitalopram, call your healthcare provider right away if your baby becomes sleepy or fussy, or is not feeding well or gaining weight.
Interactions:
Does escitalopram interact with foods or drinks?
There are no known interactions between escitalopram and foods or drinks. Do not consume alcohol while taking escitalopram. The combination can increase sleepiness or affect your alertness or concentration.
Does escitalopram interact with other medicines (drug interactions)?
Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
In particular, make sure that you discuss if you are using any of the following before taking escitalopram.
- A selective serotonin reuptake inhibitor (SSRI) or serotonin and norepinephrine reuptake inhibitor (SNRI), which is a medicine commonly used for anxiety and depression
- A nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen, naproxen, and others, which is in many prescription and OTC products for pain, swelling, and fever
- Aspirin, which is in many prescription and OTC products, including those for pain, swelling, and fever
- A blood thinner, which is a medicine used to treat or prevent blood clots
- A monoamine oxidase inhibitor (MAOI) within the past 2 weeks, which is a medicine usually used for depression or Parkinson’s disease
- Pimozide, which is a medicine used for Tourette syndrome
- A type of medicine called a triptan, such as sumatriptan, (Imitrex and others), eletriptan (Relpax), and others, which is commonly used to treat migraines
- Carbamazepine (Carbatrol, Tegretol, and others), which is a medicine commonly used to treat seizures or nerve pain
- A tricyclic antidepressant, such as amitriptyline, nortriptyline, or protriptyline, even if it is not used for depression
- St. John’s wort, which is a supplement that may be used to treat depression
- Tryptophan, which is a supplement that may be used to treat mental health conditions
- Lithium, which is a medicine for certain mental health conditions
- Buspirone, which is a medicine used for anxiety
Escitalopram may alter the blood levels of some other medicines. Tell your healthcare provider about all medicines that you take or have recently taken.
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