Escitalopram (Lexapro) Side Effects: A Complete Guide

Daniel Lieberman

Reviewed by Daniel Z. Lieberman, MD

Written by Rachel Sacks

Published 07/22/2020

Updated 11/16/2023

Starting a new medication for your mental health can be a time full of uncertainty. And there’s a lot of information about antidepressant medications out there, whether you’re curious about dosages or if you’ll experience serious side effects. It can be hard to know where to start or what to believe, but we’re here to help.

First, the good news is that you’re getting started on treatment for mental illness and that’s a big step, so congratulations! And we’re here to help uncover everything you need to know about the side effects of one common antidepressant: Lexapro® (or the generic version escitalopram).

Whether you’ve been prescribed Lexapro for depression or to deal with generalized anxiety disorder (GAD, the most common form of anxiety), this antidepressant can help make living with mental illness easier. But that better living can sometimes still come with side effects.

Of course, we’re not trying to scare you — rather, we want to inform you about Lexapro side effects in women, as well as answer questions like “How long do Lexapro side effects last?” Read on for answers, so you can spend less time searching the internet and more time planning your next vacation (or dreaming about it).

Lexapro is a brand name drug approved by the Food and Drug Administration (FDA) to treat major depressive disorder (more often referred to as depression) and generalized anxiety disorder. While Lexapro isn’t approved by the FDA to treat these conditions, your healthcare provider might also prescribe Lexapro for PMDD (premenstrual dysphoric disorder), panic disorder, obsessive-compulsive disorder (OCD), social anxiety and more, off-label.

Lexapro belongs to a class of medications called selective serotonin reuptake inhibitors (SSRIs). Other SSRIs you may have heard of include sertraline, paroxetine, citalopram and fluoxetine.

A quick note on how SSRIs are thought to work: by preventing your brain from reabsorbing serotonin, an important brain chemical that affects your mood, they increase levels of this neurotransmitter. 

Whether you use Lexapro for anxiety or major depressive disorder, it’s natural to be curious about common side effects and wonder: does Lexapro cause headaches? Will Lexapro make you tired? Should you Google “Lexapro 20 mg side effects,” just in case? Maybe you heard that your roommate’s girlfriend experienced Lexapro night sweats.

The answers to all the questions and rumors you’ve heard about common escitalopram side effects are just below. To get right to it, some common side effects of Lexapro include:

  • Insomnia or trouble sleeping

  • Nausea

  • Sweating

  • Fatigue or drowsiness

  • Dry mouth

  • Sexual side effects

There’s also a connection between Lexapro and weight — some people experience weight gain, while others may see weight loss as a side effect.

Side Effects of Lexapro in the First Week

The first week on a new antidepressant can be an adjustment for many, to say the least.

But no need to look up “Lexapro side effects first week” — the common side effects that we listed above are most likely the ones you’ll notice. Some people have reported side effects such as increased sweating, headaches, nausea and trouble sleeping to be most severe in the first week.

Lexapro Side Effects in Women

Everyone’s experience with antidepressant medication can vary — which may make you wonder if Lexapro side effects in women are different from those in men.

The short answer is yes, to an extent. Sexual side effects, such as an inability to reach orgasm and others, are also common with Lexapro, and these Lexapro sexual side effects can affect women differently than men. 

Women are more likely to see their sexual functioning affected, including low libido and anorgasmia (delayed, infrequent or absent orgasms). Meanwhile, in men, Lexapro may cause other forms of sexual dysfunction, such as delayed ejaculation.

Oh, and if you’re pregnant, you may be wondering how Lexapro may affect your pregnancy or your breast milk once you have the baby. The answer is pretty mixed.

Lexapro has a Category C rating from the FDA, meaning that while there aren’t adequate and well-controlled studies of how it affects humans during pregnancy, animal studies have shown adverse effects on the fetus.

But you’ll be glad to know that there are such low amounts of escitalopram in breast milk that the drug isn’t detectable in the baby.

If you’re planning to become pregnant or start breastfeeding, let your healthcare provider know before deciding to use Lexapro.

While these side effects are fairly mild, they can still be annoying to deal with — increased sweating and nausea aren’t such a cute look.

Fortunately, these adverse effects typically start to subside after a few weeks of treatment and are gone after a few months of treatment.

Like with any medication, Lexapro also has the possibility of more serious side effects too. Again, this isn’t to scare you, just to make sure you know everything you need to know about Lexapro.

One serious side effect of Lexapro is serotonin syndrome, a life-threatening condition of increased serotonin levels with mild to severe symptoms. 

Symptoms of serotonin syndrome include increased heart rate, nausea, diarrhea, pupil dilation, muscle twitching, hyperthermia (high body temperature), tremor, confusion, agitation, anxiety and more.

Lexapro on its own, at FDA-approved dosages, is unlikely to cause serotonin syndrome, but certain drug interactions can increase your serotonin levels and therefore, your risk of serotonin syndrome. Drug interactions can also raise your risk of other serious side effects, like increased bleeding (for example, nosebleeds that won’t stop). 

Medications that can interact with Lexapro include prescription drugs, over-the-counter medications and more, such as:

  • Monoamine oxidase inhibitors (MAOIs), another type of antidepressant

  • Pimozide

  • Serotonergic drugs (drugs that affect your serotonin) such as tricyclic antidepressants, fentanyl, buspirone, amphetamines and St. John’s Wort

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen

  • Anticoagulants (blood thinners), such as warfarin

Another serious but rare side effect of Lexapro is a type of glaucoma called angle closure glaucoma. Symptoms may include eye pain, eye swelling or redness, and changes in vision.

While these more serious side effects and drug interactions are rare, it’s important to let your healthcare provider know about any medications or supplements you’re taking before starting Lexapro. And be sure to get medical attention as soon as possible if you develop symptoms of any of these serious side effects.

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Now that we’ve covered the common side effects of Lexapro, as well as more rare but adverse effects, it’s time to cover one particular detail: will your dosage affect side effects? Does a higher dosage mean more side effects of Lexapro?

Lexapro is prescribed in three dosages: 5, 10 and 20 mg. All dosages are taken once a day. Your dosage is based on your medical condition, response to treatment, age and other prescription drugs or medications you may be taking.

While the typical recommended starting dosage is 10 mg, it’s common for your healthcare provider to change your dosage over time.

If you’re experiencing harsh side effects of escitalopram, your doctor may lower your dosage. Or if your depression symptoms either don’t improve or get worse, your provider may increase your dosage.

When your dose increases, however, so does the possibility and risk of adverse effects, although the side effects you’re at risk for don’t change. So Lexapro 20 mg side effects are the same as the side effects of 10 mg of Lexapro, but the 20 mg dose may have increased effects.

But there’s no need for alarm. Although these side effects may increase with a higher dosage, they’re still likely to eventually go away.

While there’s a chance you’ll experience some of the common side effects of Lexapro, there are ways to make them less severe and avoid the more adverse effects.

  • Use Lexapro only as directed. One way to lessen side effects is to take the medication as it’s prescribed to you. Take your prescribed dosage at the same time every day, and if you miss a dose, take it as soon as you remember, but don’t double up on your next dose. Your healthcare provider will increase the dosage if needed.

  • Consider switching Lexapro from night to morning. Many of Lexapro’s side effects can cause you to have trouble sleeping. If you’re experiencing this, taking your dose in the morning instead could help alleviate the side effects.

  • Avoid binge drinking on Lexapro. Lexapro and alcohol don’t go well together. You may be more likely to develop side effects or drug interactions, or sustain injuries due to changes in your level of motor control.

  • Be mindful of interactions. As we mentioned above, Lexapro interactions bring an increased risk of serotonin syndrome, as well as other serious side effects like increased bleeding. Always let your healthcare provider know about any medications or supplements you’re taking before starting Lexapro. Also let them know if you have low sodium levels or high blood pressure.

  • Don’t stop taking it abruptly. While it may be tempting to stop Lexapro if your depression or anxiety goes away, suddenly stopping could lead to withdrawal symptoms like irritability, nausea, dizziness, vomiting and headaches.

  • Contact your healthcare provider. If your side effects are persistent after starting escitalopram or if you experience serious side effects from this medication, contact your healthcare provider as soon as possible.

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With any prescription drug comes the possibility of experiencing side effects — and Lexapro is no exception. But with this guide, you can know what to expect.

  • Lexapro, a selective serotonin reuptake inhibitor (SSRI), is an antidepressant medication prescribed to treat a variety of mental health conditions, including depression, anxiety, post-traumatic stress disorder, OCD and panic disorder.

  • Common side effects of Lexapro include trouble sleeping, nausea, fatigue and sweating. You may also experience sexual side effects, including low libido and delayed orgasms.

  • Certain drug interactions increase the risk of rare but serious side effects like increased bleeding and serotonin syndrome, a serious condition with symptoms of nausea, muscle twitching, tremor, confusion and agitation.

  • These side effects can be alleviated by taking the medication as it’s prescribed to you, letting your healthcare provider know about any other drugs you’re taking and discussing any lasting or worsening side effects or adverse effects with them.

You can learn more about Lexapro's side effects and whether this is the right medication for you by consulting with a licensed healthcare professional through online psychiatry.

Another proven treatment for depression and anxiety is talk therapy. You can get started today with our mental health services or online therapy.

7 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

  1. Landy, K., Rosani, A., Estevez, R. Escitalopram. [Updated 2022 Oct 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Retrieved from
  2. Chu, A., Wadhwa, R. Selective Serotonin Reuptake Inhibitors. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Retrieved from
  3. Lexapro (escitalopram oxalate). (n.d.). FDA. Retrieved from
  4. Escitalopram (Lexapro). (n.d.). NAMI. Retrieved from
  5. O'Connor, E., Rossom, R.C., Henninger, M., et al. Screening for Depression in Adults: An Updated Systematic Evidence Review for the U.S. Preventive Services Task Force [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2016 Jan. (Evidence Syntheses, No. 128.) Appendix A, FDA Antidepressant Drug Labels for Pregnant and Postpartum Women. Retrieved from
  6. Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-. Escitalopram. [Updated 2022 Apr 18]. Retrieved from
  7. Wang, R. Z., Vashistha, V., Kaur, S., & Houchens, N. W. (2016, November 1). Serotonin syndrome: Preventing, recognizing, and treating it. Cleveland Clinic Journal of Medicine. Retrieved from

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Daniel Z. Lieberman, MD

Dr. Daniel Z. Lieberman is the senior vice president of mental health at Hims & Hers and of psychiatry and behavioral sciences at George Washington University. Prior to joining Hims & Hers, Dr. Lieberman spent over 25 years as a full time academic, receiving multiple awards for teaching and research. While at George Washington, he served as the chairman of the university’s Institutional Review Board and the vice chair of the Department of Psychiatry and Behavioral Sciences.

Dr. Lieberman’s has focused on , , , and to increase access to scientifically-proven treatments. He served as the principal investigator at George Washington University for dozens of FDA trials of new medications and developed online programs to help people with , , and . In recognition of his contributions to the field of psychiatry, in 2015, Dr. Lieberman was designated a distinguished fellow of the American Psychiatric Association. He is board certified in psychiatry and addiction psychiatry by the American Board of Psychiatry and Neurology.

As an expert in mental health, Dr. Lieberman has provided insight on psychiatric topics for the U.S. Department of Health and Human Services, U.S. Department of Commerce, and Office of Drug & Alcohol Policy.

Dr. Lieberman studied the Great Books at St. John’s College and attended medical school at New York University, where he also completed his psychiatry residency. He is the coauthor of the international bestseller , which has been translated into more than 20 languages and was selected as one of the “Must-Read Brain Books of 2018” by Forbes. He is also the author of . He has been on and to discuss the role of the in human behavior, , and .


  • 1992: M.D., New York University School of Medicine

  • 1985: B.A., St. John’s College, Annapolis, Maryland

Selected Appointments

  • 2022–Present: Clinical Professor, George Washington University Department of Psychiatry and Behavioral Sciences

  • 2013–2022: Vice Chair for Clinical Affairs, George Washington University Department of Psychiatry and Behavioral Sciences

  • 2010–2022: Professor, George Washington University Department of Psychiatry and Behavioral Sciences

  • 2008–2017: Chairman, George Washington University Institutional Review Board

Selected Awards & Honors

  • 2022: Distinguished Life Fellow, American Psychiatric Association

  • 2008–2020: Washingtonian Top Doctor award

  • 2005: Caron Foundation Research Award


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