Lexapro For Anxiety: Side Effects, Dosage, and Benefits

Whether you struggle with social anxiety disorder, major depression or generalized anxiety disorder (GAD), treatment options are available. The treatment of anxiety and depression typically includes therapy, the use of antidepressant medications or a combination of both.

One treatment option is Lexapro®, a medication often prescribed to help manage anxiety symptoms or depressive symptoms.

But is Lexapro good for anxiety?

Below, we look at the effectiveness of Lexapro for anxiety and include basic information on Lexapro, side effects and more.

Overview of Lexapro

The brand name of the generic drug escitalopram, Lexapro is an antidepressant medication used to treat certain mental health disorders.

The FDA has approved Lexapro to treat major depressive disorder (also known as depression) and generalized anxiety disorder (also referred to as anxiety).

Some common depressive symptoms in women tend to include:

• Pessimistic feelings

• Sad or anxious mood

• Slower speech or movement

• Fatigue

• Difficulty with sleep (either staying asleep or sleeping too much)

• Loss of interest in everyday activities

• Suicidal thoughts and behavior

Typical anxiety symptoms might look like uncontrollable thoughts, heart palpitations, numbness, excessive worry, muscle tension and more.

A healthcare provider may also prescribe Lexapro off-label as a treatment for conditions such as social anxiety disorder (also known as social phobia), panic disorder, obsessive-compulsive disorder (OCD) and premenstrual dysphoric disorder.

Read our blog on Lexapro for PMDD for more information on this.

There are different symptoms of these anxiety disorders. For example, patients with panic disorder might have panic attacks — a sudden, unreasonable fear or feeling of anxiety that occurs randomly or after being exposed to a trigger.

Our overview of anxiety disorders includes more information on anxiety symptoms, from panic attacks to symptoms of social phobia and more.

Lexapro belongs to the class of antidepressant drugs called selective serotonin reuptake inhibitors (SSRIs). These antidepressant medications work by increasing levels of serotonin — a natural chemical present in the brain and body.

Serotonin is nicknamed the body’s “feel good” chemical because of how it helps regulate your mood and happiness as well as certain aspects of physical health. Normal serotonin levels can make you feel emotionally stable, happier and more focused whereas low levels are associated with a mental illness like anxiety or depression.

Side Effects and Risks of Lexapro

There are common side effects and rare but adverse risks when taking Lexapro.

Common side effects of escitalopram are:

• Dry mouth

• Increased sweating

• Insomnia

• Drowsiness

• Fatigue or lack of energy

• Dizziness

• Nausea

• Vomiting

• Diarrhea

• Headache

• Abdominal pain

• Reduced appetite

• Decreased sex drive

The side effects of Lexapro tend to be mild and temporary but there are also rare, dangerous side effects you should be aware of.

More adverse effects of Lexapro can include low sodium blood levels and symptoms of angle closure glaucoma such as eye pain or changes in vision.

There is also a risk of serotonin syndrome, a potentially life-threatening reaction from taking Lexapro alone or with a serotonergic drug (drugs or supplements that increase serotonin levels).

Serotonin syndrome occurs when serotonin levels in the body are too high and can be fatal if untreated.

Serotonin syndrome can range in severity from mild symptoms to extremely serious.

Mild symptoms of serotonin syndrome include shivering, excessive sweating, elevated blood pressure, tachycardia (a heart rate over 100 beats per minute) and overly responsive reflexes.

Moderate symptoms of serotonin syndrome can involve agitation, hyperthermia (higher than normal body temperature), abnormal eye movements and hyperactive bowel sounds.

Severe serotonin syndrome involves a significantly elevated temperature (101.3°F or higher), confusion, rapid heart rate and dramatic changes in blood pressure, heart rate, muscle rigidity and mental state. Very severe symptoms of serotonin syndrome can potentially cause seizures, coma and death.

Medications that can increase serotonin levels or interact negatively with Lexapro and put you at risk of serotonin syndrome include triptans, fentanyl, lithium, tramadol, buspirone, amphetamines, herbal supplements like St. John's Wort and other types of antidepressants like monoamine oxidase inhibitors (MAOIs).

Additionally, another SSRI citalopram (Celexa®) shouldn’t be taken with Lexapro.

What Is a Typical Dosage of Lexapro?

You may be wondering what the best dosage of Lexapro for anxiety is. Or maybe you’re wondering when the best time to take Lexapro for anxiety is.

The amount of Lexapro you may take as a treatment for panic attacks, anxiety or even depressive symptoms can vary on different factors.

Similar to other antidepressants, Lexapro is available as a brand-name medication or as the generic form of escitalopram.

The usual initial prescribed dose for Lexapro is 10mg a day for treating either generalized anxiety disorder or major depression. The maximum dose for treating major depression is 20mg a day, although no additional benefits have been reported from this dosage.

Your healthcare provider may adjust your dosage of escitalopram over time based on how you respond to the medication.

Lexapro is available as a tablet or liquid solution that is typically taken once a day.

The oral tablet comes in 5mg, 10mg or 20mg strengths and the liquid solution is prescribed in 1mg per mL dosage.

The best dose of Lexapro for you is determined by your healthcare provider based on different factors, such as age, body weight, symptoms and if you’re currently taking any other medications.

The best time to take Lexapro for anxiety depends on when you can remember to take it. Lexapro can be taken in the morning or evening but it should be taken around the same time each day simply so that you remember to take it.

Be sure to read your prescription label carefully but if you’re unsure about your prescription in any way, don’t hesitate to ask your healthcare provider any questions you may have.

It’s important not to take more or less of your dosage of Lexapro or to suddenly stop taking your medication without talking to your healthcare provider.

Benefits of Lexapro for Anxiety

Taking Lexapro for anxiety can have many benefits for your mental health.

Lexapro and other SSRIs can help improve your mood and quality of life by increasing levels of serotonin (the “feel good” chemical), leading you to feel happier, more focused and more emotionally stable and thereby decreasing the severity of symptoms of depression or anxiety.

Typically a first choice drug for treating anxiety disorders as well as the symptoms of depression, SSRIs are generally well tolerated and efficient.

In a 10-week study comparing escitalopram to citalopram for the treatment of panic disorder, those on a 10mg to 20mg daily dose of escitalopram showed greater improvement and fewer panic attacks after four weeks. Those on citalopram didn’t show improvements until eight weeks in.

A daily 10mg to 20mg dose of Lexapro for generalized anxiety disorder was also shown to be well-tolerated with few adverse effects and effective in reducing symptoms of anxiety in an 8-week double-blind study comparing the antidepressant medication to a placebo.

Another study suggested escitalopram may also be as effective in treating social anxiety disorder as another SSRI, paroxetine (Paxil®).

After 24 weeks of treatment with escitalopram, paroxetine or a placebo for patients with social phobia, 10mg to 20mg a day of escitalopram was more effective than placebo and as effective as paroxetine in improving social anxiety.

Lexapro can start improving physical symptoms like energy, appetite and sleep in the first week or two — a sign that the medication is working.

However, you may not see improvements in a depressed mood or feel interested in your typical activities until six to eight weeks of treatment.

Taking Lexapro for Anxiety: Final Words

If you struggle with generalized anxiety disorder, panic attacks or a depressive disorder like major depression, Lexapro could offer relief from your symptoms of depression or anxiety.

Lexapro is a common antidepressant often used as a first-line treatment for symptoms of depression or anxiety and may be used “off-label” for panic disorder, social anxiety disorder and other anxiety disorders.

Anxiety disorders are extremely common, with an estimate that 31.1 percent of U.S. adults will experience an anxiety disorder at some point in life.

If you’re interested in learning more about Lexapro and whether it can be the right antidepressant for you, our online mental health services can connect you with a licensed psychiatry provider. 

You can also learn proven strategies for coping with and moving past anxiety in our guide on how to calm your anxiety.

You can discuss your symptoms of anxiety with a healthcare provider online and find out whether depression and anxiety medications are right for your treatment.