Lexapro For Anxiety: Side Effects, Dosage, and Benefits

Lexapro^®, the brand name for the drug escitalopram, is a type of antidepressant that’s used to treat a wide range of mental health conditions, including anxiety. Whether you’ve been recommended Lexapro for anxiety by a doctor or are just starting to look into your treatment options, you’ve probably got a lot of questions. 

We’re here to answer them. Read on to discover everything you need to know, from common Lexapro uses to the average dose of Lexapro for adults. 

Lexapro is a type of antidepressant. Similar to other antidepressants, it’s available as a brand-name medication (Lexapro) or as the generic form, escitalopram.

As for Lexapro uses, it is approved by the U.S. Food and Drug Administration (FDA) to treat:

• Generalized anxiety disorder (GAD) 

• Major depressive disorder (MDD) 

It’s also prescribed off-label — when a drug is prescribed for something for which it isn’t FDA-approved — for conditions like:

• Social anxiety disorder (also known as social phobia)

• Panic disorder

• Obsessive-compulsive disorder (OCD)

• Post-traumatic stress disorder (PTSD) 

• Premenstrual dysphoric disorder (PMDD) 

• Vasomotor symptoms during menopause like hot flashes

You’ve heard it can help you manage anxiety, but what does Lexapro do exactly? 

Lexapro belongs to a class of antidepressant drugs called selective serotonin reuptake inhibitors (SSRIs). These antidepressant medications work by allowing serotonin to remain active for longer periods of time before it’s reabsorbed by the brain cell that produced it, which in turn leads to higher levels of activity of this natural chemical that’s found in your brain and body.

Serotonin is nicknamed the body’s “feel good” chemical as it helps regulate your mood and happiness — as well as certain aspects of your physical health. 

Normal serotonin levels can make you feel emotionally stable, happier, and more focused. Low serotonin levels, on the other hand, are associated with mental illnesses like anxiety or depression.

So, Lexapro can reduce anxiety by getting your serotonin levels back in check. 

Lexapro can start improving your energy, appetite, and sleep in the first week or two of taking it.

That said, it might take longer than that before Lexapro fully kicks in. As such, you may have to wait four weeks — or longer — to experience the medication’s full effects.

That said, if you don’t notice any change in your symptoms or especially if you think they are worsening, be sure to talk to your healthcare provider.

Just like any medication, Lexapro has side effects. Some are common yet mild, while others are rare but serious.

Common side effects of escitalopram include:

• Dry mouth

• Increased sweating

• Insomnia

• Drowsiness

• Fatigue or lack of energy

• Dizziness

• Nausea

• Vomiting

• Diarrhea

• Constipation

• Headache

• Abdominal pain

• Reduced appetite

• Weight loss

• Sexual dysfunction, such as a reduced sex drive

Sounds bleak, but there is some good news: The initial side effects of Lexapro tend to be mild and temporary. In fact, they may get better in just a few weeks as your body adjusts to the drug.

Beyond these common side effects, however, there are also more serious side effects you should be aware of. While rare, adverse effects of Lexapro can include: 

• Low sodium blood levels

• Symptoms of angle-closure glaucoma, such as eye pain or changes in vision

• Serotonin syndrome, a potentially life-threatening medical condition that happens when your serotonin levels become too high

Additionally, Lexapro comes with a black box warning stating that antidepressants can increase the risk of suicidal thoughts and behavior in children and young adults. If you’re caring for a young person who is taking Lexapro, be sure to look out for any changes in their mood or behavior. 

There’s also the possibility of an allergic reaction to Lexapro, in which case you should get medical attention immediately.

There are quite a few drug interactions to be aware of if you’re taking Lexapro. 

Medications that can increase serotonin levels, or interact negatively with Lexapro and put you at risk of developing serotonin syndrome, include: 

• Triptans

• Fentanyl

• Lithium

• Tramadol

• Buspirone

• Amphetamines

• Herbal supplements like St. John's Wort

• Antidepressants, like monoamine oxidase inhibitors (MAOIs) and other SSRIs

You also can’t take Lexapro and pimozide, a drug for Tourette's syndrome, together.

Also note that there is an increased risk of bleeding if you take Lexapro with: 

• Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen (Advil, Motrin IB), and naproxen (Aleve)

• Antiplatelet drugs

• Warfarin or blood thinners 

Lexapro is a category C pregnancy medication, meaning that it could pose risks to your baby, but there’s not enough evidence to know for sure. If you’re breastfeeding, Lexapro also may also transfer into your breastmilk.

Depending on your situation, the benefits of Lexapro may outweigh the risks. Our guide to Lexapro and pregnancy dives into more details, though it’s a conversation you should have with your healthcare provider to determine what’s appropriate for you. 

Your healthcare provider can help you weigh up the pros and cons of breastfeeding while taking Lexapro and offer personalized medical advice on what’s safe for you and your baby.

Before taking Lexapro, let your healthcare provider know about any health conditions you have and any medications and supplements that you take currently or have recently stopped taking. 

In particular, you should let them know if you have: 

• Recently had a heart attack 

• Bleeding problems

• Low sodium levels in your blood

• Liver, kidney, or heart disease

• Glaucoma

• Seizures

• Currently drink or used to drink large amounts of alcohol 

• Take or have taken recreational drugs

Lexapro is available as a tablet or liquid solution. The oral tablet comes in 5 milligrams (mg), 10 mg, or 20 mg strengths and the liquid solution is prescribed in a 1 mg per mL dosage.

Usually, the initially prescribed dosage of Lexapro for either generalized anxiety disorder or major depressive disorder is 10 mg a day. The maximum dosage for treating anxiety or depression is 20 mg a day, although no additional benefits have been reported from this dosage in clinical trials involving large groups of people. It’s possible that some individuals, though, may benefit from the higher dose.

There isn’t one average dose of Lexapro for adults. The amount of Lexapro you take for anxiety can vary depending on different factors such as your: 

• Age

• Body weight

• Symptoms 

• Current medications

For instance, for older folks or those with hepatic impairment (liver failure), the recommended dosage is 10mg of Lexapro a day.

And your dose isn’t set in stone, either. Your healthcare provider may adjust your dosage of escitalopram over time based on how you respond to the medication.

Your healthcare provider can let you know how best to use Lexapro for anxiety. Most likely, you’ll be prescribed a once-a-day dose that you can take any time of day, morning or night, either with or without food. 

The best time to take Lexapro depends on when you can remember to take it. Taking it around the same time each day can help you to not miss a dose. 

Be sure to read your prescription label carefully. If you’re unsure about anything, don’t hesitate to talk to your healthcare provider.

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

If you want to stop taking Lexapro, your healthcare provider may recommend slowly reducing the amount you take to reduce your chances of experiencing withdrawal symptoms.

Should you overdose on Lexapro, seek medical attention straight away.

What Should I Do If I Miss a Dose of Lexapro? 

If you miss a dose of Lexapro, take it as soon as you remember. If it’s almost time for your next dose, however, skip the missed dose and take your next dose as usual. 

Do not double up on Lexapro to make up for a missed dose. 

Reaching out to a healthcare professional about anxiety can be — ironically — anxiety-provoking. But don’t be afraid to get help.

Anxiety disorders are extremely common — it’s estimated that 31.1 percent of U.S. adults will experience an anxiety disorder at some point in their lives. Lexapro could offer relief from your symptoms. 

Here’s the TL;DR on Lexapro for anxiety:

• Lexapro works by increasing your serotonin levels. This can help improve your mood, focus, energy levels, and anxiety. 

• Side effects are usually mild and temporary. Side effects of Lexapro may include nausea, fatigue, trouble sleeping, and decreased libido, but rest assured these side effects should get better with time.

• It can take a few weeks for Lexapro to kick in. Lexapro isn’t a quick fix for anxiety. It can take four weeks, or sometimes even longer, before you feel the full benefit of the medication. 

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

They can walk you through the pros and cons of taking Lexapro for anxiety. If it’s not a good fit for you, no sweat — there are plenty of other anxiety medications out there to help support your mental health.