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Lexapro For Depression: Side Effects, Dosage, and More

Kristin Hall

Medically reviewed by Kristin Hall, FNP

Written by Our Editorial Team

Last updated 9/29/2022

In the world of antidepressant medications, Lexapro® is one of the more popular options on the market today. If you’re currently using Lexapro for depression or are considering having a conversation with your healthcare provider about it, it’s perfectly reasonable to have questions.

How rough are Lexapro side effects and how likely are you to experience them? What kind of dosage recommendations can you expect from your healthcare provider? Are there any serious risks associated with taking this medication?

As usual, that’s where we come in. Read on to learn more about this prescription medication to see if it could be a good fit for you. 

The Basics of Lexapro

Lexapro (and the generic version, escitalopram) is an antidepressant in a class of medications called selective serotonin reuptake inhibitors (SSRIs). 

SSRIs are believed to work by boosting levels of serotonin (a neurotransmitter that may have an impact on your mood) in your brain. With more serotonin available in your brain, you may be less likely to experience some of the tougher symptoms of depression. 

Research supports the use of escitalopram as an effective way to treat major depressive disorder, that it can help treat depression and tends to have mild adverse effects. 

In addition to depression, Lexapro is sometimes used to treat generalized anxiety disorder (GAD). 

It is also sometimes used “off-label” to treat obsessive-compulsive disorder, eating disorders like binge eating disorder and bulimia nervosa, panic disorder or panic attacks, posttraumatic stress disorder and premenstrual dysphoric disorder

To learn more, read our blog on Lexapro for PMDD.

This means that while it’s not approved by the U.S. Food and Drug Administration (FDA) for these conditions, it may still help. 

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Lexapro Dosages For Depression

If you think Lexapro could be a good solution for you, you’ll need to speak with a healthcare provider. They will be able to assess your depression symptoms and tell you if this medication could be a good fit. 

If it’s determined that it could help you, you’ll likely be started on a low dose of escitalopram. Often, patients are started on a lower dose that is then increased at a gradual rate in order to help limit side effects. 

Lexapro for depression is available in 5mg, 10mg and 20mg tablets, and in a 1mg oral solution.

For adults with depression, the starting dose of Lexapro is usually 10mg once daily. From there, you may gradually work up to a 20mg maximum dose of Lexapro for depression. 

That said, most often, there are no additional benefits seen at 20mg a day. If a healthcare provider is going to increase your dosage, it is usually recommended that you have taken the 10mg dosage for at least a week before the increase. 

Escitalopram can take up to four weeks before you notice a change in your depression symptoms. 

Does Lexapro Work For Depression?

Lexapro can be an effective treatment for depression. In fact, it is considered to be as effective and have less side effects than older types of antidepressants like monoamine oxidase inhibitors (MAOIs). 

In three different clinical trials that each spanned eight weeks, the effectiveness of Lexapro was put to the test against a placebo. The studies involved people between the ages of 18 to 65 who all had major depressive disorder. The end result was that Lexapro helped alleviate symptoms of depression.

In a study done in 2006 escitalopram taken for major depression was compared with other medications (like citalopram and fluoxetine). 

The result? Escitalopram was found to work best. 

Who Lexapro May Not Be Good For

But just because Lexapro can treat depression doesn’t mean that everyone can take it. In fact, there are some people who probably shouldn’t. 

Generally, Lexapro is thought to not be safe for: 

  • Those who are allergic to escitalopram oxalate

  • Children under the age of 12

  • People who are pregnant or breastfeeding

Lexapro may also not be safe for older adults — think over the age of 75, respectively. This is because side effects of the medication could be more pronounced. For example, it could cause blood sodium levels to drop to dangerous levels. 

Side Effects of Lexapro for Depression

Like with any medication, there are some possible side effects associated with escitalopram

They are generally mild and go away after a while. These side effects may include:

  • Nausea 

  • Changes in sex drive 

  • Decreased appetite

  • Weight loss 

  • Dizziness 

  • Shaking

  • Yawning

  • Dry mouth

  • Joint pain

  • Tiredness

  • Muscle stiffness

  • Heartburn

  • Stomach pain

Side effects tend to be worse during the first week of taking Lexapro. At this point, you may notice increased sweating, headaches, nausea, sleep issues and nervousness. 

These things usually start to subside after a few weeks. If they don’t, contact your healthcare provider for advice. They may adjust your dosage or even change your medication.

Rarely, a person taking a dose of escitalopram experiences more severe side effects like high blood pressure, chest pain, elevated heart rate, low sodium levels and suicidal ideation. 

There may also be a small risk of serotonin syndrome. 

If you experience severe adverse reactions, reach out to your healthcare provider as soon as possible.

It’s also important to disclose any other medications you’re taking before you start taking this antidepressant. You should also make it clear if you have any other medical conditions or have had any allergic reactions in the past. 

Mental health professionals need to know this information so that they can be on the lookout for possible adverse reactions between medications. 

Black Box Warning 

Lexapro does come with a Black Box warning from the FDA. This is the strictest warning a prescription drug can be given. 

The FDA issues this warning so that people who take it understand the most severe risks associated with a medication — even if those risks are rare.

So, why does Lexapro have this warning? It’s because it can increase the risk of suicidal thoughts and behaviors — especially true for young people. 

If you have thoughts of suicide or self-harm, contact a medical professional immediately. You can dial 988 from any phone to reach someone 24-7 at the Suicide and Crisis Lifeline

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Taking Lexapro for Depression

Lexapro is an antidepressant commonly used to treat mental health conditions like major depressive disorder and generalized anxiety disorder.

It works to treat depression by increasing serotonin levels, which can balance your mood.

People like it because it tends to not have too many adverse effects. Often, to ensure you don’t experience many side effects, you will be started on a lower dosage and then your dose of escitalopram may be increased at a gradual rate. These dosage adjustments are very normal. 

In very rare instances, people experience severe adverse effects. If this happens to you, seek out medical attention as soon as you can. 

If you would like to speak to a mental health professional about psychiatric disorders and whether Lexapro could be a good option for you, Hers offers online consultations that make it easy. 

9 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. Depression. National Institute of Mental Health. Retrieved from https://www.nimh.nih.gov/health/topics/depression
  2. Escitalopram. Medline Plus. Retrieved from https://medlineplus.gov/druginfo/meds/a603005.html
  3. Kirino, E., (2012). Escitalopram for the management of major depressive disorder: a review of its efficacy, safety, and patient acceptability. Patient Prefer Adherence. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3526882/
  4. Escitalopram (Lexapro). National Alliance on Mental Illness. Retrieved from https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Escitalopram-(Lexapro)
  5. Lexapro (escitalopram oxalate). FDA Highlights of Prescribing Information. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021323s047lbl.pdf
  6. Kennedy, S., Andersen,H., Lam, R., (2006). Efficacy of escitalopram in the treatment of major depressive disorder compared with conventional selective serotonin reuptake inhibitors and venlafaxine XR: a meta-analysis. Journal of Psychiatry Neuroscience. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1413963/
  7. Kacperczyk, J., Perdyan, A., Stompor, M., (2021). Drug-Resistant Hyponatremia after Escitalopram Intake: A Series of Two Case Reports. Annals of Geriatric Medicine and Research. Retrieved from https://www.e-agmr.org/journal/view.php?doi=10.4235/agmr.21.0062
  8. 988 Suicide and Crisis Lifeline. Retrieved from https://988lifeline.org/
  9. Landy K, Rosani A, Estevez R. Escitalopram. Updated 2022 Jan 19. In: StatPearls Internet. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557734/

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.

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