Medically reviewed by Katelyn Hagerty, FNP
Written by Our Editorial Team
Last updated 7/26/2022
In the few short decades that Lexapro has been around, it has helped many people deal with mood disorders and make positive changes to their daily lives. Lexapro is an incredible antidepressant with a lot of benefits to offer. Unfortunately these benefits do sometimes come with the risk of side effects. As anyone who has woken up soaked in their bed knows, one of the common adverse effects of Lexapro is night sweats.
Is it the spicy foods, or the spicy mental health issues? Is it weight gain or menopausal symptoms? Could it be all of the above?
Look, we get it: a sweaty, rough and tumble night in bed may be everyone’s idea of a good time in theory, but there are parameters — ideally, there should be a partner (at least one), and it should be a pleasant experience. If you’re all by yourself and waking up in a sweat in the middle of the night, we’re probably talking about two different experiences.
Back to the point: night sweats suck. Whether it’s 2 AM your time and you and your damp pillow case are Googling away to see what’s wrong, or you’ve been down a side effect rabbit hole for the last couple of hours, this whole night sweats and Lexapro question is a fair one.
Lexapro and night sweats do have a steamy history together, and we’re happy to unpack the whole sticky mess of it.
Let’s start at the beginning.
Lexapro, which is also known in its generic form as escitalopram, is a selective serotonin reuptake inhibitor or SSRI — an antidepressant drug which helps your brain better regulate your mood if you have a mental health condition like depression or anxiety. It does this by helping your brain keep an extra supply of serotonin (the neurotransmitter that helps in mood regulation) on hand.
Normally, your brain reabsorbs excess serotonin that isn't used, meaning that people with mood disorders may have insufficient supply of serotonin to prevent mood fluctuations. SSRIs give you higher serotonin levels, which help your brain balance everything out better.
As with essentially all medications, SSRIs have side effects. In Lexapro’s case, common side effectsinclude diarrhea, nausea, constipation, dizziness, heartburn, weight loss, flu-like symptoms, drowsiness, sexual issues and, you guessed it, sweating.
It’s unclear exactly why this happens. There are reports that Lexapro may affect something called a muscarinic receptor, but studies have found their explorations of the root cause inconclusive. They also acknowledge that it’s entirely possible night sweats could be the result of the mood disorders themselves.
Escitalopram may indeed cause night sweats, but how and why and to what extent it is precisely responsible for night sweats is medically unclear at this point.
If you’re experiencing night sweats with Lexapro, it may be worrisome, but those night sweats have to be considered in context to determine if they’re actually dangerous. For instance, experts don’t generally recommend a panicked call to the doctor the first time you wake up a bit overheated in the middle of the night. You may experience some common side effects of SSRIs when the antidepressant drug first begins to take effect, but these often diminish over time as your brain and body adjust.
Instead, experts urge you to report “severe” versions of the symptom, especially if it doesn’t go away over time.
It can be hard to tell the difference sometimes. Severe may look different to everyone, so if you’re not sure, it’s always better safe than sorry when it comes to side effects from new medications.
But if night sweats overlap with any more serious side effects, it’s a clear sign that you should speak to a doctor immediately. These serious side effects include:
Abnormal bleeding or bruising
Swollen tongue, throat or lips
Cognitive problems and trouble thinking
If you wake up drenched in sweat and experiencing any of these problems, call your doctor immediately. They may take you off the medication, but they will do so in a safe and controlled manner to protect you from withdrawal symptoms.
Arguably, selective serotonin reuptake inhibitors (SSRIs) are the most reliable medication — with the fewest side effects — available today for people suffering from mood disorders. Antidepressants generally can be prescribed to treat a variety of conditions, from depressive disorders to generalized anxiety disorder to panic disorder to obsessive compulsive disorder.
There are several types of medications in this category, and each type of antidepressant medication comes with its own benefits and drawbacks.
If you and Lexapro aren’t getting along, you may be prescribed another SSRI, but you might also be prescribed a serotonin and norepinephrine reuptake inhibitor (SNRI) to manage two neurotransmitters instead of one. Another type of antidepressant is monoamine oxidase inhibitors, or MAOIs, which were the first antidepressant, but unfortunately had some of the worst side effects. Still, these medications can be useful for people who aren’t tolerating SSRIs well, as can TCAs or tricyclic antidepressants. These work similarly to SNRIs, but have side effects like sedation to consider.
This is just a brief overview — you can read more comprehensive information about the types of antidepressants on our blog.
If you’re getting sweaty in bed unintentionally, that’s probably something you’ll want to control, which makes total sense to us. How you do it will depend on a few things, including finding out the root cause of the sweats in question.
If that root cause is Lexapro, you may want to ask your healthcare provider about switching medications. You may also want to ask about other ways to treat depression and other mood disorders, so that the medication you do end up with has the best chances of success.
Therapy practices like cognitive behavioral therapy (CBT) can also help people with anxiety, depression and other mood disorders to learn to lessen the effects of these conditions.
It’s an effective system for learning to identify depressive and intrusive thoughts, put that negativity in a box and slowly but surely eliminate its effect on you, regaining control of your life in the process. Therapy takes time, but with practice, CBT can help bring real change.
Another thing that can bring change, frankly, is getting your physical health under control. Eating poorly, not getting enough exercise or letting weight gain go unmanaged can contribute to night sweats, sure, but they’re also harmful to your mental health.
So are not getting enough sleep, smoking, drinking in excess and illicit drugs.Studies actually show that exercise can be just as effective as medication for your mental health — it’s certainly worth considering.
Above all, if you’re not getting the quality of life you want and you’re still searching for an effective treatment for depression or anxiety, talk to a healthcare provider for more support. A depressive disorder may always be with you, but with the support of medication and online therapy, it doesn’t have to be in charge of you.