Content
Free Mental Health Assessment
Reviewed by Daniel Z. Lieberman, MD
Written by Geoffrey Whittaker
Published 07/15/2022
Updated 01/27/2025
Dosage adjustments are common with antidepressants like Lexapro®, whether you’re starting treatment or modifying your dose after years of use.
Increasing antidepressant dosages might make you more likely to experience side effects. But everyone reacts differently to Lexpro dosage increases.
Below, we separate fact from fiction about what happens when increasing Lexapro dosage.
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Lexapro is the brand name for a medication called escitalopram, an antidepressant in the selective serotonin reuptake inhibitor (SSRI) family.
SSRIs can help people with mood and psychiatric disorders, like generalized anxiety disorder or depression.
These medications have approval from the Food and Drug Administration (FDA) to treat depression and anxiety. Unlike the herbal supplements, illegal drugs, and over-the-counter (OTC) medications, they’ve been shown to be safe and effective.
Doctors also sometimes prescribe them off-label for mental health conditions like obsessive-compulsive disorder (OCD).
SSRIs help regulate the neurotransmitter serotonin.
Your healthcare provider might raise or lower your dosage of Lexapro (or its generic version, escitalopram) to make sure you’re getting the most out of the medication to support your mental health.
If you’re not taking enough Lexapro and your depression symptoms either don’t improve or get worse, your provider may increase your dosage.
Everyone is different when it comes to optimal mental health treatment, brain chemistry, and tolerance to the effects of prescription drugs like Lexapro or other SSRIs.
Escitalopram is a mental health medication that helps your brain access serotonin, by stopping brain cells that produce serotonin from reabsorbing it too quickly.
SSRIs like Lexapro typically have a lower risk of side effects than older antidepressants like monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs).
If you’re experiencing side effects like dizziness, nausea, fatigue, or trouble sleeping, your provider may reduce your dosage.
And if you have a pre-existing medical condition like kidney, heart, or liver disease, your provider may modify your dosage to prevent adverse effects.
You shouldn’t take Lexapro with other SSRIs, SNRIs, or tryptophan. And you should let your healthcare provider know if you’re using NSAIDs, aspirin, or similar medications.
Lexapro is typically effective at doses between 10 mg and 20 mg daily.
If you're on the lower end of that spectrum and still dealing with symptoms of major depressive disorder or other mood disorder, a dosage adjustment might help.
However, higher doses can also lead to stronger escitalopram side effects.
Common side effects of Lexapro include:
Nausea
Sweating
Fatigue
Dizziness
Lethargy
Dry mouth
Side effects can happen after increasing Lexapro dosage, but they’re usually temporary and nothing to stress over. That said, if they worsen or stick around for longer than a couple of weeks, it’s a good idea to check in with your healthcare provider.
Keep an eye out for serious side effects like:
Sudden weight gain or loss
Headaches
Confusion
Suicidal thoughts
Menstrual cycle changes
Allergic reactions
Fever
The maximum safe dose of Lexapro is around 20 mg per day.
Overdosing can cause serious effects, though, like:
Heart issues
Serotonin syndrome, a potentially fatal condition
Seizures
Loss of consciousness
Coma
If you think you or another person has overdosed on Lexapro or another SSRI, call your local poison control center or seek medical attention right away.
Wondering if your current Lexapro dosage is working to treat your mental health condition?
The reality is that few people find the perfect medication or dose on the first try. And it can take weeks or even months to notice effects — even when a medication is right for you.
Your healthcare provider can help give you an idea of what to expect when taking an antidepressant medication like Lexapro, including side effects.
If you’ve been taking Lexapro for a while and don’t think it’s helping or experience serious side effects, get in touch with your healthcare provider.
They can provide guidance on dosage adjustments – or might recommend trying a new medication.
If you’re not seeing results with Lexapro, consult a mental health professional or health care provider for medical advice.
They might recommend adjusting your dose or switching medications.
Let’s recap what we know about increasing Lexapro dosage:
It’s important to communicate with your healthcare provider. The only way to know whether you need to increase your Lexapro dosage, or if it’s even the right medication for you, is to let your provider know about any side effects and concerns.
Other medications are available. While Lexapro works for many people, it may not be the best choice for you, especially if you need a very high dose and don’t see noticeable improvements after a few months. Your provider can help you evaluate other options.
Consider other mental health tools. Medication can be helpful, but counseling or online psychiatry can also be useful for managing mental health conditions.
Your mental health matters, and there’s no one-size-fits-all solution.
Looking for more guidance? We can set you up with a free mental health consultation, a personalized treatment plan, and ongoing support that fits your needs. Get started today!
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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.
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
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
2022: Distinguished Life Fellow, American Psychiatric Association
2008–2020: Washingtonian Top Doctor award
2005: Caron Foundation Research Award
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Lieberman, D. Z., Swayze, S., & Goodwin, F. K. (2011). An automated Internet application to help patients with bipolar disorder track social rhythm stabilization. Psychiatric services (Washington, D.C.), 62(11), 1267–1269. https://ps.psychiatryonline.org/doi/10.1176/ps.62.11.pss6211_1267?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
Lieberman, D. Z., Massey, S. H., & Goodwin, F. K. (2010). The role of gender in single vs married individuals with bipolar disorder. Comprehensive psychiatry, 51(4), 380–385. https://www.sciencedirect.com/science/article/abs/pii/S0010440X0900128X?via%3Dihub
Lieberman, D. Z., Kolodner, G., Massey, S. H., & Williams, K. P. (2009). Antidepressant-induced mania with concomitant mood stabilizer in patients with comorbid substance abuse and bipolar disorder. Journal of addictive diseases, 28(4), 348–355. https://pubmed.ncbi.nlm.nih.gov/20155604
Lieberman, D. Z., Montgomery, S. A., Tourian, K. A., Brisard, C., Rosas, G., Padmanabhan, K., Germain, J. M., & Pitrosky, B. (2008). A pooled analysis of two placebo-controlled trials of desvenlafaxine in major depressive disorder. International clinical psychopharmacology, 23(4), 188–197. https://journals.lww.com/intclinpsychopharm/abstract/2008/07000/a_pooled_analysis_of_two_placebo_controlled_trials.2.aspx