If you have any medical questions or concerns, please contact your doctor. Articles in the Health Guide are based on peer-reviewed research and information from medical societies and government agencies. However, they are not a substitute for professional medical advice, diagnosis or treatment.
Lexapro side effects
Postponing a day when you are depressed is already a lot to achieve. Depression doesn’t just affect the mind; it also affects the body. Depression and chronic pain are closely linked (Lee, 2018). So it’s only natural if you want to know if your antidepressant is causing side effects, what they are, and how likely you are to experience them when you’re already dealing with depression.
Lexapro is the brand name for the drug escitalopram. It is FDA approved for the treatment of major depressive disorder (MDD) and generalized anxiety disorder (GAD).
Generic Lexapro has the same active ingredient as its branded version.
Common Lexapro side effects include fatigue, nausea, sleep problems, and sexual dysfunction.
Lexapro may cause more serious side effects such as serotonin syndrome and worsening depression in children and adolescents.
What is Lexapro?
Lexapro is a prescription drug from a group of drugs called selective serotonin reuptake inhibitors, or SSRIs. SSRIs are used to treat depression, anxiety, and other mood disorders. Researchers believe that depression is caused by an imbalance of chemicals in our brain, and globally by SSRIs. are considered first line treatment (Bauer, 2009).
Lexapro is specifically approved for the treatment of major depressive disorder (MDD) and generalized anxiety disorder (GAD), but it may be used off-label by healthcare professionals to treat obsessive-compulsive disorder (OCD) (Zutshi, 2007).
Lexapro is the brand name for escitalopram oxalate. Although escitalopram can be confused with alprazolam, a common anxiety medication sold under the brand name Xanax, these medications are not the same. Previously, Lexapro could only be manufactured by Forest Laboratories Inc. (in partnership with pharmaceutical company Lundbeck).
Lundbeck made Lexapro available as a tablet or oral solution. Tablets come in three dosages: 5 mg, 10 mg and 20 mg. The oral solution is only available in one strength equivalent to 5 mg (FDA, nd). Lexapro was launched in 2002, but its patent expired in March 2012 , which meant that other companies could seek approval from the U.S. Food and Drug Administration (FDA) to manufacture and market escitalopram (Llamas, 2013).
What are SSRIs and how do they work?
Depression can be treated in many ways, and there are several types of antidepressants. Medications used to treat this mood disorder include (FDA, 2009):
- Selective serotonin reuptake inhibitors (SSRIs)
- Monoaminoxidase Inhibitors (IMAO)
- Tricyclic antidepressants
- Atypical antidepressants
- Selective serotonin and norepinephrine reuptake inhibitors (SNRIs)
There are also many different types of SSRIs, including:
- Citalopram (brand name of Celex)
- Escitalopram (brand name Lexapro)
- Fluoxetine (brand names Prozac, Sarafem, Symbiax)
- Fluvoxamine (brand name Luvox, Luvox CR)
- Paroxetine (trade name Paxil, Paxil CR, Pekseva)
- Sertraline (brand name Zoloft)
- Vilazodone (brand name Viibryd)
In the brain, chemical messengers called neurotransmitters carry messages from brain cell to brain cell. Serotonin is one type of neurotransmitter. SSRIs work by keeping serotonin levels high between brain cells. SSRIs are thought to treat certain mental illnesses in this way.
Possible side effects of Lexapro first week
Here are the most common potential Lexapro side effects and how often they occurred in participants with MDD in clinical trials testing the drug’s efficacy and safety:
- Nausea (15%)
- Sleep problems (9%)
- Ejaculation disorder (9%)
- Diarrhea (8%)
- Drowsiness (6%)
- Dry mouth (6%)
- Increased sweating (5%)
- Vertigo (5%)
- Flu-like symptoms (5%)
- Fatigue/Fatigue (5%)
- Loss of appetite (3%)
- Low sex drive (3%)
These common Lexapro side effects also appear to be dose-dependent, meaning that you are more likely to experience these side effects if you take 20mg than 10mg. Other potential side effects of Lexapro were noted, although they were not observed in more than 2% of the participants in these studies. These symptoms included weight gain, blurred vision, muscle stiffness, and joint pain (FDA, 2017).
In clinical trials, 8% of participants who received Lexapro for GAD and 6% of participants who received prescription drugs for MDD discontinued the drug due to side effects. MDD treatment studies have shown that more people stopped using Lexapro when they were given 20mg rather than 10mg daily.
If you are experiencing side effects from Lexapro, it is important to talk to your doctor before stopping your medication. If you stop taking Lexapro suddenly, you may experience withdrawal symptoms such as nightmares, irritability, headache, nausea, dizziness, or vomiting (NAMI, 2016).
Side effects of Lexapro in men and women
Unfortunately, sexual dysfunction is a common side effect of SSRI treatment. In fact, studies have shown that this specific side effect occurs in 20–70% of patients taking these medications and is a common reason patients want to stop treatment (Osis, 2010). These sexual side effects include:
- erectile dysfunction
- Ejaculation disorder (delayed ejaculation)
- Decreased sex drive
Although researchers have noted this effect with many SSRIs, paroxetine causes the highest rate of sexual dysfunction. Patients taking SSRIs who experience changes in their sex drive or sexual satisfaction should discuss these changes with their health care providers. In some cases, bupropion, mirtazapine, vilazodone, vortioxetine, or SNRIs may be good alternative treatments (Jing, 2016).
Lexapro drug interactions
You should not take Lexapro with certain medicines, including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, amphetamines, and St. John’s wort. You should also avoid prescription drugs that affect the breakdown of serotonin in the body, especially MAOIs such as rasagiline and tranylcypromine. Combining these drugs increases the risk of a serious condition called serotonin syndrome. This syndrome occurs when there is too much active serotonin in your body. It can cause mild symptoms such as tremors and diarrhea, but can also be life-threatening (Volpi-Abadie, 2013).
You should also be careful when taking Lexapro with any blood-thinning medication, from real prescription blood thinners like warfarin to over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen and naproxen. Lexapro may increase your risk of bleeding if you take these medicines.
It may take some time to experience the full effects of Lexapro and understand the extent to which you are experiencing side effects. Lexapro may cause drowsiness and may affect your ability to make decisions or react to events. For this reason, it is recommended that you do not drive or operate heavy machinery until you understand how this antidepressant is affecting you.
For the same reason, standard medical advice is to avoid drinking alcohol while taking Lexapro. Alcohol similarly affects your ability to make decisions and react to events. Clinical trials have not shown that Lexapro aggravates these effects of alcohol, but it is possible that the combination could be dangerous in certain situations.
Patients and their families should be monitored for any behavioral changes, including worsening depression, panic attacks, and suicidal ideation, when starting Lexapro or after a dose change. Children, teenagers and young adults are at increased risk for these side effects. In fact, the FDA has required all manufacturers of antidepressants to update their SSRI drug package information to include these risks found in short-term studies (FDA, 2018).
When to Seek Medical Care
There are serious potential side effects of antidepressants such as Lexapro. You should seek immediate medical attention if you experience increased depression, anxiety, or suicidal thoughts. Contact someone if you notice unusual changes in mood or behavior. You should also call your doctor right away if you experience (FDA, 2017):
- Any symptoms of serotonin syndrome, including coordination problems, hallucinations, heart palpitations, sweating, nausea, vomiting, muscle stiffness, or high or low blood pressure.
- Any symptoms of an allergic reaction, including swelling of the face, lips, or tongue, difficulty breathing, rash, or hives.
- abnormal bleeding
- Manic episodes, which may include racing thoughts, increased energy, reckless behavior, and talking more or faster than usual.
- Changes in appetite or weight, especially in children and adolescents.
- Vision problems, including eye pain, swelling or redness around the eyes.