Lexapro

Medically Reviewed By Alisha D. Sellers, BS Pharmacy, PharmD

Lexapro at a glance

Key highlights to know about Lexapro are:

  • Lexapro (escitalopram) is used to treat patients with depression, including major depressive disorder. It is also prescribed for generalized anxiety disorder.
  • Lexapro is taken by mouth with or without food.
  • Lexapro should not be used with alcohol.
  • Weight gain can occur. However, in placebo-controlled studies, weight gain in patients taking Lexapro was similar to patients not taking Lexapro.
  • Lexapro tablets and oral solution are available as a generic medication, called escitalopram.
  • Escitalopram, the generic version of Lexapro, is typically a moderate-cost drug, defined as costing $30–$100 per month.

Important safety warnings for Lexapro

Users of Lexapro should be aware of these safety warnings:

  • Suicidal thoughts or actions warning: An increase in suicidal thoughts or actions can occur with Lexapro in children, teenagers, and young adults. This is likely to occur within the first few months of treatment or after a change in dose. Tell your healthcare professional right away if you notice new or sudden changes in mood, behavior, actions, thoughts, or feelings. If you, or someone you are with, is considering or planning suicide, call the National Suicide Prevention Lifeline at 800-273-TALK (8255).
  • Serotonin syndrome warning: Lexapro may cause a condition called serotonin syndrome. Serotonin syndrome can be life threatening. Contact your healthcare professional right away if you experience agitation, hallucinations, changes in mental status, muscle twitching or problems with coordination, sweating, fever, nausea, vomiting, diarrhea, or rigid muscles.
  • Discontinuation of treatment with Lexapro warning: Lexapro should not be suddenly stopped. Irritability, agitation, dizziness, anxiety, headache, difficulty sleeping, and confusion can occur when Lexapro is stopped suddenly. Talk with your healthcare professional before stopping Lexapro.
  • Seizures warning: Convulsions can occur with Lexapro. Contact your healthcare professional if you experience these events.
  • Manic episodes warning: Manic episodes can occur with Lexapro. During a manic episode, you may have high energy, difficulty sleeping, racing thoughts, reckless behavior, excessive happiness, and irritability. Contact your healthcare professional right away if you experience any of these symptoms.
  • Hyponatremia warning: Low salt (sodium) levels can occur when taking Lexapro. This is more common in older adults. Tell your healthcare professional if you experience headache, weakness, confusion, or problems with concentrating or memory.
  • Angle closure glaucoma warning: Lexapro may cause an eye condition called angle closure glaucoma in certain people. Before starting Lexapro, your doctor may recommend that you get an eye exam to see whether you are at risk. If you have eye pain, changes in vision, eye swelling, or eye redness, contact your healthcare professional right away.

Talk with your doctor about these warnings in the context of your individual treatment plan and medical history.

What Lexapro treats

This medication is used to treat:

  • adults and adolescents (age 12 to 17 years) with major depressive disorder
  • adults with generalized anxiety disorder

Doctors sometimes prescribe medications for different uses. Ask your doctor or pharmacist for information about other uses of this medication.

How it works

Lexapro is a prescription drug that belongs to a class of medications called selective serotonin reuptake inhibitors (SSRIs). Lexapro works by blocking the uptake of serotonin in the brain. This increases the amount of serotonin in the brain. Serotonin is a chemical that regulates mood.  

It comes as a tablet and a solution that you take by mouth. Lexapro is available as a generic medication called escitalopram.

Side effects of Lexapro

Lexapro side effects are possible and may go away with continued use. Serious side effects are rare.

Common side effects

The more common side effects that occur with Lexapro include:

Serious side effects

Call your doctor right away if you have serious side effects. Seek emergency medical care (call 911) if you experience life threatening symptoms, such as:

  • difficulty breathing
  • chest pain
  • loss of consciousness
  • sudden vision changes
  • swelling of the face, mouth, tongue, or throat

Serious side effects and their symptoms can include:

  • Suicidal thoughts or actions. Symptoms include:
    • new or sudden changes in mood, behavior, thoughts, feelings, or actions
    • new or worsening depression, anxiety, or panic attacks
    • agitation, restlessness, anger, or irritability
    • thoughts about suicide or dying
  • Serotonin syndrome. Symptoms include:
    • agitation, hallucinations, coma, or change in mental status
    • problems with coordination or muscle twitching
    • fast heartbeat and high or low blood pressure
    • sweating or fever
    • nausea, vomiting, or diarrhea
    • rigid muscles
  • Severe allergic reactions. Symptoms include:
    • swelling in your face, mouth, and tongue
    • trouble breathing
    • rash
    • itching
    • hives
    • fever
    • joint pain
  • Manic episodes. Symptoms include:
    • increased energy
    • trouble sleeping
    • racing thoughts
    • reckless behavior
    • talking more or faster than usual
    • excessive happiness or irritability
  • Low salt (sodium) levels in the blood. Symptoms include:
    • headache
    • weakness
    • confusion
    • trouble with concentrating, thinking, or memory
  • Visual problems. Symptoms include:
    • eye pain
    • changes in vision
    • swelling or redness in or around the eye
  • Seizures. Symptoms include:
    • convulsions

Other side effects are possible. Talk to your doctor or pharmacist if you have any side effect that bothers you or that does not go away.

Cost of Lexapro

Without insurance, the generic version of Lexapro is typically a moderate-cost drug (defined as costing $30–$100 per month). You can check the out-of-pocket cash pay price for Lexapro on prescription drug discount websites.

With insurance, prices can vary considerably. Insurance may control whether a brand or generic version is used. Individual health plans may have preferred drugs with better pricing.

If the price of Lexapro on your health plan is too expensive, ask your doctor or pharmacist whether there is an equivalent drug you can substitute. This might be the generic version, escitalopram, or another drug in the same class of medications (SSRIs).

How Lexapro may interact with other medicines

Lexapro may interact with other prescription and over-the-counter (OTC) medications, vitamins, or herbal supplements you are taking. To avoid harmful interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbal supplements you are taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Medications containing escitalopram or citalopram should not be used with Lexapro. This includes Celexa. Certain medications may increase the chances of side effects, and increased monitoring may be necessary. Check with your pharmacist or doctor if you are on any of these medications.

This is not a complete list of drugs that may interact with Lexapro. However, examples of drugs that may interact with Lexapro include:

Monoamine oxidase inhibitors (MAOIs)

Drugs referred to as MAOIs should not be used with Lexapro.

MAOIs are used for multiple reasons, but they are commonly used to treat mood disorders and depression. Use of Lexapro with MAOIs can cause a life threatening side effect called serotonin syndrome.

Contact your doctor right away if you experience fever, muscle spasms, confusion, changes in heart rate and blood pressure, or stiff muscles. Wait 2 weeks after stopping an MAOI to start Lexapro. Talk with your pharmacist or doctor if you are not sure whether you are taking an MAOI. Examples of MAOIs include:

  • linezolid (Zyvox)
  • methylene blue (Provayblue, Urolene Blue)
  • isocarboxazid (Marplan)
  • phenelzine (Nardil)
  • selegiline (Eldepryl, Zelapar)

Orap (pimozide)

Do not take Lexapro with Orap. Taking Lexapro and Orap together can cause a life threatening heart problem.

Blood thinners and drugs that increase bleeding

Taking Lexapro with blood thinners may increase your risk of bleeding or bruising. Other drugs typically used for pain, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and aspirin can also increase risk of bleeding. Tell your healthcare professional if you notice an increase in bleeding. Avoid NSAIDs and aspirin when possible.

Examples of drugs that can increase bleeding include:

  • ibuprofen (Advil, Motrin)
  • naproxen (Aleve, Naprosyn)
  • aspirin (Bayer Plus, Bufferin)
  • warfarin (Coumadin, Jantoven)

Disclaimer: Since drugs interact differently in each person, this information is not guaranteed to include all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare professional about possible interactions with all prescription drugs, vitamins, herbal supplements, and OTC drugs that you are taking.

Other Lexapro alerts

This drug comes with several alerts and warnings:

Liver disease

Liver disease may affect how Lexapro is removed from your body. If you have liver disease, your healthcare professional may prescribe you a lower dose of Lexapro.

Call your doctor right away if you have serious side effects. Seek emergency medical care (call 911) if you experience life threatening symptoms, such as:

Warnings for other groups

For children: This drug has not been studied in children younger than 12 years of age with major depressive disorder or younger than 18 years of age with generalized anxiety disorder. Children may experience a decrease in appetite and weight loss with Lexapro. Growth and weight should be monitored in children and adolescents (< 18 years of age) taking Lexapro.

For pregnant and breastfeeding people

The following sections contain useful information to know if you are pregnant or breastfeeding.

Can I take Lexapro when pregnant?

Reports have not shown that this drug is associated with a risk of major birth defects or miscarriage in pregnant people. However, it is not known with certainty whether this drug will harm your unborn baby.

Use of Lexapro later in pregnancy may cause complications to the newborn called persistent pulmonary hypertension of the newborn (PPHN) and poor neonatal adaptation. This may result in longer hospitalization, respiratory support, and tube feeding for the newborn.

Tell your doctor if you are pregnant or plan to become pregnant and are taking Lexapro. A pregnancy exposure registry exists for people who take this drug during pregnancy in order to collect information about the health of you and your baby. To participate, visit the pregnancy exposure registry website or call 866-961-2388 toll-free.

Can I take Lexapro when breastfeeding?

Lexapro may pass into breast milk. Tell your healthcare professional if you are breastfeeding or plan to breastfeed and are taking Lexapro. Breastfed infants should be monitored for excess tiredness, restlessness, agitation, poor feeding, or poor weight gain.

How and when to take Lexapro

This drug is taken by mouth with or without food, either in the morning or evening.

All possible dosages and forms may not be included here. Your dose will depend on:

  • your age
  • the condition being treated
  • the severity of your condition
  • other medical conditions you have

Drug forms and strengths

  • Form: Tablet
    • Strengths: 5, 10, or 20 milligrams (mg)
  • Form: Oral solution
    • Strengths: 1 mg per milliliter (ml)

Dosage for major depressive disorder

  • Adolescents (age 12–17 years)
    • Initial/Recommended: 10 mg once daily
    • Maximum: 20 mg once daily
  • Adults (age ≥ 18 years)
    • Initial/Recommended: 10 mg once daily
    • Maximum: 20 mg once daily

Dosage for generalized anxiety disorder

  • Adults (age ≥ 18 years)
    • Initial/Recommended: 10 mg once daily
    • Maximum: 20 mg once daily

If you miss a dose of Lexapro

If you miss a dose of Lexapro, take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the next dose at the regular time. Do not take two doses at the same time.

If you take too much Lexapro

If you take too much Lexapro, you have a higher risk of developing overdose symptoms. Common symptoms of overdose include: convulsions, coma, dizziness, low blood pressure, difficulty sleeping, nausea, vomiting, sleepiness, and irregular heartbeat.

There are rare reports of Lexapro overdose leading to death and kidney failure. If you think you or a loved one has taken too much of this drug, call your doctor or local poison control center at 800-222-1222.

Seek emergency medical care (call 911) in case of life threatening symptoms, such as:

  • difficulty breathing
  • chest pain
  • loss of consciousness
  • sudden vision changes
  • swelling of the face, mouth, tongue, or throat

Helpful tips when taking Lexapro

Keep these considerations in mind if your doctor prescribes Lexapro for you.

General

  • Lexapro may be taken with or without food.
  • If you are taking Lexapro, alcohol should be avoided.
  • Weight gain has been reported with Lexapro. In placebo-controlled studies, patients taking Lexapro had a similar weight gain when compared to those not taking Lexapro.

Storage

  • Lexapro should be kept at a temperature between 68–77°F (20–25°C).
  • Lexapro can still be used if temporarily exposed to temperatures between 59–86°F (15–30°C).
  • The Lexapro bottle should be stored with the lid on tightly.

Alcohol

Lexapro did not increase the effects of alcohol when studied. However, alcohol should not be used by people taking Lexapro. The combination is not advised.

Refills

Your doctor will write the number of authorized refills on your prescription. Talk with your pharmacist if you have questions about refills.

Travel

When planning to travel, keep these tips in mind for packing your medication.

  • Bring enough medication for the full number of days of your trip, plus at least 2 days to be safe.
  • Keep your medication with you, in a purse or a carry-on bag if flying. Do not put it into a checked bag in case you are separated from your luggage.
  • Keep your medications in their original containers, if possible, to reduce delays during airport or security screening. Keep all your medications together to expedite the process.
  • Avoid leaving your medication in a parked car for extended periods to protect it from extreme temperatures (hot or cold).

Availability

Many pharmacies stock this drug. When filling your prescription, be sure to call ahead to make sure your pharmacy carries it and has it in stock.

Prior authorization

Many insurance companies do not require a prior authorization for this drug. If a prior authorization is necessary, your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Medications similar to Lexapro

There are a few medications that work like Lexapro. These include:

  • Celexa (citalopram)
  • Prozac (fluoxetine)
  • Luvox CR (fluvoxamine)
  • Paxil (paroxetine)
  • Zoloft (sertraline)
  • Viibryd (vilazodone)

Discontinuing use of Lexapro

When stopping Lexapro, the dose should be decreased over time. If stopped too quickly, symptoms from discontinuation may occur. Symptoms from sudden discontinuation of Lexapro include:

  • anxiety, irritability, change in mood, restlessness, or change in sleep patterns
  • headache, sweating, nausea, or dizziness
  • electric shock-like sensations, shaking, or confusion

Do not stop taking this drug unless instructed to do so by your doctor.

Healthgrades disclaimer:

This information is for educational purposes only. It should not be interpreted as medical advice, diagnosis, or treatment. Healthgrades takes every effort to ensure this information is accurate and up to date. This content is not intended to cover all possible uses, side effects, warnings, precautions, allergic reactions, or drug interactions. Do not assume that the absence of such information means the medication is safe for your personal use. Always consult your doctor, pharmacist, or healthcare professional before taking or discontinuing any medication.

Medical Reviewer: Alisha D. Sellers, BS Pharmacy, PharmD
Last Review Date: 2022 Jan 24
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Lexapro - escitalopram tablet, film coated; Lexapro - escitalopram solution. (2021). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=13bb8267-1cab-43e5-acae-55a4d957630a