What Are the Side Effects of Lexapro?

Key Takeaways

• Lexapro (escitalopram) belongs to a class of medications called SSRIs
• The medication is commonly prescribed for anxiety or depression
• Most side effects are mild and improve over time as your body adjusts
• Nausea, fatigue, sleep changes, and sexual side effects are most commonly reported
• Serious side effects are less common but may include suicidal thoughts, serotonin syndrome, or allergic reactions
• It is important to talk to your doctor about any side effects or concerns during treatment

What Is Lexapro?

Lexapro (escitalopram) is a prescription medication used to treat depression and generalized anxiety disorder. It is available as both a tablet and a liquid solution and is approved for adults and adolescents ages 12 and older.[1]

Lexapro is the brand name for escitalopram, part of a group of medications called selective serotonin reuptake inhibitors (SSRIs). These medications work by increasing serotonin levels in the brain. Serotonin plays a key role in mood regulation, so higher levels can help reduce symptoms of anxiety and depression.

How Lexapro Works in the Brain

SSRIs like Lexapro prevent the brain from reabsorbing serotonin too quickly, keeping more of it available for longer. Over time, this can improve mood, sleep, and emotional stability.

Because serotonin also affects appetite, sexual function, and sleep regulation, those systems can shift while the body adjusts. Most side effects trace back to this mechanism, which is why they tend to be dose-dependent and most noticeable in the first week or two of treatment.

Compared to older antidepressants like monoamine oxidase inhibitors (MAOIs), SSRIs carry a lower risk of serious drug interactions and are generally better tolerated.

Common Side Effects of Lexapro

Many people tolerate Lexapro well, especially after the first few weeks. Side effects are often mild and ease as the body adjusts to the medication.

Common side effects in adults include:

• Nausea
• Fatigue or drowsiness
• Dizziness
• Trouble sleeping
• Increased sweating
• Dry mouth
• Constipation
• Reduced appetite
• Sexual side effects such as decreased libido or difficulty with arousal

Some people also notice increased anxiety early in treatment. This typically improves within the first two to four weeks.

Lexapro Side Effects in the First Week

The first week tends to be the most uncomfortable. The body hasn't had time to adapt to elevated serotonin levels, so symptoms like nausea, fatigue, and sleep disruption are more noticeable. Most people find these manageable, and they usually ease within two to three weeks as the body adjusts.

If side effects feel severe early on, don't stop the medication without talking to your doctor first. Stopping suddenly can trigger withdrawal symptoms.

Lexapro Side Effects in Women

Women may experience certain side effects more intensely. Reduced libido and difficulty reaching orgasm are among the most frequently reported sexual side effects in women taking SSRIs. Hormonal differences in how women metabolize escitalopram can also mean that some experience more pronounced nausea or mood fluctuations early in treatment.

Women who are pregnant or breastfeeding should discuss Lexapro use with their doctor. Use during pregnancy is typically reserved for cases where the benefits outweigh potential risks.

Lexapro Side Effects in Men

In men, sexual side effects are the most commonly reported concern. These include decreased libido, difficulty achieving or maintaining an erection, and delayed ejaculation. Research suggests sexual dysfunction affects 40 to 65% of people3 taking SSRIs, with men reporting different patterns than women. If sexual side effects persist, your doctor may adjust the dosage or explore alternative medications.

Side Effects in Children and Adolescents

Children and teens taking Lexapro may experience similar side effects as adults, along with a few additional concerns.

These can include:

• Increased thirst
• Nosebleeds
• Restlessness or agitation
• Difficulty urinating
• Changes in appetite or weight
• Slowed growth in some cases

Because of these potential effects, doctors typically monitor height and weight throughout treatment.

Serious Side Effects 

Some Lexapro side effects require immediate medical attention, even though they're far less common.

Suicidal Thoughts and Behavior

Lexapro carries a boxed warning from the FDA for increased risk of suicidal thoughts and behaviors in children, teens, and young adults. This risk is highest during the first few months of treatment or after a dosage change.

Seek help immediately if you notice:

• Thoughts of self-harm or suicide
• Worsening depression
• Sudden mood or behavior changes
• Increased agitation or irritability

If you or someone you know is in crisis, you can call or text 988, the Suicide and Crisis Lifeline, for 24/7 support.

Serotonin Syndrome

This condition occurs when serotonin levels in the brain become too high, often due to medication interactions. This is a medical emergency and requires immediate care.

Symptoms may include:

• Confusion or agitation
• Rapid heart rate
• Fever or sweating
• Muscle stiffness or twitching
• Nausea or diarrhea

Allergic Reactions

Severe allergic reactions are rare but possible. Symptoms may include swelling of the face or throat, difficulty breathing, or a severe rash.

Other Potential Risks

Additional serious side effects may include:[2]

• Seizures, especially in those with a history of seizures
• Low sodium levels, which can cause confusion or weakness
• Manic episodes in people with bipolar disorder
• Eye problems such as increased pressure or glaucoma symptoms

Who Should Be Cautious When Taking Lexapro?

Before starting Lexapro, it is important to talk with your doctor about your medical history. Certain conditions may increase your risk of side effects.

These include:

• A history of suicidal thoughts or behaviors
• Bipolar disorder
• Seizure disorders
• Glaucoma
• Low sodium levels
• Pregnancy or breastfeeding

Your doctor may adjust your dosage or monitor you more closely based on your health history.

Drug Interactions to Know

Lexapro interacts with a wide range of medications. Some interactions increase the risk of serotonin syndrome; others raise bleeding risk or alter how the drug is metabolized.

Common interactions include:

• MAOIs (monoamine oxidase inhibitors): Combining Lexapro with MAOIs like phenelzine or tranylcypromine can cause a dangerous spike in serotonin. These medications should never be taken together.
• St. John's Wort: This herbal supplement also raises serotonin levels and significantly increases the risk of serotonin syndrome when combined with Lexapro.
• Blood thinners and NSAIDs: Aspirin, ibuprofen, naproxen, and warfarin all increase bleeding risk when taken with Lexapro.
• Other antidepressants or serotonergic medications: Combining Lexapro with other medications that affect serotonin raises the risk of serotonin syndrome.
• Lithium: May enhance serotonergic effects; requires close monitoring if used together.

Always share a full list of medications and supplements with your provider before starting Lexapro.

When to Talk to Your Doctor

If side effects are persistent, getting worse, or interfering with daily life, contact your doctor. They may adjust your dosage, recommend strategies to manage specific symptoms, or consider alternative medications.

Finding the right treatment for depression and anxiety takes time, and changes are normal. Don't make adjustments to your dose or stop the medication without guidance.