Lexapro (Escitalopram) for Anxiety and Depression

What Is Lexapro (Escitalopram)?

The Food and Drug Administration approves Escitalopram for the treatment of major depressive disorder and generalized anxiety disorder. Sometimes, Lexapro is prescribed off-label, meaning it’s prescribed for a condition that it hasn’t been FDA-approved to treat.

Physicians may prescribe medications off-label when they believe a patient may benefit, despite a lack of current research to show a drug’s effectiveness for the patient’s condition.

Some of the conditions that physicians may prescribe Lexapro off-label for include:

Social anxiety disorder
Obsessive-compulsive disorder
Panic disorder
Post-traumatic stress disorder
Premenstrual dysphoric disorder
Menopausal symptoms

How Escitalopram Works: The Science Behind Lexapro

While research on exactly how SSRIs work is ongoing, it can be helpful to understand how escitalopram works if you’re considering it for the treatment of anxiety, depression, or another mental health condition.

In the brain, neurotransmitters like serotonin carry signals from one neuron to the next. These signals affect a wide variety of bodily processes, including mood, decision-making, hunger, sleep, thoughts, emotions, motor control, heart rate, digestion, and more.

Typically, neurons send neurotransmitters to one another. When the neurotransmitter gets to its destination, it’s absorbed into the brain in a process called reuptake.

Serotonin plays a key role in many of the body’s feel-good processes. If serotonin levels in the brain become imbalanced, mood disorders, sleep disturbances, and other issues can occur. It’s thought that SSRIs like Lexapro stop the reabsorption of serotonin, allowing more of it to accumulate in the brain.

Researchers believe that when the reuptake is inhibited, serotonin concentration levels in the brain increase, leading to a decrease in the symptoms associated with depression and anxiety disorders.

Many factors can affect how long it will take for you to begin to feel the effects of an SSRI. Most people who take Lexapro for anxiety and/or depression find that they feel some symptom relief within one to two weeks but it can take up to eight weeks to feel the full effect of your medication.

Escitalopram FAQs

Is Lexapro the Same as Escitalopram?

Yes. Lexapro is a brand name for the generic medication escitalopram.

Does Lexapro Cause Weight Gain?

Many SSRIs including Lexapro are associated with weight gain, especially during long term use. A recent study showed that about 41% of people who took Lexapro gained weight.

What Happens if You Mix Lexapro and Alcohol?

It’s not a good idea to combine alcohol with SSRI medications, including Lexapro. Drinking alcohol can increase the symptoms of anxiety and depression and may worsen Lexapro side effects.

What’s the Difference Between Lexapro and Zoloft?

Zoloft (generic name sertraline) is FDA-approved to treat a wider range of mental health conditions than Lexapro.

Both drugs carry the risk of similar side effects but Zoloft is more likely to cause said side effects than Zoloft. There is some research suggesting that Lexapro may be more effective than Zoloft for treating depression.

Lexapro for Anxiety and Depression: Effectiveness and Timing

Lexapro has been proven effective in improving symptoms of generalized anxiety disorder, as well as in treating the symptoms of major depressive disorder.

A doctor speaks with a patient during an appointment

Most people take Lexapro in the morning but you may need to adjust the time that you take your medication based on the side effects of escitalopram that you experience. For example, if you find that Lexapro makes you feel sleepy it might make more sense for you to take your medication in the evening.

Medications affect people differently based on individual brain chemistry and other factors. Comparing Lexapro vs Zoloft may help you determine which medication may be a better fit for your needs.

Lexapro Use Cases:

Major depressive disorder
Generalized Anxiety

Zoloft Use Cases:

Major depressive disorder (MDD)
Obsessive compulsive disorder (OCD)
Post traumatic stress disorder (PTSD)
Premenstrual dysphoric disorder (PMDD)

When comparing the effectiveness of the two medications, research currently suggests that Lexapro is more effective than Zoloft. When comparing tolerability, research suggests that Zoloft has a lower risk of side effects than Lexapro.

Side Effects of Lexapro and What to Watch For

Side effects of Lexapro can differ from one person to another. Your doctor may talk with you about common side effects as well as side effects that indicate a serious problem.

Some of the common side effects of Lexapro include:

Anxiety and agitation
Constipation
Dizziness
Drowsiness
Dry mouth
Increased muscle movements or shakiness
Increased thirst
Nausea
Nosebleeds
Sexual dysfunction
Sleep problems
Sweating
Weight gain

Rare and serious side effects of Lexapro can include:

Severe nervous system reaction including very stiff muscles, high fever, tremors and lightheadedness
Low levels of sodium in the body that may cause symptoms including slurred speech, severe weakness, loss of coordination, vomiting and feeling unsteady
Pain or burning during urination
Racing thoughts, suicidal thoughts or behaviors, risk taking behaviors, feelings of happiness or sadness
Blurred vision, tunnel vision, eye pain and appearance of halos around lights

If you experience any of the side effects in the above list, it’s important to reach out for emergency medical care right away.

Weight gain is a common concern among people who take Lexapro. While some people (about 41%) who take Lexapro experience weight gain, this side effect is more common in those who smoke and/or live a sedentary lifestyle.

It’s important to be aware of things you should avoid while taking Lexapro. It’s not a good idea to drink alcohol or use drugs when you’re taking an antidepressant, as these can increase side effects and/or worsen your depression or anxiety.

You should also avoid certain medications and supplements when taking Lexapro, including MAOIs, pimozide (brand name Orap), serotonergic drugs (including some antidepressants, migraine medications, pain relievers, and some stimulants), NSAIDs (like aspirin and ibuprofen), blood thinners, and St. John’s wort.

You should talk with a healthcare professional about potential drug interactions before taking antiarrhythmics, methadone, or antibiotics while taking Lexapro.

Benefits and Risks of Lexapro: When It’s Most Effective

SSRIs like Lexapro are most effective when paired with therapy, such as cognitive behavioral therapy.

Working with a therapist can help you develop the coping mechanisms you need to thrive while your medication works to balance your brain chemistry. Many people take Lexapro and similar medications long-term (for years). Checking in with your doctor and therapist regularly can help ensure that your medication is working well.

If you and your doctor decide that escitalopram is no longer a good fit for your needs, it’s important to use a taper schedule to help avoid Lexapro withdrawal symptoms. Slowly lowering your dose (with your doctor’s guidance) over time before stopping your medication completely can help to reduce the likelihood of withdrawal.

Symptoms associated with Lexapro withdrawal may include:

Brain fog
Chills
Confusion
Concentration and memory issues
Crying
Dizziness
Muscle tension

Lexapro Generic Availability and Cost Effectiveness of Escitalopram

Often, choosing Lexapro generic drugs (as opposed to brand name) can significantly lower the cost of your medication.

Currently, a 30-day supply of brand-name Lexapro can cost more than $500, while the same supply of generic escitalopram can cost less than $10. Choosing to shop for generic drugs over brand-name drugs can also help you more easily access your medication in the event of a supply shortage.