Escitalopram — Practical Guide to Uses, Dose and Side Effects

Escitalopram is a commonly prescribed SSRI (selective serotonin reuptake inhibitor) used for depression and anxiety. If you or someone close to you is starting it, here's the straightforward info you actually need: how it works, what to expect, and simple tips to use it safely.

What it treats and how fast it works

Doctors use escitalopram for major depressive disorder, generalized anxiety disorder, panic disorder, and sometimes for social anxiety. It raises serotonin levels in the brain, which helps mood and worry over time. Many people notice some improvement in sleep or appetite within a week, but mood and anxiety symptoms usually take 2–6 weeks to improve and sometimes up to 8–12 weeks for full effect.

Typical dosing and practical tips

Common starting doses are 5–10 mg once daily. Typical therapeutic doses range from 10–20 mg per day. Always follow your prescriber's directions—don’t double doses if you miss one. Take it at the same time each day to keep levels steady. You can take escitalopram with or without food. If it makes you sleepy, try taking it at night; if it causes restlessness, take it in the morning.

If your doctor wants you to stop, they’ll usually taper the dose gradually. Stopping suddenly can cause discontinuation symptoms like dizziness, electric shock sensations, insomnia, or flu-like feelings. Tell your prescriber if you start to feel worse or notice new symptoms.

Common side effects include nausea, dry mouth, sweating, fatigue or insomnia, and reduced sexual desire or function. Most side effects improve after a few weeks. If you experience severe agitation, chest pain, fainting, seizures, or signs of serotonin syndrome (high fever, fast heartbeat, severe confusion, muscle stiffness), get urgent medical help.

Watch for worsening mood or suicidal thoughts, especially in people under 25. Your doctor should check in regularly during the first few months.

Important interactions: don’t combine escitalopram with MAO inhibitors or with certain migraine drugs (triptans) without medical advice—this can raise the risk of serotonin syndrome. St. John’s wort and some supplements can interact too. Also, SSRIs can increase bleeding risk when used with NSAIDs or blood thinners, so tell any provider about all medicines you take.

Pregnancy and breastfeeding: the risks and benefits need a careful talk with your doctor. Some people continue treatment during pregnancy if the benefit outweighs the risk; decisions are individual.

Final practical notes: keep a simple list of your meds, take escitalopram consistently, don’t mix it with alcohol regularly, and reach out to your prescriber if side effects last more than a few weeks or your symptoms don’t improve. If you’re ever unsure, ask—safe use starts with clear communication.