Lexapro (Escitalopram): What You Need to Know

Lexapro is a commonly prescribed SSRI for depression and anxiety. It works by increasing serotonin in the brain, which helps mood and reduces worry. Most people start to feel better within two to four weeks, but it can take six to eight weeks for full benefit. If you or a loved one are starting Lexapro, this page gives clear, practical tips on dosing, side effects, interactions, and when to contact your doctor.

How it’s used and typical dosing

Doctors usually start adults at 10 mg once daily. For some, 5 mg is a gentler start. The typical effective range is 10–20 mg per day. Older adults and people sensitive to side effects may stay at lower doses. Take it at the same time every day; picking morning or evening helps you remember. Do not double doses if you miss one—take the next dose at the usual time and tell your prescriber about missed doses if it happens often.

Side effects, safety, and interactions

Common side effects include nausea, sleep changes, dry mouth, and reduced sexual desire or performance. These often ease after two to four weeks. Watch for more serious signs: severe agitation, marked mood changes, sudden swelling, or unusual bleeding. Lexapro can raise bleeding risk when combined with blood thinners, NSAIDs, or aspirin. Avoid starting an MAOI within two weeks of stopping Lexapro — that combo risks serotonin syndrome, a medical emergency. Mixing Lexapro with other serotonergic drugs like tramadol, triptans, or certain supplements (like high-dose St. John’s Wort) also increases that risk.

If you’re pregnant, planning pregnancy, or breastfeeding, talk to your doctor. Many people use SSRIs during pregnancy, but risks and benefits must be weighed. Don’t stop taking Lexapro suddenly: taper slowly under medical supervision to avoid withdrawal symptoms such as dizziness, irritability, sleep problems, and electric shock sensations.

Alcohol can worsen depression and increase side effects like drowsiness. Try to limit or avoid alcohol while on Lexapro. Also mention all your medications, prescription and over-the-counter, to your prescriber so they can check for interactions.

Expect regular follow-ups at first—your prescriber will check symptoms, side effects, and may adjust dose. If you notice worsening mood, new suicidal thoughts, or any signs of serotonin syndrome (rapid heartbeat, high fever, tremor, confusion), seek urgent medical care.

Practical tip: keep a simple symptom diary for the first eight weeks. Note mood, sleep, appetite, and side effects. This helps your clinician decide whether the dose is right or whether a different treatment is better.

Want specific advice for kids, seniors, or combining medication with therapy? Talk to your healthcare team. Medication works best when combined with counseling, lifestyle habits like regular sleep and exercise, and support from people who care about you.

If side effects continue after a month, ask your doctor about switching or dose change. Generic escitalopram is common and cheaper. Ask your pharmacist about savings programs and safe online suppliers, and always keep an up-to-date medication list for each appointment visit.