Lexapro
Generic name: escitalopram · Brand name: Lexapro®
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How It Works
Lexapro is a selective serotonin reuptake inhibitor (SSRI) — the same class as sertraline, but considered one of the most selective and well-tolerated SSRIs available. It works by blocking the reabsorption of serotonin in the brain, increasing the amount available between nerve cells. Over time, this helps stabilize mood and reduce anxiety. It does not cause sedation or immediate relief — it works gradually as the brain adjusts.
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What It Treats
Major Depressive Disorder (MDD)
Persistent low mood, fatigue, loss of interest, sleep and appetite changes
Generalized Anxiety Disorder (GAD)
Excessive, hard-to-control worry, muscle tension, restlessness
Social Anxiety & Panic
Often used off-label with good evidence for both conditions
OCD & PTSD
Commonly used off-label; discuss with your provider
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Dosing Overview
| Population | Start | Typical Range | Max |
|---|---|---|---|
| Adults Depression / GAD |
5–10 mg | 10–20 mg | 20 mg |
| Older Adults 65+ |
5 mg | 10 mg | 10 mg |
| Adolescents (12–17) Depression |
5–10 mg | 10–20 mg | 20 mg |
Taken once daily, with or without food. Doses adjusted based on response and tolerability — typically every 4–6 weeks.
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What to Expect — Timeline
1–2
Weeks 1–2
Body adjusting. May notice sleep changes, mild nausea, or fatigue before mood lifts
3–4
Weeks 3–4
Many notice improved sleep, energy, or motivation. Anxiety may still feel elevated
6–8
Weeks 6–8
Mood and anxiety typically improve significantly at a therapeutic dose
3–6m
3–6 Months
Full therapeutic benefit. Duration of treatment discussed based on your history
⏳ Be patient. Lexapro is not a fast-acting medication. Most people need at least 4–8 weeks at a therapeutic dose before evaluating effectiveness. Do not stop without talking to your provider.
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Side Effects
Common (often temporary)
- Nausea or upset stomach
- Headache
- Fatigue or drowsiness
- Dry mouth
- Increased sweating
- Insomnia
- Sexual side effects
- Decreased appetite
Call us if you notice
- Worsening depression or anxiety
- New or increased suicidal thoughts
- Agitation or restlessness
- Unusual bleeding
- Hypomania or mania-like symptoms
- Serotonin syndrome signs (fever, confusion, tremor)
Most side effects are mild and improve within the first 1–2 weeks. Lexapro is generally very well tolerated and has fewer drug interactions than many other SSRIs. Sexual side effects may persist — let your provider know.
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Tips for Success
Same Time DailyTake at the same time each day — morning or evening both work well.
With or Without FoodLexapro can be taken either way, but food helps if nausea occurs.
Don't Stop AbruptlyStopping suddenly can cause dizziness and mood changes. Always taper with guidance.
Limit AlcoholAlcohol can worsen depression and anxiety and may increase side effects.
Tell All ProvidersLet other prescribers know you take Lexapro — it can interact with certain medications.
Track Your MoodJournaling or a mood app helps you and your provider see what's changing over time.
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Important Safety Information
Black Box Warning (under 25): Antidepressants may increase risk of suicidal thinking in children, adolescents, and young adults, especially in the first few weeks. Monitor closely and contact us right away if new or worsening thoughts of self-harm appear.
Serotonin Syndrome: A rare but serious reaction that can occur when Lexapro is combined with certain medications (MAOIs, triptans, tramadol, St. John's Wort). Signs include fever, agitation, rapid heart rate, muscle twitching, or confusion — seek emergency care immediately.
Drug Interactions: Do not take with MAOIs (must wait 14 days between). Use caution with blood thinners, NSAIDs, and other serotonergic medications. Lexapro has fewer interactions than many SSRIs, but always share your full medication list.
Pregnancy & Breastfeeding: Discuss risks and benefits with your provider. Lexapro is one of the better-studied SSRIs in pregnancy, but decisions should be individualized. Do not stop without consultation.
QT Interval: High doses of Lexapro can affect heart rhythm in some people. Your provider will consider your cardiac history when prescribing. Do not exceed the recommended maximum dose.
Questions? I'm here.
Reach me between appointments if you have concerns about side effects, notice mood changes, or have questions about your medication. You don't have to wait until your next visit.
360-389-3712
info@rootedmindspsychiatry.com