Lexapro Dosage: Escitalopram Min And Max Doses

Last Updated: June 3, 2020

Authored by Sharon Levy, MD, MPH

Lexapro which is also called Escitalopram is an oral drug used for treating depression and generalized anxiety disorder. Lexapro dosages are available in different milligrams. The dosage of Escitalopram is based on some factors. These are age, medical condition, response to treatment, and other medications that an individual might be taking.
There are recommended daily dosages of Escitalopram for an individual, considering the factors mentioned above. Increase in Lexapro doses can be prescribed by a doctor if needed. But FDA does not approve doses higher than 20mg. This article will discuss the best time to take Lexapro and the right dosage for an individual ranging from children to the elderly. Read further to know more!

Regular Adult Dosage

For Major Depressive Disorder

Taking Lexapro 10mg once in a day is the recommended dosage. Controlled MDD studies showed the efficacy of a flexible dose trial of 10mg to Escitalopram 20mg. However, an increase in the dose to 20mg should happen after a minimum of three weeks.
In the case of acute episodes of major depressive disorder which may require sustained pharmacological therapy for several months, maintenance treatment is generally required. Continuous use of Escitalopram 10mg or 20mg once daily in adults who responded to taking the oral drug during eight-weeks of acute treatment phase was systematically evaluated. The evaluation demonstrated that it could be beneficial for maintenance treatment but determining the need for it requires a periodical reassessment of patients.                       

For Generalized Anxiety Disorder

It is recommended that an individual adult should start with the dosage of Lexapro 10mg per day. An increase in the dose from 10mg to Escitalopram 20mg tab should occur after at least one week. Even though there is no systematic study showing the efficacy of Lexapro dosage for GAD maintenance treatment after eight weeks, any extended therapy should be assessed periodically.    

Off-Label Use Dosages

Off-label Lexapro dosages for adults depends on the condition of an individual.

  • For insomnia, the dosage should be between Lexapro 5mg to 20mg for over eight weeks
  • For obsessive-compulsive disorder, an adult requires a dosage of Lexapro 10mg tab once daily. Lexapro for OCD dose may be increased to 20mg per day after one week. However, a periodical assessment is required for extended therapy.
  • Vasomotor symptoms associated with menopause require a daily dosage of Escitalopram 10mg for adults. If the symptoms are not adequately controlled the dosage can be increased to 20mg daily after four weeks.

Pediatric Dosage

For Major Depressive Disorder

Lexapro dose is not approved for an individual less than the age of 12 years. In a case where it is required, the doctor must be the one to determine the dose and use. On the other hand, the ages between 12 and 17 years can begin with a recommended Lexapro 10mg dosage per day and increase to 20mg after at least three weeks.

For Generalized Anxiety Disorder

There is no established efficacy or safety of the use of Escitalopram dosages for children. Lexapro dose and its use for children must be determined by a doctor individually for each case.

Off-Label Use Dosages

teen taking lexaproA clinical trial of Lexapro doses is rarely done on children. Therefore, the results are unknown. Although there has been a debate about the safety of this oral drug for children and adolescents, a study found that antidepressants such as Lexapro help adolescents with MDD. However, children must be closely watched and assessed.

Geriatric Dosage

For Major Depressive Disorder

Escitalopram 10mg is the recommended dosage for most elderly. Clinical trials found no benefits at escitalopram 20mg dose for the elderly.   

For Generalized Anxiety Disorder

Lexapro dosage for anxiety in elderly should not exceed 10 mg doses because there were no benefits found in the dose of 20mg for older adults.

Off-Label Use Dosages

Even though the drug can be prescribed as off-label for panic disorder, post-trauma stress disorder, and obsessive-compulsive disorder, a health provider should justify their thinking when recommending an off-label Lexapro dose. Patients should be closely observed while using the drug.

Dosage for Specific Populations

  • During pregnancy – even though it is recommended that women should stay away from the drug as possible during pregnancy, it might be impossible for those who rely on medications to function every day. However, little research has been done regarding the efficacy of Escitalopram dosage during pregnancy. An individual should take the oral drug only if it is necessary while pregnant. Also, it should be as directed by a health care provider.
  • Hepatic impairment – Escitalopram dose of 10mg is recommended to be taken per day for people with hepatic impairment.
  • Renal impairment – No Lexapro dose adjustment is necessary. People with severe renal impairment should take caution when taking the medication.

Dosage Forms and Strengths

It is available in Lexapro tablets which are round, film-coated tablets that boast Escitalopram Oxalate in strengths matching 5mg, 10mg, and 20mg Escitalopram base. Lexapro 10mg and 20mg are scored for ease of swallowing and dose flexibility. Also, it is available in oral solution to boast Escitalopram Oxalate in strengths matching 1mg per ml Escitalopram base.

What If One Missed A Dose?

If an individual miss an Escitalopram dose¸ it can be taken as soon as the person remembers. But if it is closer to the time the next dose would be taken, skip the missed doses and continue with the regular dosing schedule or talk to a doctor about it. Do not use double Lexapro dose.  

When And How To Take Lexapro?

Escitalopram dosage should be taken once per day, and it can be taken in the morning or at night, with food or without taking food. A person should start with a recommended dose, but the doctor may adjust the dose if needed. A person using the oral liquid should shake well and use a medicine cup, oral syringe, or measuring spoon that is marked to measure each dose. As the body of an individual adjusts to the medication, Lexapro weight loss may occur even though it is a less common side effect. It is one thing to know when and how to use the medication, and it is another thing to know how long it will take to work. So, how long does it take for Lexapro to work?
There may be someman thinking hot to take escitalopram improvement in appetite, energy, and sleep within the first one to two weeks. This may be an early sign that the Escitalopram Oxalate dosage is working. However, lack of interest in activities and depressed mood may require about six to eight weeks for full improvement. An individual taking the drug can also check the Lexapro prescribing information for more data on when and how to take the medication. Additionally, Lexapro recreational value is unknown so it can’t be used for recreational purposes.
Furthermore, if a person is taking any drugs or medication, the individual should let the doctor know. Do not drink alcohol while taking Lexapro because it can worsen the side effects of the oral drug on the motor and mental skills. Also, in a situation where another substance like Xanax is prescribed to a patient, some people might wonder if it can be taken with Escitalopram. Lexapro and Xanax can be taken together in most cases. However, the individual need to watch out for possible side effects.

Escitalopram Dosage Treatment Discontinuation

If there is sudden discontinuation from the drug dosage, Escitalopram withdrawal symptoms are likely to be noticed.  According to the National Alliance on Mental Illness, stopping Lexapro suddenly may cause symptoms such as a headache, nightmares, nausea, irritability, dizziness or more. An individual can discontinue or reduce the intake of the drug under the guidance of a doctor.
Also, there are substance abuse rehabilitation centers that help people who want to stop the use of Lexapro at the appropriate time. The rehab centers are known to help addicts with drug addiction treatments.

Page Sources

  1. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021323s047lbl.pdf

Published on: February 20th, 2019

Updated on: June 3rd, 2020

About Author

Sharon Levy, MD, MPH

After successful graduation from Boston University, MA, Sharon gained a Master’s degree in Public Health. Since then, Sharon devoted herself entirely to the medical niche. Sharon Levy is also a certified addiction recovery coach.


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  • Angela
    Well explained in plain English.