Lexapro Severe And Moderate Drug Interactions

Last Updated: December 18, 2019

Authored by Sharon Levy, MD, MPH

Escitalopram is an antidepressant that belongs to a group of drugs known as selective serotonin reuptake inhibitors (SSRI). Lexapro interacts with many drugs which could result in severe, serious or moderate complications. Some of the Escitalopram interactions can lead to serotonin syndrome which includes dizziness, hyperthermia, autonomic instability, rapid fluctuation of vital signs and mental status, vomiting, nausea, myoclonus, flushing, and delirium. The aim of this article is to educate readers on Lexapro interactions with food and drugs, and also outline the side effects of escitalopram with other medications.

Severe Drug Interactions With Escitalopram

Just like many antidepressant drugs, Escitalopram comes with numerous side effects. Also, concomitant use with other drugs can lead to health issues. Listed below are some severe Lexapro drug interactions:

  • Escitalopram and Leuprolide: A concomitant use increases the toxicity of torsades de pointes. Torsades de pointes is a specific type of abnormal heart Escitalopram by prolongation of QT intervals, thereby, doubling the risks of rhythm that can lead to sudden cardiac death.
  • Escitalopram and Selegiline: A combination of these drugs increase serotonin levels leading to serotonin syndrome: Excess production of serotonin in the body.
  • Escitalopram and Ziprasidone: Using these drugs together Increases QT intervals.
  • Escitalopram and Pimozide: Results in a serious heart problem that can lead to death. Patients should not use these drugs if they are allergic to any of the Lexapro ingredients or pimozide ingredients.
  • Escitalopram and Sparfloxacin: These medications should not be used together and can result in very harmful effects. Patients would experience an increase in heartbeat, which sometimes lead to death.

Serious Drug Interactions With Escitalopram

Due to serious drug interactions with escitalopram, some of the drugs listed below are not advised to be used unless under special circumstances. However, if the benefits outweigh the risks, Lexapro max dose to be used must be closely monitored by a medical professional. The maximum dose should not exceed 40 mg daily.

  • Wellbutrin and Lexapro: The concomitant use of these drugs increase toxicity and precipitate seizures and panic attacks.
  • Lexapro and Adderall (Amphetamine+dextroamphetamine): The concomitant use increases the effects of amphetamine thereby causing serotonin syndrome.
  • Lexapro and Tramadol: The use of the two drugs together causes decreased respiratory rate, QT Prolongation, cardiac arrhythmias, and serotonin syndrome. Consistent use of these drugs together can lead to addiction. However, treating substance dependent individuals addicted to either of these stimulants can be done by tapering the dose gradually until it is stopped.
  • Lexapro and Trazodone: drugs interaction conceptCauses dose-dependent prolongation of QT interval. ECG should also be closely monitored.
  • Lexapro and Buspar: The concomitant use increases the risks of serotonin syndrome.
  • Phentermine and Lexapro: The use of both drugs together cause serotonin syndrome.
  • Lexapro and Vyvanse: Combining these medications cause serotonin syndrome.

Moderate Drug Interactions With Escitalopram

The following drugs listed below are moderate drug interactions with Escitalopram. These drugs should not be used together unless under strict supervision by medical personnel.

  • Lexapro and Ativan: A dose titration should be done because concomitant use of these drugs causes prolonged CNS and respiratory depression.
  • Lexapro and Abilify: Combining these stimulants can increase the blood levels of Abilify, thereby increasing the severity of the side effects such as seizures, drowsiness, Parkinson like symptoms, low blood pressure
  • With Gabapentin: Cautious dosage titration is required to prevent CNS prolongation and respiratory depression.
  • With Klonopin: The use of both drugs should be monitored to prevent respiratory depression.
  • Lexapro and Ibuprofen (Advil):  This doubles the risk of bleeding. Hence, clinical and laboratory observations should be done for hematological complications.
  • Lexapro and Weed: A mixture of these drugs cause prolonged CNS depression,  dizziness, confusion, and difficulty in concentrating.
  • Lexapro and Benadryl: Usage together increases the side effects leading to prolonged CNS and respiratory depression.
  • With Desmopressin: These medicines interact moderately, however, it can result in some risks when taken together. According to reports, concomitant use can double the risks of having hyponatremia;  low levels of salt in the blood. Hyponatremia can cause death.

Escitalopram Interactions With Food

There are no reports about escitalopram reacting with food in any way —However, food may increase or decrease the absorption rate of the drug. According to Lexapro prescription,  it can be taken with or without food.  Alcohol, on the other hand, reacts with escitalopram. It is known to worsen the negative effects of each medication thereby altering the mental and motor skills causing impairment of judgment, and mostly leads to addiction. If this happens, consult a doctor or enroll in a drug and alcohol rehabilitation center. The aim is to ensure gradual withdrawal from Lexapro without causing withdrawal syndrome.

Always Follow the Doctor’s Advice

It is important that the doctor’s prescription is followed at all time. An increase in dosage or change in diet can spell great danger.

On no account should anyone use any of these medications listed above without the doctor’s instruction. Also, patients who use escitalopram may experience symptoms such as a decrease in Lexapro sex drive, mood swing, anxiety, hallucination, delayed ejaculation, erectile difficulty, delayed orgasm, or anorgasmia (Mostly in women). Patients can also experience a sudden increase or decrease in weight. Lexapro and weight gain occur after 16-22 weeks of use.

Page Sources

  1. Debasish Sanyal, Suddhendu Chakraborty, Ranjan Bhattacharyya, An interesting case of serotonin syndrome precipitated by escitalopram, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2991707/
  2. Andrew F. Leuchter, Ira M. Lesser, Madhukar H. Trivedi, A. John Rush, David W. Morris, Diane Warden, Maurizio Fava, Stephen R. Wisniewski, James F. Luther, Bradley N. Gaynes, Jonathan W. Stewart, An Open Pilot Study of the Combination of Escitalopram and Bupropion-SR for Outpatients With Major Depressive Disorder, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2778329/

Published on: February 20th, 2019

Updated on: December 18th, 2019

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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  • katie
    Is it safe to take lexapro and Valium?