Lexapro Side Effects: Escitalopram Adverse Reactions

Last Updated: June 10, 2020

Authored by Sharon Levy, MD, MPH

Lexapro is a commonly prescribed medication that is known for its numerous side effects and interactions. Lexapro is used to treat the major depressive disorder and severe, persistent anxiety. While medications that treat these conditions are vital, the number of documented Lexapro side effects and drug interactions does make its use concerning. Here are the side effects of Lexapro, as well as drug interactions, that all users should know.

Common Lexapro Side Effects

The first thing to know in understanding the side effects is how does Lexapro work. The medication acts on the central nervous system, primarily the brain, to restore the natural balance of serotonin. Given that the brain and central nervous system as a whole run the body, it is understandable that the side effects of escitalopram are numerous and wide-ranging.
Lexapro side effects in the first week tend to be the worst. As the body adjusts to the medication, many of the most common Lexapro side effects go away or at least become significantly more tolerable. However, certain side effects will not get better. Lexapro side effect nausea Common escitalopram side effects include:

  • Headache
  • Nausea
  • Gas
  • Heartburn
  • Constipation
  • Diarrhea
  • Weight fluctuation
  • Loss of appetite
  • Dizziness
  • Shakiness
  • Dry mouth
  • Increased sweating
  • Feelings of nervousness
  • Feelings of restlessness
  • Fatigue
  • Excessive sleep
  • Yawning
  • Ringing in the ears
  • Insomnia
  • Sexual side effects (decreased sex drive, inability to orgasm, ejaculatory delay)

It is important to note that there are less common side effects users can encounter that are not well publicized because they are not considered serious. For example, Lexapro hair loss has been reported by users. Lexapro brain zaps are also noted by patients. Any symptoms that develop after starting use of the drug is potentially a side effect.
For users, some of these side effects are more difficult to deal with than the conditions they are attempting to treat. For example, Lexapro weight gain can be significant, and if the user’s depression is fueled by body image issues, escitalopram may not be the right antidepressant for them. Lexapro insomnia may make depressive episodes more severe.

Serious Escitalopram Side Effects

Serious side effects of Lexapro are relatively rare. However, because they have the potential to be dangerous or long-lasting, they are extremely concerning. Should anyone experience the following serious and/or long-term effects of Lexapro, they should contact a medical professional immediately.

  • Low sodium levels
  • Lexapro headache, weakness, and cognitive problems that have a late onset
  • Teeth grinding
  • Eye pain woman touching her eyes
  • Blurred vision
  • Tunnel vision
  • Halos around lights
  • Swelling and redness around the eye
  • Racing thoughts
  • Risk-taking behaviors
  • Extreme happiness or sadness
  • Slurred speech
  • Severe weakness
  • Confusion
  • Loss of coordination
  • Fast or uneven pulse

All SSRI antidepressants, which includes escitalopram, can increase the risk of bleeding externally and internally. As such, any abdominal pain and Lexapro nausea should be taken seriously. Lexapro also has the potential to cause serotonin syndrome. This can include the sudden onset of Lexapro-caused diarrhea, shivering, confusion, severe muscle tightness, fever, seizures, hallucinations, and even death.
Additional severe side effects can be caused by suddenly stopping escitalopram or by taking too much. Lexapro withdrawal symptoms can be deadly. No patient should ever stop the use of the drug without help from a doctor. Medical professionals understand how to wean off Lexapro safely. Patients also should avoid increasing their dosage on their own. Lexapro overdose is possible and can lead to death.

Signs of Lexapro Allergic Reaction

In addition to rare and common side effects of Lexapro, there is also the risk that an allergic reaction might occur. This risk is not unique to Lexapro; any drug has the potential to cause an allergic reaction. These reactions often occur shortly after taking a drug for the first time, but in some cases, it may take hours, days, or even weeks for the reaction to present itself. Signs of symptoms of an allergic reaction to escitalopram include:

  • Skin rash
  • Hives
  • Itching
  • Fever
  • Swelling
  • Wheezing
  • Runny nose
  • Itchy and watery eyes
  • Difficulty breathing
  • Anaphylaxis
  • Drop in blood pressure
  • Loss of consciousness
  • Joint pain
  • Anemia
  • Kidney inflammation

Should any of these symptoms present in a patient, they should seek emergency medical attention. Any allergic reaction has the potential to turn deadly in very little time.
In addition to allergic reactions, Lexapro drug interactions are highly concerning. These interactions can impact the effectiveness of Lexapro, the effectiveness of the other substances, and intensify serious side effects and allergic reactions. Before taking escitalopram, patients must let their doctor know about all medications, supplements, illegal drugs, and other substances they are using. This includes legal substances. For example, mixing Lexapro with alcohol can be deadly.

Escitalopram Black Box Warning

Escitalopram carries a black box warning. Black box warnings are the most serious type of warning the Food and Drug administration issues for medications. They must be prominently displayed on packaging and promotional materials, as well as on the FDA’s website and the website of the pharmaceutical company that manufactures the drug. Doctors prescribing drugs with black box warnings are required to educate patients on the risks before prescribing the drug. As such, every patient should know about the black box warning before receiving an escitalopram prescription.

Variables That Impact Side Effect Emergence

There is no one Lexapro side effect that every patient is guaranteed to experience. This is because there are many variables at play that impact the emergence of side effects. Every patient is unique, which means that their risk of developing side effects is also different. Variables that can impact side effect emergence include:

  • The dose taken
  • The frequency the medication is taken at
  • Toleranceyoung sad man with depression
  • Genetic variations
  • Metabolism
  • Age
  • Gender
  • Size
  • Muscle mass
  • Race
  • Pregnancy
  • Breastfeeding
  • Organ diseases—heart, kidney, liver
  • Mood
  • Expectation

Many of these variables cannot be changed by the doctor or patient, which means that the ability to reduce escitalopram side effects is limited. However, there are some steps to take that can make them more tolerable or eliminate them in certain situations.

How To Reduce Lexapro Side Effects

The first step in managing side effects is speaking with the prescribing doctor. With their guidance, the patient should be able to develop a plan for combating side effects. In most cases, the doctor will not advise attempting to reduce side effects until the first week on the medication is complete, as many side effects are transient. After that time, the following steps may be advised:

  • Alter the time doses are taken, such as moving them to after meals
  • Stay hydrated to battle nausea
  • Eat smaller, more frequent meals to settle the stomach
  • Fit 30 minutes of physical activity into each day to prevent weight gain
  • Keep water nearby to deal with dry mouth
  • Eat foods with a higher water content to combat dry mouth
  • Practice relaxation techniques to tamp down anxiety
  • Sit or stand up slowly to eliminate dizziness from low blood pressure
  • Seek increased counseling for depression and emergency care for suicidal thoughts

No matter how severe the side effects are, patients should never stop taking Lexapro on their own. It is vital that the medication is weaned off of in a safe and supervised manner.
Anyone who is abusing Lexapro or using it in combination with alcohol or illegal drugs should seek help. Substance addiction treatment can help the patient get clean and save their life. These facilities are adept at treating both addiction and underlying conditions, such as depression and anxiety. For every patient, the right rehab facilities are out there.

Page Sources

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3950535/

Published on: February 20th, 2019

Updated on: June 10th, 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.


Leave a comment

  • Josh shaulson
    I’m an 18 year old male whose suffered from extreme anxiety for as long as I can remember. I finally garnered up the strength to start lexapro two days ago and have had extreme headaches nausea and mild stomach discomfort, my psychiatrist says to stop and try something else, should I stop or give it some time ?
  • Janice Mueva Advincula Anota
    Ma’am good morning,I take escetalopram jovia,more than 2 years and I feel now that I’m bloated and constipation,and I I feel also that I have dissmenohria even I i have no menstruation period.and I feel that my joint is pain..and have urination problem..and also I have a stomach discomfort. I’m worried now my condition,please give me an advice ma’am..thank you and gobless..