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Escitalopram (Lexapro): What It Is, How It Works, Uses & More

Katelyn Hagerty FNP

Medically reviewed by Kristin Hall, FNP

Written by Our Editorial Team

Last updated 10/28/2020

Despite being relatively common, depression and other mental health issues carry a stigma. 

Maybe you’re worried about being seen as emotionally weak, or wondering what people close to you will think if they find out you’re struggling. 

It can be hard to ask for help when you’re suffering, but that difficult first step can change everything. 

You don’t have to suffer with depression and anxiety. Drugs like escitalopram exist to help. It’s okay to admit you need that help. In fact, it’s a sign of strength to reach out. 

That said, if you’ve decided to take the first step toward taking control of your mental health, here’s what you should know about escitalopram.

What Is Escitalopram? 

Escitalopram is a medication used to treat mood disorders. The Food and Drug Administration (FDA) first approved the brand name version of escitalopram, Lexapro®, in 2002, specifically for use in the treatment of major depressive disorder and generalized anxiety disorder. Generic escitalopram was then approved in 2012, making it more affordable to get the drug.

Escitalopram is known as a selective serotonin reuptake inhibitor, or SSRI, a class of antidepressant drugs that affects chemicals in the brain.

How Do Selective Serotonin Reuptake Inhibitors Work? 

SSRIs, as you might have guessed, primarily work on the brain chemical serotonin. Serotonin is one of several hormones partly responsible for mood regulation. The Endocrine Society says when your serotonin levels are normal, you should feel emotionally stable, happy and calm. However, too little serotonin is associated with  depression, anxiety, suicidal tendencies, and obsessive-compulsive disorder. 

Escitalopram and other SSRIs work by blocking the reabsorption of serotonin into neurons, leaving more of the feel-good chemical circulating in your body. This group of medications is called “selective” because they work on serotonin and not on other neurotransmitters, or chemicals.

In addition to escitalopram and the brand name Lexapro, other SSRIs include: citalopram (Celexa®), fluoxetine (Prozac®), paroxetine (Paxil®), and sertraline (Zoloft®).

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Who Is Escitalopram For? 

The FDA has approved escitalopram for the treatment of major depressive disorder in adolescents and adults, and generalized anxiety disorder in adults. 

It may also be prescribed for “off-label” use in the treatment of obsessive-compulsive disorder and panic disorder.  

Both major depressive disorder and generalized anxiety disorder are relatively common mental illnesses. 

The Anxiety and Depression Association of America reports 6.7 percent of the U.S. population is affected by major depressive disorder, while 3.1 percent is affected by generalized anxiety disorder. 

However, not all of these people are receiving treatment.

You may already have spoken with your healthcare provider and received a diagnosis of depression or anxiety, but perhaps you’re reading up because you haven’t yet asked for medical advice. If you suspect you are battling one or both of these conditions, talking with a healthcare professional or mental health professional is a good first step.

Clinically, a major depressive episode implies prominent or persistent dysphoric or depressed moods that begin to interfere with your daily functioning, as well as include at least four of the following nine symptoms:

  • Loss of interest in day-to-day activities

  • Depressed mood

  • Noticeably significant changes in appetite and/or weight

  • Psychomotor agitation or retardation

  • Altered thinking or a loss of concentration

  • Suicide ideation or attempt

  • Feeligns of worthlessness or guilt

  • Insomnia or hypersomnia

  • Increased fatigue 

 Generalized anxiety disorder may be clinically characterized by feelings of excessive worry and anxiety that you find difficult to control, which persist for at least six months. It must also be associated with at least three of these symptoms:

  • Being easily fagigued

  • Difficulty concentrating

  • Irritability

  • Restlessness or feeling on edge

  • Difficulty sleeping

  • Muscle tension

If you’re struggling with these symptoms and have suicidal thoughts, it’s important to seek help as soon as possible. See the “How to Get Help Right Away” section at the bottom of this page for resources available to you 24/7. 

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Escitalopram Risks, Side Effects and Complications

Perhaps the most well-publicized risk of antidepressant medications is a possible increased risk of suicidal thoughts and behavior. 

It’s counterintuitive that a medication designed to treat suicidal thoughts could actually make them worse. However, according to the FDA, this risk is only heightened in children and adolescents. 

For adults over age 24, there is a lessened risk of suicidal thoughts and behavior. For people younger, the benefits of taking escitalopram must be balanced with this and other possible risks. 

More common side effects of taking escitalopram or Lexapro, include: 

  • Gas 

  • Constipation

  • Diarrhea

  • Heartburn

  • Trouble sleeping or sleepiness/drowsiness

  • Decreased interest in sex or inability to obtain or keep an erection 

  • Dry mouth 

These side effects do not require medical attention and may very well subside as your body gets used to the medication. 

Slightly less common, but also not serious effects may include: 

  • Pins and needles or tingling 

  • Chills

  • Cough

  • Sweating

  • Shivering

  • Pain in the neck, shoulders and face

  • Unusual dreams

  • Drowsiness

  • Sore throat or stuffy/runny nose

  • Appetite changes

  • Trouble breathing

  • Yawning

  • A general feeling of discomfort

Rare, serious side effects that warrant immediate medical attention include: 

  • Confusion and dizziness

  • Muscle cramps

  • Irregular heartbeat

  • Shortness of breath

  • Headache

  • Thirst

  • Nausea and vomiting

  • Coma

  • Weakness

  • Swelling of the face, ankles or hands

Combining escitalopram with other medications can lead to additional complications. Make sure to tell your healthcare provider about all medications you take, to lessen these drug interaction risks.

It’s important to continue taking escitalopram even when you begin to feel better. Stopping this medication can lead to withdrawal symptoms, so if you decide to go off of escitalopram, your healthcare provider can help you gradually reduce your dosage to minimize these effects.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

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