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Medication guide

Escitalopram (Lexapro): uses, side effects, and what to expect

Medically reviewed by Dr. Iman Yunis, DNP, PMHNP-BC · Last reviewed October 26, 2026

A plain-language guide to one of the most commonly prescribed medications for depression and anxiety.

New patients typically seen within 2–3 days

  • ✓ Plain-language guide
  • ✓ Reviewed by a psychiatric NP
  • ✓ Not a substitute for medical advice

The short answer

Escitalopram (Lexapro) is an SSRI antidepressant approved by the FDA for major depression in adults and teens 12 and up and for generalized anxiety disorder. It is usually taken once a day, and most people notice the full effect after 4 to 8 weeks at a steady dose. Do not stop it suddenly; talk with your prescriber about any change.

Safety first

Before you read

Never start, stop, or change a medication on your own. Talk with your prescriber first. If you have thoughts of harming yourself, call or text 988 now, or call 911 in an emergency.
FDA boxed warning: Antidepressants, including escitalopram, may increase the risk of suicidal thoughts and behaviors in children, teens, and young adults under 25, especially in the first few months and after dose changes. Anyone starting an antidepressant should be watched for new or worsening mood, agitation, or suicidal thoughts.

Uses

What escitalopram is used for

Escitalopram is a selective serotonin reuptake inhibitor (SSRI). It is FDA-approved to treat:

  • Major depressive disorder (depression)
  • Generalized anxiety disorder (GAD)

Your prescriber may also discuss other uses based on your history.

What to expect

How it works and how long it takes

SSRIs increase the availability of serotonin, a brain chemical involved in mood and anxiety. Escitalopram is usually taken once a day, with or without food.

It takes time. Some people notice changes in sleep, energy, or appetite within 1 to 2 weeks, but it may take several weeks to feel the full benefit. Keep taking it as prescribed even if you do not feel better right away, and keep your follow-up visits.

Side effects

Common side effects

These are often mild and may ease over the first few weeks. Tell your prescriber if they bother you or do not go away.

  • Nausea
  • Sexual side effects, such as lower desire or delayed orgasm
  • Drowsiness or trouble sleeping
  • Increased sweating

When to call

Serious side effects: call your prescriber right away

  • New or worsening depression, anxiety, agitation, or thoughts of self-harm
  • Unusual excitement or very high energy
  • Unusual bleeding or bruising
  • Seizures
  • Fever, confusion, fast heartbeat, muscle stiffness, or loss of coordination (possible serotonin syndrome)

For signs of a severe allergic reaction, such as swelling of the face or throat or trouble breathing, call 911.

Cautions

Interactions and who should be careful

  • Do not take with MAO inhibitors, or within two weeks of stopping one
  • Tell your prescriber about other medications that affect serotonin, including other antidepressants, triptans, tramadol, St. John’s wort, and tryptophan
  • NSAIDs such as ibuprofen, naproxen, and aspirin, and blood thinners, may increase bleeding risk
  • Tell your prescriber about a history of bipolar disorder, seizures, bleeding problems, or heart rhythm problems

Pregnancy and breastfeeding

If you are pregnant, planning pregnancy, or breastfeeding

Tell your prescriber if you are pregnant, planning pregnancy, or breastfeeding. Untreated depression and anxiety also carry risks for parent and baby, so the decision is made together with your prescriber and your OB or midwife. Learn about our women’s mental health care.

Stopping

Stopping escitalopram safely

Do not stop escitalopram suddenly. Stopping abruptly can cause discontinuation symptoms such as dizziness, irritability, nausea, tingling sensations, anxiety, and trouble sleeping. Your prescriber can lower the dose gradually if stopping is right for you.

Not working?

When a medication is not helping enough

If escitalopram is not helping, is causing side effects you cannot tolerate, or has stopped working, a thorough review can help. Options may include adjusting the dose, switching medications, adding therapy, or GeneSight® testing to help guide choices.

Dr. Yunis offers medication reviews by video across Washington, and new patients are typically seen within 2–3 days.

FAQ

Common questions about escitalopram

How long does Lexapro take to work?

Some people notice early changes within 1 to 2 weeks, but the full benefit may take several weeks. Your prescriber will check in and may adjust the dose.

Is escitalopram the same as Lexapro?

Yes. Lexapro is the brand name, and escitalopram is the generic medication.

Can I drink alcohol on escitalopram?

Alcohol can worsen depression and anxiety and add to drowsiness. Ask your prescriber what is safe for you.

What if escitalopram is not working?

Do not stop it on your own. Talk with your prescriber about adjusting the dose, switching, adding therapy, or GeneSight testing.

Sources

Where this information comes from

This guide summarizes publicly available drug information from MedlinePlus (U.S. National Library of Medicine). It is general education, not medical advice, and does not cover every use, side effect, or interaction. Always follow the guidance of your own prescriber and pharmacist.

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