Best Time of Day to Take Lexapro and Other Tips

Lexapro is the brand name of the generic form of escitalopram. Lexapro (escitalopram) belongs to a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). The U.S. Food and Drug Administration (FDA) approved Lexapro to treat generalized anxiety disorder and major depressive disorder in adults and children 12 years and older. Specifically, depression is the FDA-approved indication for adults and children 12 years and older. 

In this article, we will discuss some important tips for taking Lexapro, including the best time to take it, possible side effects, interactions with other medications, and more.

How Lexapro Affects the Brain and Mood

Lexapro (escitalopram oxalate) belongs to a group of antidepressant medications called selective serotonin reuptake inhibitors (SSRIs). 

SSRIs (selective serotonin reuptake inhibitors) work by increasing the levels of a natural chemical called serotonin in the central nervous system. Serotonin plays a key role in mood regulation, mental wellness, sleep, and other vital bodily functions.

Lexapro is available in both brand name and generic form (escitalopram). This medication is available as oral tablets and an oral solution. The usual Lexapro starting dose is 10 milligrams (mg) by mouth once daily. However, the dose can be increased to 20 mg daily for the treatment of depression if the 10 mg-dosage is not effective. 

While the maximum recommended dose of Lexapro is 20 mg daily to treat depression, the dose of Lexapro is higher for the treatment of obsessive-compulsive disorder (OCD). You should always discuss with your doctor before increasing or decreasing the dose of this medication or if you want to stop taking it. 

Lexapro Uses

Lexapro is approved by the U.S. Food and Drug Administration (FDA) to treat: 

• Major depressive disorder (MDD), commonly known as depression, in adults and children 12 years and older

• Generalized anxiety disorder (GAD) in adults

Lexapro may also be used off-label to treat: 

• Panic disorder

• Obsessive-compulsive disorder (OCD)

• Post-traumatic stress disorder (PTSD)

• Eating disorders such as binge eating disorder and bulimia nervosa

• Premenstrual dysphoric disorder (PMDD) 

• Insomnia

• Vasomotor symptoms of menopause, such as hot flashes and night sweats

• Prevention of depression in stroke survivors

Off-label prescribing of medications is a very common practice. A 2006 study revealed that about 1 in 5 prescriptions for commonly prescribed medications are for off-label uses.  

Best Time of Day to Take Lexapro

Is it better to take Lexapro in the morning or at night?

You can take Lexapro either in the morning or at night based on your personal preference and side effects. This medicine is usually taken once a day, with or without food. 

If Lexapro makes you sleepy, it may be better to take it at night. If Lexapro does not cause sleepiness or drowsiness, you can take it in the morning. Make sure you take Lexapro around the same time every day for the best results. 

Advantages of taking Lexapro in the morning

• Some people have sleep problems with Lexapro and other SSRIs, and taking Lexapro at bedtime can cause insomnia. If you experience trouble sleeping on Lexapro, taking the medicine in the morning may help. 

• In many cases, it is believed that taking Lexapro in the morning can help to regulate mood and energy levels throughout the day since the medication can reach its peak of effectiveness during the day.

Benefits of taking Lexapro at night

• If Lexapro causes drowsiness and dizziness, taking the medicine at night can minimize these side effects during the daytime.

• The sedative effects of Lexapro can enhance sleep in some people.

How to switch Lexapro from night to morning?

If you have been taking Lexapro at night and experience insomnia, you may want to consider switching to a morning Lexapro dose. To do this, choose a day that you’d like to make the switch. Skip your Lexapro dose that night and take it the next morning and every morning thereafter.

Does Lexapro Work Better at Night or in the Morning?

Sedative Effects of Lexapro May Improve Sleep

Some randomized controlled trials have found that perimenopausal and postmenopausal women with hot flashes benefit from Lexapro. By improving vasomotor symptoms, Lexapro may improve sleep quality in postmenopausal women. Lexapro has also been found to reduce sleep problems in some people with major depressive disorder and generalized anxiety disorder, which makes sense since depression and anxiety can cause sleep problems. As a result, improved mood and anxiety will come with better sleep quality. 

Lexapro May Cause Insomnia as a Side Effect

If you are experiencing sleep problems after starting Lexapro, your insomnia may be a side effect of the antidepressant medication. However, remember that approximately 75% of adults with depression symptoms also suffer from insomnia. Therefore, your trouble sleeping may be due to your depressed mood or anxiety. 

Side Effects of Lexapro

Common side effects of Lexapro include:

• Gastrointestinal symptoms like nausea, diarrhea, and constipation

• Dry mouth, increased thirst, increased sweating 

• Insomnia

• Drowsiness

• Dizziness

• Unusual tiredness

• Yawning

• Shaky feelings or increased muscle movements

• Weight changes (weight gain or weight loss)

• Runny nose, sneezing, flu-like symptoms

• Decreased sex drive

• Impotence in men

Seek immediate medical attention if you develop signs and symptoms of an allergic reaction or serotonin syndrome (see below). Call the National Poison Control Center at  1-800-222-1222 or go to the nearest emergency room in case of an overdose.

Does Lexapro cause weight gain?

Weight changes are a possible side effect of Lexapro. Some people can gain weight on this medicine, while others might lose weight. Weight changes can also occur indirectly if you begin to eat more as your anxiety and depression ease. Eating a healthy diet and getting regular exercise can help offset any weight changes caused by Lexapro.

Practical Tips: How do I get the best results from Lexapro?

Best Time of Day to Take Lexapro

You can take Lexapro in the morning or evening. If you are having trouble sleeping while taking this medicine, it may help to take it in the morning. On the other hand, if you experience drowsiness or sleepiness, taking Lexapro at bedtime can help with this problem. (Find out: How Much Sleep Do You Need Each Night?)

Consistency

To get the best outcomes, you should take Lexapro (generic drug escitalopram) regularly as prescribed. You may notice some improvement in your symptoms after 1-2 weeks. However, it can take 4 weeks or longer for Lexapro to have its full effects. Tell your doctor if you notice worsening symptoms of depression during Lexapro (escitalopram) treatment. Do not stop taking escitalopram suddenly—this can lead to withdrawal symptoms.

Dosing

Take Lexapro at the prescribed dose only. Do not take a higher or lower dose or take it more or less frequently than prescribed. Changing the dose of prescription drugs without medical oversight can cause serious side effects. 

Missed Dose

If you miss a dose of Lexapro, take it as soon as you remember. However, if it is nearly time for your next dose, skip the missed dose and take the next dose according to your regular dosing schedule. Do not take a double dose or extra medicine to make up for a missed dose.

Warnings and Risks: What Should I Avoid While Taking Lexapro?

Hazardous Activities

Lexapro can make you dizzy and drowsy and affect your movements, thinking, and judgment. Do not drive, operate machinery, or do any activity that requires focus and mental alertness until you know how this medication affects you. Remember, if you drink alcohol, it can worsen the side effects Lexapro causes.

Medical Conditions

Lexapro may not be suitable for people with certain medical conditions. Tell your healthcare professional if you have or are at an increased risk of:  

• Heart disease

• Liver disease

• Kidney disease

• Recent stroke

• High blood pressure

• Glaucoma

• Seizures

• Sexual dysfunction

• Bleeding disorders

• Suicidal thoughts

• Drug addiction or misuse of pain medications

Screening for Bipolar Disorder

Bipolar disorder can initially present with depressive symptoms. Starting Lexapro in bipolar patients may trigger mixed or manic episodes. Your healthcare provider will perform a screening for bipolar disorder before giving you antidepressant medication.

Drug Interactions

Lexapro can interact with other medications and cause serious adverse effects. Drug interactions can reduce the efficacy of medications or intensify their side effects. 

Lexapro can make you drowsy. Therefore, combining Lexapro with other medications that can also make you sleepy can worsen the sedative effect. Examples include sleeping pills, muscle relaxers, opioid pain medicines, and seizure treatment. 

You should not take Lexapro if you have taken any monoamine oxidase inhibitors (MAOIs) in the past 14 days. MAOIs are serotonergic drugs that can raise serotonin levels in the body. Examples of MAO inhibitors are isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Emsam), and tranylcypromine (Parnate). Linezolid is an MAO inhibitor that is used to treat infections. 

Avoid taking Lexapro if you are taking citalopram (Celexa) or pimozide — this is also applied to other SSRIs, SNRIs (serotonin and norepinephrine reuptake inhibitors), and any serotonergic agents (any medications that can increase the serotonin levels).  

Other possible drug interactions with Lexapro (generic drug escitalopram) include:

• Aspirin and other NSAIDs (ibuprofen, naproxen)

• Migraine medications

• Diuretics (water pills)

• Anticoagulants (blood thinners) such as warfarin

• Supplements such as St. John’s Wort and tryptophan

This list does not contain all the possible interactions with Lexapro. Give your doctor a complete list of your medications, including prescription medications, over-the-counter products, and herbal supplements to avoid potentially dangerous drug interactions.

Serotonin Syndrome

Serotonin syndrome is a rare but potentially life-threatening condition in which there is too much serotonin in the body. Taking Lexapro with other antidepressants can increase the risk of increased serotonin levels. Signs and symptoms of serotonin syndrome include fever, confusion, fast heart rate, sweating, muscle spasms or stiffness, agitation, hallucinations, nausea, vomiting, and diarrhea. Seek emergency medical care if you develop these symptoms. 

Withdrawal Symptoms

Do not stop Lexapro antidepressant therapy suddenly—this can lead to withdrawal symptoms. Ask your doctor how to lower the dose of Lexapro slowly. Remember, it can take 4 weeks or more to get the full benefits of Lexapro. Talk to your doctor if you do not notice any improvement in your mood after several weeks.

Suicidal Thoughts

People taking antidepressant medications, especially young adults between the age of 18 and 24, can develop suicidal thinking and actions. Children under 18 are also at risk. Call your doctor immediately if you notice any unusual changes in mood or suicidal thoughts. Make sure your family members know to contact your doctor if you are unable to seek care for yourself.

Use During Pregnancy

A meta-analysis evaluating the use of SSRIs during pregnancy found that there is an increased risk of persistent pulmonary hypertension in newborns with maternal SSRI use during pregnancy. This meta-analysis looked at the maternal use of all SSRIs, not just Lexapro specifically. 

The results of this meta-analysis revealed that there is an association between SSRI use during pregnancy and the risk of persistent pulmonary hypertension in newborns. However, the authors also pointed out that the clinical significance of this finding is modest and that the benefits of treating depression during pregnancy likely outweigh this risk. 

If you get pregnant while taking an antidepressant, you should let your doctor know right away; never stop taking an antidepressant without discussing it with your doctor first. Similarly, talk to your doctor if you are breastfeeding or plan to breastfeed.