Lexapro

( Escitalopram Oxalate )

Medically Reviewed by Harshi Dhingra, M.D.

Last Reviewed: Jun 20, 2022

Warnings

What are the risks of taking Lexapro (escitalopram)?

Lexapro can cause serious health problems, especially in certain high-risk groups.

Suicidal Thinking: In people under the age of 24 years, escitalopram (Lexapro) can increase the risk of suicidal thoughts and behavior. The risk is greatest in the first few months of treatment and after dose changes. Please be vigilant for unusual mood changes or behaviors, especially if a teenager or young adult is taking Lexapro. Call their health care provider immediately if you notice any worsening in mental health symptoms.
Serotonin syndrome: A rare but potentially life-threatening complication of Lexapro, this is a condition in which there are excessive levels of serotonin in the brain. The risk of serotonin syndrome is higher in people who take other drugs that affect serotonin levels, such as other antidepressants, lithium, triptans (medicines used to treat migraines and cluster headaches), and St John’s Wort. This syndrome can include fever, confusion, muscle stiffness and spasms, fast heart rate, and sweating. Seek medical attention right away if you experience any of these symptoms during Lexapro treatment.
Withdrawal: Stopping Lexapro cold turkey can lead to withdrawal symptoms such as nausea, vomiting, dizziness, headache, irritability, nightmares, and paresthesias (abnormal sensations in the skin). Always talk to a healthcare professional if you want to stop taking Lexapro.
Abnormal heart rhythm: Lexapro can cause problems with heart rhythm. Please contact your doctor immediately or go to the emergency room if you experience symptoms such as dizziness, fast heart rate, chest pain, or difficulty breathing. The risk of this occurring is higher in people with pre-existing heart rhythm problems, recent heart attack, liver problems, low magnesium levels, low potassium levels, and those with a family history of heart rhythm problems. The chances of this complication occurring are also higher in people on other drugs that affect heart rhythm.
Increased risk of bleeding: Taking Lexapro can increase your risk of abnormal bruising or bleeding. This is especially true when on other medicines like blood thinners, aspirin, or NSAIDs (Advil, Motrin, Aleve, Naproxen). Call your healthcare provider without delay if you notice unexplained bruises, dark-colored stools, pink or red urine, or bleeding from the nose or gums.
Low sodium: Lexapro can cause low sodium levels in the blood. The symptoms can include confusion, problems with memory and concentration, weakness, and headache. This risk is greater in older individuals, people who are on diuretics (water pills), and those who are dehydrated.
Mania: People with bipolar disorder have alternating depression and mania. If such a person presents initially with depression and is treated with an antidepressant like Lexapro, it can precipitate a manic episode. Call your doctor right away if you have symptoms such as overactivity, overexcitement, euphoria, or delusions.

Your doctor or pharmacist can prescribe other medications to treat anxiety and depression if you are at high risk of Lexapro complications.

What should I tell my doctor before starting Lexapro (escitalopram)?

Tell your healthcare provider about all your medical conditions. Lexapro may not be suitable for people with certain medical conditions. Tell your doctor if you have had a heart attack or stroke. Also, tell your doctor if you have high blood pressure, seizures, bleeding problems, liver, kidney, or heart disease.

Give your doctor a complete list of all your medications, including prescription drugs, over-the-counter medicines, vitamins, dietary supplements, and herbal products, especially products containing St. John’s Wort or tryptophan. This can help avoid serious drug interactions and adverse effects.

Tell your doctor if you have previously had an allergic reaction to escitalopram or citalopram (Celexa) or any active ingredient in Lexapro preparations. Your pharmacy can provide you with a list of ingredients.

Lexapro is a pregnancy category C drug. It means doctors are unsure about its safety during pregnancy. Before starting Lexapro, tell your doctor if you are pregnant, breastfeeding, or plan to become pregnant. Lexapro can cause problems in newborn infants, especially if the mother takes this medication in the last few months of the pregnancy.

Lexapro (escitalopram) can cause a condition called closed-angle glaucoma. This is associated with fluid becoming trapped in the eye, leading to a quick increase in eye pressure. Untreated, this can lead to vision loss. Talk to your doctor about getting an eye exam before starting Lexapro.

What precautions should I take while on Lexapro (escitalopram)?

Keep all your appointments with your doctor and other healthcare providers while on Lexapro to ensure proper medical care is provided. Your doctor may need to change your dose several times to fine-tune your treatment for major depressive disorder and generalized anxiety disorder.

Rarely, people under the age of 24 years experience mental health changes and suicidality on Lexapro. Call your doctor if you notice any unusual behaviors in yourself or anyone in your family who is taking Lexapro.

Lexapro can make you dizzy and drowsy. Do not drive, operate heavy machinery, or do anything that requires focus and attention before knowing how this medicine affects you. Keep in mind that alcohol can add to the drowsiness caused by this medicine.

Please call your doctor if you become pregnant during treatment with Lexapro. This medicine should be used with caution in women who are pregnant or breastfeeding.

Get medical help immediately if you experience symptoms such as nausea, changes in vision, eye pain, or swelling around the eyes. These can be signs of closed-angle glaucoma.

Tell your healthcare providers and dentist that you are on Lexapro before any surgery, including dental surgery.

What are Lexapro (escitalopram) interactions?

Taking Lexapro with certain other medications can affect how well this medicine works. Drug interactions can also increase the risk of serious adverse effects. Your physician may choose a different antidepressant for you, change the dose or frequency of one or both medicines, or monitor you carefully for side effects if there are known interactions between Lexapro and any of your other medicines.

Using Lexapro with the following medications is not recommended:

pimozide (Orap)
MAO inhibitors such as isocarboxazid (Marplan), linezolid (Zyvox), phenelzine (Nardil), tranylcypromine (Parnate), selegiline (Eldepryl, Zelapar, Emsam), and methylene blue. If you have taken these drugs within the last 14 days, you should not take Lexapro.

There can also be interactions between Lexapro and medicines such as:

blood thinners
aspirin and NSAIDs (Motrin, Advil, Aleve, Naproxen)
amphetamine, dextroamphetamine, and methamphetamine (Adderall, Mydayis, Dexedrine, Desoxyn)
carbamazepine (Tegretol)
cimetidine (Tagamet)
water pills
fentanyl (Duragesic, Fentora)
medications used to treat anxiety
medications used to treat seizures
medications used to treat migraine headaches
other SSRIs, SNRIs, and tricyclic antidepressants
sedatives and tranquilizers

This list does not describe all possible Lexapro interactions. Give your healthcare provider a complete list of your medications, including prescription and non-prescription drugs, vitamins and dietary supplements, and herbal remedies. Also, tell your healthcare provider if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription drugs.

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