Escitalopram: what it does and how to use it safely

Escitalopram (brand name Lexapro) is a commonly prescribed SSRI used for depression and generalized anxiety disorder (GAD). It boosts serotonin in the brain to help lift mood and reduce worry. You won’t feel a change right away — effects usually build over 2–4 weeks and can keep improving up to 8–12 weeks.

Typical dosing and practical tips

Most adults start at 10 mg once daily. Doctors may lower the start dose to 5 mg for sensitive people or raise it to 20 mg if needed. Take it the same time each day, with or without food. If you miss a dose, take it when you remember unless it’s almost time for the next dose — then skip and continue the schedule. Don’t double up.

Want quicker relief from symptoms? It rarely happens. Talk with your prescriber if you see no improvement after 6–8 weeks or if side effects are strong. Never stop suddenly — tapering over days or weeks is often needed to avoid withdrawal symptoms like dizziness, headache, or electric shock sensations.

Common side effects and red flags

Typical side effects include nausea, dry mouth, drowsiness or trouble sleeping, sweating, and sexual side effects (lower libido or delayed orgasm). Most fade after a few weeks. Serious but rare risks: serotonin syndrome (agitation, fast heartbeat, high fever, tremor), low sodium in older adults, and increased bleeding risk when combined with NSAIDs or blood thinners.

Call your doctor right away for sudden mood changes, suicidal thoughts (especially in people under 25), severe allergic reaction, or symptoms of serotonin syndrome. If you’re older, your doctor may start lower and monitor sodium levels or balance issues.

Watch drug interactions. Don’t combine escitalopram with MAO inhibitors, linezolid, or pimozide. Use caution with triptans, other antidepressants, St. John's wort, blood thinners, and certain antibiotics — these can raise serotonin or bleeding risk. Always tell your provider about all meds and supplements.

Pregnancy and breastfeeding deserve a careful talk. Some people stay on SSRIs while pregnant because untreated depression has real risks. Your doctor will weigh benefits and possible risks with you.

Practical checklist: follow your prescribed dose, take it daily, avoid alcohol or limit it, report mood shifts or worsening symptoms, and don’t stop without guidance. If cost or access is an issue, ask your clinic about generic escitalopram — it’s the same active drug and usually cheaper.

If you have questions about how escitalopram fits your life — sleep, sex, work, or other meds — bring them up with your prescriber or pharmacist. Small changes to timing, dose, or switching drugs can make a big difference in how you feel.