What are the side effects of Lexapro (escitalopram)?

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From the Guidelines

Lexapro (escitalopram) commonly causes side effects including nausea, headache, insomnia, drowsiness, dry mouth, dizziness, and sexual dysfunction (decreased libido, delayed orgasm) 1. These side effects are typically mild to moderate and often improve within the first few weeks of treatment.

Common Side Effects

  • Nausea
  • Headache
  • Insomnia
  • Drowsiness
  • Dry mouth
  • Dizziness
  • Sexual dysfunction (decreased libido, delayed orgasm) More serious but less common side effects include serotonin syndrome (confusion, rapid heart rate, high fever), allergic reactions, unusual bleeding, vision changes, and severe mood changes including suicidal thoughts 1.

Serious Side Effects

  • Serotonin syndrome
  • Allergic reactions
  • Unusual bleeding
  • Vision changes
  • Severe mood changes including suicidal thoughts Weight changes, particularly weight gain, may occur with long-term use.

Special Considerations

  • Weight changes
  • Long-term use Abruptly stopping Lexapro can cause withdrawal symptoms like dizziness, irritability, and "brain zaps," so the medication should be tapered gradually under medical supervision 1.

Withdrawal Symptoms

  • Dizziness
  • Irritability
  • "Brain zaps" Side effects vary between individuals based on factors like dosage, age, and other medications.

Factors Affecting Side Effects

  • Dosage
  • Age
  • Other medications If experiencing concerning side effects, patients should contact their healthcare provider rather than discontinuing the medication on their own.

From the FDA Drug Label

What are the possible side effects of Escitalopram tablets? Escitalopram tablets may cause serious side effects, including all of those described in the section entitled “What is the most important information I should know about Escitalopram tablets? ” Common possible side effects in people who take Escitalopram tablets include: • Nausea • Sleepiness • Weakness • Dizziness • Feeling anxious • Trouble sleeping • Sexual problems • Sweating • Shaking • Not feeling hungry • Dry mouth • Constipation • Infection • Yawning Other side effects in children and adolescents include: • increased thirst • abnormal increase in muscle movement or agitation • nose bleed • difficult urination • heavy menstrual periods • possible slowed growth rate and weight change.

The possible side effects of Lexapro (escitalopram) include:

  • Common side effects:
    • Nausea
    • Sleepiness
    • Weakness
    • Dizziness
    • Feeling anxious
    • Trouble sleeping
    • Sexual problems
    • Sweating
    • Shaking
    • Not feeling hungry
    • Dry mouth
    • Constipation
    • Infection
    • Yawning
  • Side effects in children and adolescents:
    • Increased thirst
    • Abnormal increase in muscle movement or agitation
    • Nose bleed
    • Difficult urination
    • Heavy menstrual periods
    • Possible slowed growth rate and weight change 2.

Note: Lexapro is another name for the drug escitalopram.

From the Research

Side Effects of Lexapro

The side effects of Lexapro, also known as escitalopram, can vary depending on the individual and their medical history. Some studies have investigated the potential side effects of Lexapro, including:

  • Increased risk of suicidality in children and young adults aged 18-24, as noted in the black box warning for SSRIs 3
  • Intense suicidal thoughts and self-harm following escitalopram treatment, although this is considered a rare phenomenon 4
  • No indication that escitalopram provokes suicidal behavior compared to placebo in either major depressive disorder (MDD) or anxiety disorders 5
  • Reduced risk of suicidal behavior in time periods after SSRI-treatment initiation, compared to the 30 days before initiation 6

Specific Side Effects

Some specific side effects of Lexapro that have been reported include:

  • Suicidal thoughts and behaviors, particularly in children and young adults 3, 4
  • Self-harm and intense suicidal thoughts, although these are considered rare 4
  • No fatal suicides during the full treatment period on escitalopram, and no significant difference in suicidal behavior between escitalopram and placebo patients 5

Age-Related Side Effects

The side effects of Lexapro can vary depending on the age of the individual. For example:

  • Children and young adults aged 18-24 may be at increased risk of suicidality 3
  • Adults without certain risk factors do not seem to carry this increased risk of suicidality 3
  • The risk of suicidal behavior declines over treatment time, and is reduced in time periods after SSRI-treatment initiation 6

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Intense suicidal thoughts and self-harm following escitalopram treatment.

Indian journal of psychological medicine, 2011

Research

Escitalopram and suicidality in adult depression and anxiety.

International clinical psychopharmacology, 2005

Research

Selective serotonin reuptake inhibitors and suicidal behaviour: a population-based cohort study.

Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 2022

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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