From the Research
Yes, escitalopram (Lexapro) can cause urinary incontinence as a side effect, though it's not among the most common adverse effects. Escitalopram is a selective serotonin reuptake inhibitor (SSRI) typically prescribed for depression and anxiety disorders at doses ranging from 10-20 mg daily. The medication can affect the nervous system's control of bladder function by altering serotonin levels, which play a role in urinary control. If you experience urinary incontinence while taking escitalopram, you should report this to your healthcare provider promptly. They may consider adjusting your dosage, switching to a different antidepressant, or implementing strategies to manage this side effect. Don't stop taking the medication suddenly without medical guidance, as this could lead to discontinuation symptoms. The incontinence is typically reversible once the medication is adjusted or discontinued. Other urinary side effects that might occur include urinary retention or hesitancy, which represent the opposite problem of difficulty emptying the bladder.
Management of Urinary Incontinence
Some key points to consider in managing urinary incontinence, especially in the context of escitalopram use, include:
- Reporting any symptoms of urinary incontinence to your healthcare provider promptly 1
- Considering adjustments to medication or alternative treatments for depression and anxiety
- Implementing strategies to manage urinary incontinence, such as pelvic floor exercises, which have been shown to improve symptoms and quality of life in patients with urinary incontinence 2, 3, 4
Importance of Recent Evidence
The most recent study on the topic, from 2025, highlights the importance of physical exercises, including pelvic floor training, in managing urinary incontinence in older women 4. This study, along with others 2, 3, supports the use of non-pharmacological interventions to improve symptoms and quality of life. Given the potential for escitalopram to contribute to urinary incontinence, healthcare providers should be aware of these management options and discuss them with patients experiencing this side effect.
Clinical Considerations
In clinical practice, it's essential to weigh the benefits of escitalopram against the potential risks, including urinary incontinence. Healthcare providers should monitor patients for signs of urinary incontinence and be prepared to adjust treatment plans as needed. The reversible nature of escitalopram-induced urinary incontinence, as suggested by the discontinuation of symptoms upon adjustment or discontinuation of the medication, is a critical consideration in managing this side effect 1.