Can you take Lexapro (escitalopram) and Xanax (alprazolam) together?

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Last updated: June 7, 2025View editorial policy

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From the Guidelines

Lexapro (escitalopram) and Xanax (alprazolam) can be taken together under close medical supervision, but this combination requires careful monitoring due to potential risks of increased sedation, dizziness, and cognitive impairment. These medications work differently in the brain - Lexapro is an SSRI antidepressant that increases serotonin levels to treat depression and anxiety disorders over the long term, while Xanax is a benzodiazepine that enhances GABA effects for rapid anxiety relief on a short-term basis. The combination may be prescribed when someone needs both ongoing anxiety/depression management and quick relief from acute anxiety symptoms. According to the clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders 1, caution is advised when starting the second non-MAOI serotonergic drug at a low dose, increasing the dose slowly, and monitoring for symptoms, especially in the first 24 to 48 hours after dosage changes.

Key Considerations

  • The combination of Lexapro and Xanax carries risks, including increased sedation, dizziness, and cognitive impairment.
  • Xanax has addiction potential, so it's typically prescribed for short periods while Lexapro builds effectiveness over several weeks.
  • Never adjust dosages or timing without medical guidance, as improper use could lead to withdrawal symptoms or adverse effects.
  • Always inform your doctor about all medications you're taking to avoid harmful drug interactions, as noted in the guideline for using second-generation antidepressants to treat depressive disorders 1.

Monitoring and Supervision

  • Regular monitoring of patient status, therapeutic response, and adverse effects of antidepressant therapy is crucial, beginning within 1 to 2 weeks of initiation of therapy 1.
  • Patients should be monitored for the emergence of agitation, irritability, or unusual changes in behavior, as these symptoms can indicate that the depression is getting worse.
  • The risk for suicide attempts is greater during the first 1 to 2 months of treatment, and close monitoring is essential during this period.

From the Research

Combination of Lexapro and Xanax

  • The provided studies do not directly address the combination of Lexapro (escitalopram) and Xanax (alprazolam) 2, 3, 4, 5, 6.
  • However, it is known that Lexapro is a selective serotonin reuptake inhibitor (SSRI) used for the treatment of major depressive disorder (MDD) and anxiety disorder 2, 3.
  • Xanax, on the other hand, is a benzodiazepine used for the treatment of anxiety disorders.
  • There is a risk of serotonin syndrome when combining SSRIs with other medications that increase serotonin levels 4.
  • Switching or combining antidepressants, including SSRIs, must be carried out cautiously and under close observation to avoid adverse effects such as serotonin syndrome 5.
  • It is essential to consult a healthcare professional before taking any combination of medications, including Lexapro and Xanax, to discuss potential risks and benefits.

Potential Risks and Interactions

  • The combination of Lexapro and Xanax may increase the risk of adverse effects such as drowsiness, dizziness, and impaired cognitive function.
  • There is also a risk of serotonin syndrome, a potentially life-threatening condition caused by excessive levels of serotonin in the body 4, 5.
  • Healthcare professionals should be consulted to discuss the potential risks and benefits of combining these medications and to determine the best course of treatment.

Importance of Medical Supervision

  • It is crucial to consult a healthcare professional before taking any combination of medications, including Lexapro and Xanax.
  • Medical supervision is necessary to monitor for potential adverse effects and to adjust the treatment plan as needed.
  • Healthcare professionals can provide guidance on the safe use of these medications and help minimize the risk of adverse effects 2, 3, 5.

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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