Can Lexapro Cause Ringing in Ears?
Yes, Lexapro (escitalopram) can cause tinnitus (ringing in the ears), and this is explicitly listed in the FDA drug label as a symptom of discontinuation syndrome when stopping the medication. 1
Direct Evidence from FDA Drug Label
The official Lexapro prescribing information specifically identifies tinnitus (ringing in your ears) as one of the symptoms that can occur with discontinuation syndrome when suddenly stopping the medication 1. This is the most authoritative source confirming the association between Lexapro and ear ringing.
Additional Supporting Evidence
Recent pharmacovigilance data from the FDA Adverse Event Reporting System (FAERS) database analyzing reports from 2004-2023 found a significant association between escitalopram and inner ear signs and symptoms, including tinnitus 2. This real-world post-marketing surveillance data reinforces that tinnitus is a recognized adverse effect of escitalopram.
A separate FAERS analysis (2012-2023) examining drug-related tinnitus across all medications also identified antidepressants, including SSRIs like escitalopram, among drugs associated with tinnitus reports 3.
Clinical Context and Mechanism
The paradox here is important to understand: antidepressants like escitalopram can both cause tinnitus as a side effect AND are sometimes used to treat tinnitus in depressed patients 4. However, current clinical practice guidelines explicitly recommend against routinely using antidepressants for the primary treatment of tinnitus 5.
Key Clinical Considerations
- Timing matters: Tinnitus may occur during treatment or upon discontinuation
- Discontinuation syndrome: If stopping Lexapro, taper slowly rather than stopping abruptly to minimize withdrawal symptoms including tinnitus 1
- Severity varies: The impact on quality of life can range from mild to severe 2
- Not a reason to avoid treatment: While tinnitus is a recognized side effect, it should be weighed against the therapeutic benefits for the primary indication (depression/anxiety)
What to Do If Tinnitus Develops
If a patient on Lexapro develops tinnitus, perform a targeted history and physical examination to rule out other causes 5. Obtain a comprehensive audiologic examination, particularly if the tinnitus is unilateral, persistent (≥6 months), or associated with hearing difficulties 5. Do not automatically discontinue the antidepressant without considering whether the tinnitus is bothersome enough to warrant medication changes versus the risk of undertreating the primary psychiatric condition.