From the FDA Drug Label
Psychiatric Disorders ... Dreaming Abnormal 3% 2%
Lexapro (escitalopram) can cause abnormal dreaming, which may be related to nightmares. The incidence of abnormal dreaming was 3% in patients treated with escitalopram, compared to 2% in placebo-treated patients 1.
From the Research
Yes, Lexapro (escitalopram) can cause nightmares as a side effect in some people. This selective serotonin reuptake inhibitor (SSRI) antidepressant is commonly prescribed for depression and anxiety disorders, typically at doses ranging from 10-20mg daily. While not everyone experiences this side effect, some patients report vivid dreams or nightmares, particularly during the first few weeks of treatment or after dose adjustments. These sleep disturbances occur because SSRIs alter brain chemistry by increasing serotonin levels, which affects sleep architecture and REM sleep patterns 2.
Key Points to Consider
- The intake and withdrawal of SSRIs, such as Lexapro, may intensify dreaming, which can be experienced in different ways and has the potential to cause nightmares 2.
- If you experience persistent or distressing nightmares while taking Lexapro, it's essential to discuss this with your healthcare provider rather than stopping the medication abruptly.
- Your doctor might suggest taking the medication earlier in the day, gradually adjusting the dosage, or potentially switching to a different medication if the side effect significantly impacts your quality of life.
- Most sleep-related side effects tend to improve over time as your body adjusts to the medication.
Relevant Studies
- A study from 2013 reviewed the impact of antidepressants on dreaming in depressive patients and healthy volunteers, finding that SSRIs can decrease dream recall frequency and may cause nightmares upon intake or withdrawal 2.
- Another study from 2011 focused on the effects of escitalopram on sleep problems in patients with major depression or generalized anxiety disorder, indicating that escitalopram can be beneficial for treating sleep problems in these conditions but did not specifically address nightmares 3.
Clinical Implications
Given the potential for Lexapro to cause nightmares, healthcare providers should monitor patients for this side effect, especially during the initial treatment phase or when adjusting doses. Patients experiencing distressing nightmares should be managed on a case-by-case basis, considering adjustments to their medication regimen to mitigate this side effect while effectively treating their underlying condition.