From the Guidelines
Escitalopram is associated with several common side effects, including nausea, headache, insomnia, and sexual dysfunction, which are typically mild to moderate and often improve within the first few weeks of treatment 1. The most frequently reported side effects of escitalopram include:
- Nausea and vomiting, which are the most common reasons for discontinuation in efficacy studies 1
- Headache
- Insomnia or drowsiness
- Dry mouth
- Dizziness
- Increased sweating
- Fatigue
- Sexual dysfunction, including decreased libido, delayed ejaculation in men, and difficulty reaching orgasm
- Gastrointestinal disturbances such as diarrhea or constipation These side effects occur because escitalopram increases serotonin levels in the brain, which affects multiple body systems beyond just mood regulation. It is essential for patients to be aware of these potential side effects and to consult their healthcare provider if they are severe or persistent, rather than discontinuing the medication abruptly, as sudden cessation can lead to withdrawal symptoms 1. Starting at a lower dose (typically 5-10mg daily) and gradually increasing if needed can help minimize initial side effects. Taking the medication at the same time each day, either morning or evening depending on individual response, may also help manage side effects. Severe adverse events, such as suicidal behavior, are rare but can occur, particularly in adults aged 18 to 24 years with major depressive disorder (MDD) or other psychiatric indications who receive second-generation antidepressants, including escitalopram 1. However, the risk of suicidal behavior is lower in older adults, and antidepressant use may be protective against suicidal behavior in this population 1. Other severe adverse events, such as seizures, cardiovascular risks, hyponatremia, hepatotoxicity, or serotonin syndrome, are scarce but should be kept in mind when patients are being treated with escitalopram 1.
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 common side effects of escitalopram include:
- Nausea
- Sleepiness
- Weakness
- Dizziness
- Feeling anxious
- Trouble sleeping
- Sexual problems
- Sweating
- Shaking
- Not feeling hungry
- Dry mouth
- Constipation
- Infection
- Yawning In children and adolescents, other side effects may include:
- Increased thirst
- Abnormal increase in muscle movement or agitation
- Nose bleed
- Difficult urination
- Heavy menstrual periods
- Possible slowed growth rate and weight change 2
From the Research
Common Side Effects of Escitalopram
The common side effects of escitalopram, a Selective Serotonin Reuptake Inhibitor (SSRI), include:
- Nausea, which occurred in more than 10% of escitalopram-treated patients 3
- Insomnia
- Ejaculation disorder
- Diarrhea
- Dry mouth
- Somnolence 3
- Sexual side effects, such as delayed ejaculation and absent or delayed orgasm, although escitalopram is reported to have a lower degree of sexual dysfunction compared to other SSRIs 4, 5
- Headache, diarrhea, and nausea are also mentioned as side effects, but are generally not serious 6
Less Common but Significant Side Effects
Less common but significant side effects of escitalopram include:
- Syndrome of inappropriate antidiuretic hormone (SIADH), which is a rare but significant side effect of SSRIs, including escitalopram 6
- Hyponatremia, which has been associated with treatment with other SSRIs, and has been reported in at least one case of escitalopram-induced SIADH 6
Patient-Reported Side Effects
Patient-reported side effects of escitalopram and other SSRIs include: