Can escitalopram (Lexapro) cause night sweats?

Night Sweats as a Side Effect of Escitalopram

Yes, escitalopram (Lexapro) can definitely cause night sweats, which is a well-documented side effect of selective serotonin reuptake inhibitors (SSRIs). The FDA drug label for escitalopram specifically lists sweating as a common side effect, occurring in approximately 5% or more of patients taking the medication 1.

Mechanism and Prevalence

Night sweats occur due to the serotonergic effects of escitalopram on thermoregulation in the central nervous system. SSRIs like escitalopram affect both serotonergic and noradrenergic pathways that regulate body temperature and sweating 2.

• Sweating is listed among the "common possible side effects" in the FDA-approved medication guide for escitalopram 1
• The incidence of increased sweating with escitalopram is approximately 5% in patients with major depressive disorder, which is significantly higher than the 2% observed with placebo 1
• Night sweats can begin shortly after starting the medication or may develop after months of treatment

Management Options

If you're experiencing night sweats from escitalopram, several approaches can be considered:

1. Dose adjustment:

   • Lower doses of escitalopram may reduce sweating while maintaining therapeutic effect
   • Consider discussing with your healthcare provider about reducing the dose if symptoms are bothersome

2. Timing of medication:

   • Taking escitalopram in the morning rather than evening may help reduce nighttime sweating for some patients

3. Pharmacological interventions:

   • Alpha-adrenergic blockers may reduce night sweats in patients taking SSRIs 3
   • Mirtazapine has been reported to reduce SSRI-induced excessive sweating in a dose-dependent manner 4

4. Environmental modifications:

   • Sleeping in a cooler room
   • Using moisture-wicking bedding and sleepwear
   • Avoiding spicy foods, caffeine, and alcohol before bedtime

5. Medication switch:

   • If night sweats are severe and intolerable, switching to a different antidepressant with lower rates of sweating may be considered
   • Mirtazapine is noted to have a lower incidence of sweating as a side effect 5

Important Considerations

• Don't stop medication abruptly: Discontinuing escitalopram over 10-14 days helps limit withdrawal symptoms 5
• Evaluate for other causes: While escitalopram is a likely cause, other conditions that can cause night sweats should be ruled out if symptoms are severe or accompanied by other concerning symptoms
• Risk-benefit assessment: The benefits of treating depression or anxiety with escitalopram may outweigh the discomfort of night sweats for many patients

When to Contact Your Healthcare Provider

Contact your healthcare provider if:

• Night sweats are severe or significantly affecting sleep quality
• You experience other concerning symptoms alongside night sweats
• You're considering stopping or changing your medication

Night sweats, while uncomfortable, are generally not dangerous and may improve over time as your body adjusts to the medication. However, if they remain problematic, your healthcare provider can help you explore the management options outlined above.