Missing One Day of Escitalopram 5mg: Clinical Consequences
Missing a single 5 mg dose of escitalopram for one day is unlikely to cause significant clinical consequences or withdrawal symptoms, and you can simply resume your regular dose the next day without adverse effects. 1
Why One Missed Dose Is Generally Well-Tolerated
- Escitalopram has a long half-life of 27-32 hours, meaning the medication remains in your system for an extended period after the last dose, providing a pharmacological buffer against abrupt changes in serotonin levels 2
- The extended half-life ensures that serotonin transporter occupancy remains relatively stable even after missing a single dose, as therapeutic blood levels decline gradually rather than precipitously 3
- At the 5 mg dose, you are at the lower end of the therapeutic range (typical dosing is 10-20 mg daily), which further reduces the likelihood of experiencing discontinuation symptoms from a single missed dose 4, 2
What Discontinuation Syndrome Looks Like (If It Occurs)
While discontinuation syndrome is uncommon after missing just one dose, you should be aware of potential symptoms that typically emerge only with abrupt cessation or multiple missed doses: 1
- Mood and cognitive symptoms: Dysphoric mood, irritability, agitation, anxiety, confusion 1
- Sensory disturbances: Paresthesias (electric shock sensations), dizziness 1
- Physical symptoms: Headache, lethargy, insomnia 1
- Onset timing: These symptoms typically appear after several days of discontinuation, not after a single missed dose 5
Escitalopram has a lower risk of discontinuation syndrome compared to shorter half-life SSRIs like paroxetine or sertraline, making single missed doses even less concerning 4
What You Should Do
- Simply take your next scheduled dose at the regular time—do not double the dose to "make up" for the missed one 1
- If you miss multiple consecutive doses (3+ days), contact your prescriber before resuming, as a more gradual restart may be warranted 1
- Continue monitoring for any unusual symptoms, though they are unlikely at this dose and duration of missed medication 4
Important Caveats
- Patients on higher doses (20 mg) or with longer treatment duration may be more susceptible to discontinuation symptoms, though even in these cases a single missed dose rarely causes problems 4, 6
- Avoid intentionally skipping doses as a pattern, as this can destabilize therapeutic response and increase the risk of symptom recurrence 4
- The FDA label emphasizes that discontinuation symptoms are "generally self-limiting" when they do occur, typically resolving within 1-2 weeks 1