Is escitalopram (Selective Serotonin Reuptake Inhibitor (SSRI)) associated with diarrhea?

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Last updated: April 27, 2025View editorial policy

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From the Guidelines

Escitalopram can cause diarrhea as a side effect, and if you're experiencing it, you should continue taking the medication as prescribed but consult your healthcare provider. The diarrhea is often temporary and resolves within the first few weeks of treatment as your body adjusts to the medication 1. To manage symptoms, stay hydrated, consider a bland diet (BRAT - bananas, rice, applesauce, toast), and avoid spicy foods, caffeine, and alcohol which may worsen diarrhea. Some key points to consider when managing diarrhea caused by escitalopram include:

  • Staying hydrated to prevent dehydration
  • Avoiding foods that can irritate the stomach or worsen diarrhea
  • Considering over-the-counter medications like loperamide (Imodium) for temporary relief, but using them with caution and not for extended periods without medical advice
  • Monitoring for severe symptoms such as fever, blood in stool, or significant abdominal pain, and contacting your doctor immediately if these occur Escitalopram causes diarrhea by increasing serotonin levels in the gut, which can accelerate intestinal motility and alter fluid balance in the digestive tract 1. It's essential to follow the guidance of your healthcare provider and report any concerns or severe symptoms promptly to ensure the best outcome. Some studies have reported that sertraline had a higher rate of diarrhea than citalopram, which is closely related to escitalopram 1, but the overall approach to managing diarrhea as a side effect remains similar. Given the potential for diarrhea and other side effects, it's crucial to work closely with your healthcare provider to monitor your response to escitalopram and adjust your treatment plan as needed to minimize adverse effects and maximize the benefits of the medication 1.

From the FDA Drug Label

Gastrointestinal Disorders Nausea 15% 7% Diarrhea 8% 5% Constipation 3% 1% Indigestion 3% 1% Abdominal Pain 2% 1%

Diarrhea is a reported adverse reaction in patients taking Escitalopram, with an incidence of 8% compared to 5% in placebo-treated patients 2.

  • The incidence of diarrhea in patients with Major Depressive Disorder was 8% for Escitalopram and 5% for placebo.
  • The incidence of diarrhea in patients with Generalized Anxiety Disorder was also 8% for Escitalopram and 6% for placebo 2. Key points:
  • Diarrhea is a common adverse reaction associated with Escitalopram treatment.
  • The incidence of diarrhea is higher in Escitalopram-treated patients compared to placebo-treated patients.

From the Research

Escitalopram and Diarrhoea

  • Escitalopram is associated with gastrointestinal side effects, including diarrhoea, as reported in a systematic review and meta-analysis 3.
  • The study found that escitalopram and sertraline were the least tolerated antidepressants on the gastrointestinal tract, being associated with all considered side effects except constipation and increased appetite 3.
  • Another study reviewed the use of escitalopram in the management of major depressive disorder in adults, but did not specifically mention diarrhoea as a side effect 4.
  • A review of escitalopram's efficacy, safety, and patient acceptability found that the drug had a predictable tolerability profile with generally mild to moderate and transient adverse events, but did not specifically mention diarrhoea 5.
  • A study examining the prophylactic efficacy of fluoxetine, escitalopram, sertraline, paroxetine, and concomitant psychotherapy in major depressive disorder did not mention diarrhoea as a side effect of escitalopram 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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