Is Itching a Common Side Effect of Lexapro?
No, itching (pruritus) is not listed among the most common side effects of Lexapro (escitalopram), though it can occur as an uncommon adverse reaction.
Most Common Side Effects
According to the FDA drug label, the most common side effects of Lexapro include 1:
- Trouble sleeping
- Sweating
- Decreased sex drive
- Delayed ejaculation
- Nausea
- Tiredness/sleepiness
- Delayed orgasm or inability to have an orgasm
Itching is notably absent from this list of most common side effects.
Evidence on Pruritus with Escitalopram
Research Findings
A 2021 cross-sectional study examining side effect profiles of SSRIs in a naturalistic setting found that patients treated with escitalopram had significantly higher incidence of pruritus (itching) compared to other SSRIs 2. This suggests that while not among the "most common" side effects, pruritus does occur with escitalopram at a rate higher than some other SSRIs in the same class.
Case Reports
There are documented case reports of escitalopram-induced skin reactions:
- A 2022 case report described escitalopram-induced dermatitis medicamentosa (drug rash) 3
- A 2012 case report documented citalopram (a closely related SSRI) causing subacute cutaneous lupus erythematosus with "strongly itching" erythema 4
Clinical Context
When to Be Concerned
If a patient develops itching on Lexapro, consider:
- Drug-induced cutaneous reaction - May occur with or without visible rash 5
- Timing - Reactions can occur shortly after starting the medication (within days) 4
- Associated symptoms - Look for rash, blisters, fever, or other systemic symptoms that would suggest a more serious reaction 3, 4
Important Caveats
- SSRIs rarely cause dermatological side effects overall 3
- Drug-induced pruritus can occur without visible skin lesions 5, 6
- The FDA label does not list pruritus among common side effects, suggesting it occurs in less than 5% of patients 1
Bottom Line
While itching is not a "common" side effect by FDA standards, it does occur with escitalopram and may be more frequent than with some other SSRIs. If a patient develops significant pruritus, especially with accompanying rash or systemic symptoms, evaluation for drug-induced cutaneous reaction is warranted, though most cases of isolated itching are likely mild and self-limited.