Escitalopram Summary
Managing the Side Effects of Oral Escitalopram Tablets: A Guide
Escitalopram oxalate (Lexapro) is a ** generic ** prescription medication used to address:
- generalized anxiety disorder in adults
- major depressive disorder in adults and children aged 12 and above
Escitalopram is available as an oral tablet and an oral solution; this article focuses on the side effects associated with the tablet form. For more information regarding the oral solution, consult your healthcare provider.
If your treatment with escitalopram proves successful, your doctor might recommend continuing the medication long-term. Like other medications, escitalopram can have side effects.
Below, you'll find details about potential common, mild, and serious side effects. For a general overview of escitalopram, refer to ** this article **. Your doctor can provide further insight.
Escitalopram: More Common Side Effects
Certain side effects may arise when taking escitalopram, some being more prevalent than others. These side effects can be temporary, lasting between a few days and weeks. However, if they persist or worsen, be sure to communicate with your doctor or pharmacist.
Some common side effects observed during clinical trials include:
- fatigue
- somnolence (drowsiness or tiredness)
- insomnia
- excessive sweating
- sexual side effects*
- nausea*
Escitalopram: Mild Side Effects
Mild side effects can occur while using escitalopram. The list below does not encompass all possible mild side effects. For more information, consult escitalopram’s prescribing information.
Mild side effects associated with escitalopram include:
- fatigue
- somnolence (drowsiness or tiredness)
- insomnia
- excessive sweating
- dry mouth
- constipation
- sexual side effects*
- nausea*
- diarrhea*
- headache*
- mild allergic reaction*
These side effects may be temporary, lasting between a few days and weeks. However, if they persist or worsen, contact your doctor or pharmacist.
Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you develop a side effect while taking escitalopram and wish to share it with the FDA, visit MedWatch*.
Escitalopram: Serious Side Effects
Escitalopram may cause serious side effects. The list below may not encompass all possible serious side effects of the drug. For more information, consult escitalopram’s prescribing information.
If you encounter serious side effects while taking escitalopram, contact your doctor immediately. If the side effects seem life-threatening or you suspect a medical emergency, call 911 or your local emergency number.
Serious side effects reported and their symptoms include:
- Serotonin syndrome (a condition caused by high levels of the chemical serotonin). Symptoms can include:
- fever
- elevated heart rate
- dizziness
- tremors (shaking)
- seizure
- hallucinations (seeing or hearing things that aren't there)
- fluctuations in blood pressure
- Hyponatremia (low sodium levels). Symptoms may include:
- confuseness
- weakness
- difficulty concentrating
- headache
- memory problems
- instability and falling
- Mania or hypomania, periods of heightened energy levels. Symptoms may include:
- racing thoughts
- increased talkativeness or speaking rapidly
- impulsive behaviors, such as excessive spending
- Seizure. Symptoms may include:
- staring off into space or blinking quickly
- loss of consciousness
- involuntary body movements
- Increased bleeding and bruising. Symptoms may include:
- increased bleeding or frequent bruising
- prolonged bleeding, such as from the nose or gums
- blood in urine, stools, or vomit
- Suicidal thoughts and behaviors in young people.*
- Severe allergic reaction.†
Escitalopram: Side Effects in Children
Escitalopram is approved for use in children aged 12 and above to treat major depressive disorder (MDD). During clinical trials, children experienced side effects similar to those in adults. Additionally, they reported back pain, nasal congestion, and vomiting.
Importantly, it should be noted that these side effects were observed in children aged 6 to 17 years, who were taking the drug for MDD. Whether these side effects are specifically prevalent in children over 12 is unknown. Escitalopram is not approved for use in children under 12. The safety of escitalopram for this age group is undetermined.
If you have questions about how escitalopram may affect your child, consult their doctor.
Escitalopram: FAQs about Side Effects
Escitalopram may cause various side effects. Below, you will find answers to frequently asked questions about the drug's side effects.
Usually, side effects of escitalopram can be more intense with higher dosages. In clinical trials, the most common mild side effects of escitalopram were more prevalent in individuals consuming 20-mg tablets compared to those consuming 10-mg tablets. (For more information about these common side effects, refer to the "Escitalopram: Mild side effects" section above.)
Higher dosages of this drug may also escalate the risk of severe side effects in individuals with liver or kidney issues. This is because escitalopram is metabolized by the liver, and the remaining substance is eliminated from the body through the kidneys. As a result, if these organs are not functioning properly, the drug can accumulate in the body and enhance the risk of severe side effects.
Side effects of escitalopram, such as hyponatremia (low sodium levels), might be more pronounced in the elderly. This is because older adults may be more sensitive to medication effects, including escitalopram.
If you have concerns about the side effects you might experience with your escitalopram dosage, consult your doctor or pharmacist.
Is weight gain or weight loss a side effect of escitalopram?
There's a possibility that escitalopram could cause weight gain or weight loss as a side effect. In clinical trials of escitalopram, there were no reports of weight loss. However, there have been reports of weight loss since the drug became available for use. Weight gain was seldom reported as a side effect in clinical trials. It's unclear if escitalopram directly causes weight changes or how frequently it does.
Children taking selective serotonin reuptake inhibitors (SSRIs), including escitalopram, may experience weight loss during treatment. This weight loss can also result in delayed growth. For this reason, your child's doctor will closely monitor your child's weight and growth during escitalopram treatment.
Weight gain or loss can also be a symptom of major depressive disorder (MDD) or generalized anxiety disorder. Changes in weight can occur due to symptoms of these conditions, such as changes in appetite or physical activity level.
If you're concerned about weight changes while taking escitalopram, discuss this with your doctor. They can propose ways to maintain a healthy weight for you.
What escitalopram side effects can I expect in the first week of treatment and long term?
During the first week of escitalopram treatment, you may experience side effects more frequently than in subsequent weeks. These side effects are usually mild. The frequency of these side effects may decrease over time as your body gets accustomed to the medication.
If you're taking escitalopram to treat MDD, your depression may worsen at the start of treatment. This is more likely to occur in children and young adults up to 24 years old. If you experience bothersome side effects or if they persist, talk to your doctor. They can discuss with you ways to alleviate these side effects. They can also help determine if other treatment options would be more suitable for you.
Escitalopram: Side effect specifics
Learn more about some of the side effects that escitalopram may cause. To find out how often side effects occurred in clinical trials, refer to the prescribing information for escitalopram.
Suicidal thoughts and behaviors in young people
Escitalopram carries a boxed warning for suicidal thoughts and behaviors in young people. This is a serious notification from the Food and Drug Administration (FDA).
Signs of suicidal thoughts or behaviors include:
- worsening depression or anxiety
- thoughts of harming oneself
- aggressiveness
- feeling agitated or irritable
- behaviors and feelings that aren't typical for you
In brief-term studies, people ages 24 years and younger who were taking antidepressants had an increased risk of suicidal thoughts and behaviors. (Escitalopram is a type of antidepressant.) It's unclear whether the antidepressants caused the increased risk or if there were other factors. For example, depression and certain other mental health conditions also increase the risk of suicidal thoughts and behaviors.
What you can do
If you have thoughts of harming yourself while taking escitalopram, call 911 or your local emergency number. Or tell your doctor right away.
It's important to watch for signs of worsening depression, such as those listed above. It can take several weeks to notice whether escitalopram is easing your symptoms. So, it's important to have support during this time. Those close to you can also help you watch for these signs.
Before starting escitalopram treatment, talk with your doctor about your medical history, including if you've ever had suicidal thoughts or behaviors. If you are under 24 years old or if your child is prescribed escitalopram, the doctor will discuss the risks and benefits of taking the drug.
- Decreased sexual desire (less interest in sexual activity)
- Impotence (inability to achieve or maintain an erection)
- Delayed climax (needing more than 30 minutes of sexual stimulation to reach orgasm)
Sexual side effects can affect women as well, including:
- Inability to reach orgasm (anorgasmia)
- Decreased sexual desire
What you can do
Discuss sexual side effects you're experiencing while taking escitalopram with your doctor. Various factors, including medical conditions, treatments, and lifestyle habits, can cause sexual side effects. Your doctor may be able to determine if escitalopram is causing the side effects and suggest ways to reduce them or improve your sexual satisfaction.
Nausea
Nausea is a common side effect of escitalopram. It was observed in clinical trials for both Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD). People taking 20-mg escitalopram doses reported nausea more frequently than those on 10-mg doses. However, most individuals were able to tolerate this side effect. Some people chose to discontinue the medication due to nausea.
Nausea can also be a symptom of a potentially serious side effect called serotonin syndrome, which can be deadly if left untreated. To learn more, see the “Escitalopram: Serious side effects” section above.
What you can do
If you're experiencing bothersome nausea or if it doesn't go away, consult your doctor. They can determine if escitalopram is the cause and may recommend a lower dose or alternative treatment options.
Diarrhea
Diarrhea is a common side effect of escitalopram, observed in clinical trials for both MDD and GAD. People taking 20-mg doses reported this side effect more frequently than those on 10-mg doses.
Diarrhea can also be a symptom of serotonin syndrome, which can be fatal. For more details, see the “Escitalopram: Serious side effects” section above.
What you can do
If you're experiencing severe or persistent diarrhea, speak with your doctor. They can help determine its cause and may suggest reducing your dose or exploring alternative treatment options.
Headache
Headache is a common side effect reported in clinical trials of escitalopram for people with GAD. However, it wasn't observed in clinical trials of the drug for MDD. Headaches with escitalopram are generally considered mild.
Headaches might also be a symptom of a potentially serious side effect called hyponatremia (low sodium levels in your body). This side effect is more common in older adults. For other symptoms of hyponatremia, see the “Escitalopram: Serious side effects” section above.
What you can do
Disclose bothersome or persistent headaches to your doctor. They can help determine if hyponatremia or other conditions are responsible and recommend ways to alleviate your headaches, such as over-the-counter pain medications like ibuprofen.
Allergic reaction
An allergic reaction is a possible side effect of escitalopram, although it wasn't reported in clinical trials. It has been observed after its release and the frequency is unclear.
Symptoms can range from mild to severe, including:
- Skin rash
- Itching
- Flushing
- Swelling under the skin (especially in the eyelids, lips, hands, or feet)
- Swelling of mouth, tongue, or throat, which could make it difficult to breathe
What you can do
For mild symptoms of an allergic reaction, contact your doctor right away. They may suggest measures to alleviate your symptoms and determine if you should continue taking escitalopram. If your symptoms are severe and you believe you're experiencing a medical emergency, immediately call 911 or your local emergency number.
Help is available
If you or someone else is dealing with feelings of suicide or self-harm, please seek help:
- Call or text the 988 Lifeline at 988 or chat at 988lifeline.org. You'll be connected with caring counselors available for free and confidential support 24/7.
- Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
- Visit Befrienders Worldwide to find a helpline in your country.
- Contact 911 or your local emergency services number if you feel safe to do so.
If calling on behalf of someone else, stay with them until help arrives. If it's not possible to be in the same household, stay on the phone with them until help arrives.
This medication, escitalopram, carries a warning for an elevated risk of self-destructive thoughts and actions in young individuals. This is a serious caution issued by the Food and Drug Administration (FDA). For further details, check out the "Escitalopram: Side effect details" section above.
Additional precautions
It's crucial to discuss your medical background with your doctor before taking escitalopram. Escitalopram might not be the appropriate treatment for you if you have specific health conditions or factors that impact your health. These are referred to as drug-condition or drug-factor interactions. The health conditions and factors to consider are:
Narrow-angle glaucoma. If you suffer from glaucoma, share this information with your doctor before initiating escitalopram therapy. Escitalopram can potentially intensify the risk of a sudden, serious exacerbation of glaucoma, causing blurry vision and severe eye pain. Your doctor will assess whether escitalopram is suitable for you.
Liver or kidney issues. If you have liver or kidney problems, inform your doctor before starting escitalopram. They might reduce your dosage or suggest an alternative option. They will closely monitor you for side effects during your treatment.
Seizures. Escitalopram may increase the likelihood of seizures while being administered. If you've experienced seizures in the past, inform your doctor. They will help determine if escitalopram is compatible with your health.
Bipolar depression or mania. Prior to starting escitalopram, make sure to inform your doctor if you have a bipolar disorder. Escitalopram may increase your risk of experiencing mania or hypomania if you have this condition. Your doctor can help determine if escitalopram is safe for you to take.
Low blood pressure. Share your history of low blood pressure or consumption of blood pressure medications called diuretics with your doctor. Escitalopram might cause hyponatremia, which can worsen with certain factors, such as low blood pressure or diuretic use.
Drug interactions. Escitalopram may interact with numerous drugs. (For detailed information, see this article.) This may increase your risk of side effects or intensify existing side effects. Discuss all your prescription drugs and over-the-counter products with your doctor before commencing escitalopram treatment.
Allergic reactions. If you've had an allergic reaction to escitalopram, citalopram, or any of their components, your doctor is unlikely to prescribe escitalopram to you. Using escitalopram could result in another allergic reaction. Seek alternative treatment options from your doctor.
Escitalopram and alcohol
There are no documented interactions between escitalopram and alcohol. Nonetheless, the drug manufacturer suggests abstaining from alcohol during escitalopram treatment. This is due to the potential for both substances to induce similar side effects, such as:
- drowsiness
- insomnia
- nausea
- fatigue
- issues with motor coordination
Ingesting alcohol while taking escitalopram might intensify these side effects.
Should you wish to drink alcohol, consult your doctor about the safety of doing so while on escitalopram.
Pregnancy and breastfeeding while using escitalopram
The safety of utilizing escitalopram during pregnancy remains unclear. However, certain selective serotonin reuptake inhibitors (SSRIs) have been examined during pregnancy. (Escitalopram belongs to the SSRI family.)
Studies revealed that children born to individuals consuming an SSRI during pregnancy experienced more complications postpartum than those who did not. These complications were more prevalent when an SSRI was used during the third trimester of pregnancy than in earlier trimesters.
Complications include:
- breathing problems
- alterations in muscle tone
- tremors (shakes) or jitters
- feeding difficulties
- pulmonary hypertension (a lung condition causing low oxygen levels in the body)
If you're taking escitalopram during pregnancy, consider enrolling in the National Registry for Antidepressants. This registry collects data on a drug's effects when used during pregnancy, assisting researchers in understanding the safety of escitalopram and other antidepressants during pregnancy. You can report any side effects or complications associated with taking escitalopram during pregnancy at the registry's website or by calling 844-405-6185.
The safety of utilizing escitalopram while breastfeeding is not fully established. Escitalopram gets transferred into breast milk. There have been rare reports of unwanted side effects in breastfed infants, such as poor feeding, insufficient weight gain, excessive sleepiness, and agitation.
If you are pregnant, breastfeeding, or considering either, discuss the pros and cons of taking escitalopram with your doctor. They will be able to discuss the potential risks and benefits with you.
Misuse of escitalopram
It's highly unlikely that escitalopram usage will prompt misuse. Misuse refers to employing a drug in an unprescribed manner or for unintended purposes.
Nevertheless, ingesting an excessive amount of escitalopram can result in severe side effects. These may include nausea, vomiting, dizziness, seizures, and variations in heart rate or heart rhythm. Occasionally, these effects can be life-threatening.
If you or someone else has consumed more escitalopram than recommended, keep a close eye out for the mentioned symptoms. Consider calling 911 or your local emergency number if you suspect a medical emergency.
If you have queries related to escitalopram misuse, discuss them with your physician.
When to consult your doctor
Mild escitalopram side effects are common, but some serious side effects may arise and warrant medical attention. Consult your doctor about how to reduce your risk or prevent these side effects.
Before commencing escitalopram treatment, engage in a discussion with your doctor regarding any past instances of suicidal tendencies or actions. Escitalopram has been associated with an increased risk of suicidal thoughts and actions in adolescents. This is a significant concern raised by the Food and Drug Administration (FDA). For further information, refer to the "Escitalopram: Side effect specifics" section above.
If you wish to gather more insights about escitalopram, engage in a conversation with your doctor or pharmacist. They can offer clarification on any side effects related to the medication. Additionally, they can provide information regarding Lexapro, the brand-name alternative to escitalopram.
While a generic drug and its brand-name equivalent share the same active component, they are anticipated to have similar side effects. To access additional information on escitalopram and Lexapro, refer to the following articles:
- Further information about escitalopram. For additional details on various aspects of escitalopram, consult this article.
- Dosage. To learn about Lexapro's dosage, visit this article.
- Drug comparison. Find out how escitalopram compares to citalopram and sertraline.
- Insights into your condition. For details about your condition, refer to our anxiety hub or depression hub.
Disclaimer:Medical News Today has taken every possible measure to ensure that all information is accurate, comprehensive, and up-to-date. However, this article should not be used as a substitute for a healthcare expert's knowledge and advice. Always consult your physician or another healthcare professional before taking any medication. The drug information provided here is subject to change and is not intended to cover all possible uses, dosages, precautions, warnings, drug interactions, allergic reactions, or side effects. The absence of warnings or other information for a specific drug does not suggest that the drug or drug combination is safe, effective, or appropriate for all patients or for all specific uses.
In some rare cases, the use of escitalopram may lead to an unintended side effect:
- There have been reports of anthrax contamination in escitalopram tablets manufactured in certain regions. While the risk of contracting anthrax is extremely low, it is essential to inform your healthcare provider if you suspect any unusual symptoms following the intake of escitalopram, such as fever, sweats, muscle aches, and fatigue.
Although not directly related to escitalopram's side effects, the medication may also have an impact on a person's mental state, including:
- Despite the drug's effectiveness in treating major depressive disorder and generalized anxiety disorder, individuals undergoing escitalopram therapy might experience suicidal thoughts or behaviors, especially young people under 24 years old. Utilize the National Suicide Prevention Lifeline (1-800-273-8255 in the US) or consult with your healthcare provider if you or someone close to you are experiencing such thoughts.
