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Lexapro (escitalopram) is an antidepressant medication used to treat depression and anxiety disorders. While Lexapro is unlikely to interact with most substances, it can cause an increased risk of serotonin syndrome if used alongside serotonergic medications and substances. It is important to be aware of Lexapro interactions and symptoms to ensure safe use and effective treatment.
- Lexapro (escitalopram) is an antidepressant medication that impacts serotonin levels in the brain.
- Most substances do not interact with Lexapro, but serotonergic substances, such as other antidepressants, can interact and cause an increased risk of serotonin syndrome.
- Lexapro should be taken as prescribed, and any medications taken concurrently should be discussed with a doctor to ensure that the treatment is effective and to reduce the risk of adverse effects and drug interactions.
Lexapro and how it affects the brain
Lexapro (escitalopram) is an antidepressant medication classed as a selective serotonin reuptake inhibitor (SSRI). It is used to treat depression and anxiety disorders and works by affecting the level of serotonin in the brain. [1]
Serotonin is a neurotransmitter involved in several functions, including the regulation of mood, appetite, sleep, and stress response. Lexapro is a highly selective SSRI, and it prevents the reuptake of serotonin, thus causing an increase in serotonin levels in the brain. [2]
Polysubstance use and Lexapro
Certain medications and substances can interact with Lexapro, which can result in adverse effects or a change in the effectiveness of the medication. Before starting Lexapro treatment, ensure that the prescribing doctor is aware of any other medications, treatments, or substances that are currently being used. It may be necessary to wait before commencing treatment, utilize an alternative treatment option, or alter Lexapro doses.
The effectiveness of medications can be impacted by polysubstance use. This can mean that people using Lexapro treatment do not experience the full extent of the mental health benefits of the medication and are, therefore, at risk of worsening symptoms.
Additionally, people who are in recovery may need to consider Lexapro interactions. Lexapro might be used to manage mental health symptoms associated with or occurring concurrently with addiction issues. Unmanaged mental health symptoms might contribute to a relapse. Treatment providers can tailor treatments to individual needs to help prevent Lexapro interactions and ensure treatment is appropriate and effective.
Common medications that interact with Lexapro
While Lexapro is found to have a low potential for drug interactions, the serotonergic effects of Lexapro can be increased by certain medications, which can increase the risk of serotonin syndrome. [1][3] Serotonin syndrome is a potentially life-threatening condition caused by excessive amounts of serotonin in the brain, which may require hospital treatment. It can cause many physical, psychological, and cognitive symptoms, including confusion, fever, high temperature, agitation, changes in mental state, shaking, and muscle rigidity. [4]
Medications that can increase the risk of serotonin syndrome when combined with Lexapro include: [1][2][5]
- Antidepressants, such as monoamine oxidase inhibitors (MAOIs) (Lexapro should not be used within 14 days of MAOI treatment), other SSRIs, serotonin and norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs)
- Prescription stimulants, such as amphetamines and methylphenidate
- Prescription opioids, such as hydrocodone, tramadol, fentanyl, and buprenorphine
- Triptans for migraine treatment, such as almotriptan, naratriptan, and eletriptan
- Lithium
Pimozide, a medication used to treat tics associated with Tourette Syndrome, should not be taken with Lexapro, as this combination can cause serious issues with cardiac functioning. [1]
Other substances and supplements
Lexapro (escitalopram) can interact with a range of substances—from alcohol and cannabis to illicit drugs and herbal supplements. These interactions may increase the risk of side effects, reduce the effectiveness of treatment, or trigger serious health conditions like serotonin syndrome. Below is a breakdown of how Lexapro may interact with various substances and what to watch out for.
Lexapro and alcohol
Using alcohol while taking Lexapro is not recommended. Alcohol has a depressant effect on the central nervous system (CNS). This combination can worsen some side effects of Lexapro, including dizziness and drowsiness, which can cause an increased risk of accidental harm. Additionally, combining Lexapro and alcohol may cause some impairments in thinking, concentration, and judgment. [6]
Lexapro is often used to treat mental health symptoms, such as depression and anxiety. Alcohol can exacerbate these symptoms, which may mean that Lexapro treatment is inadequate at managing the severity of the condition. Alcohol can also impair decision-making and inhibition, which can mean that mental health concerns (such as thoughts of self-harm and suicide) are not effectively managed. [7]
Lexapro and weed
Cannabis and Lexapro can impact one another and cause increased risks. For example, cannabis can increase anxiety symptoms or cause paranoia, reducing the benefits of Lexapro, as the medication may be used to help manage these symptoms. [8]
Cannabis can also impact serotonin levels, meaning that a combination of cannabis and Lexapro can cause an increased risk of serotonin syndrome. [9] Combining cannabis and Lexapro can also cause a higher risk of side effects, including diarrhea, dizziness, fatigue, cough, and flu symptoms. [8]
Others
Some illicit substances are known to interact with Lexapro, including the following substances, which may increase the risk of serotonin syndrome: [5]
- Methamphetamine
- Cocaine
- MDMA (ecstasy)
- LSD
- Ayahuasca
- Psilocybin (magic mushrooms)
Other legal substances or supplements that can interact with Lexapro include: [5]
- St John’s wort
- Nutmeg
- Panax ginseng
- Syrian rue
Recognizing dangerous symptoms
Dangerous symptoms that may occur when Lexapro interacts with other substances include: [1][2]
- Fever
- Extreme confusion
- Changes in mental status
- Oversedation
- Drowsiness and dizziness
- Impaired cognitive functioning, including poor memory and concentration
- Changes in heart rate and blood pressure
- SeizuresÂ
- Hallucinations
- Loss of consciousness
- Shaking
- VomitingÂ
If any of these symptoms occur, contact a medical professional immediately, as this may indicate signs of drug interactions, overdose, or serotonin syndrome. In an emergency, such as losing consciousness, trouble breathing, or severe psychological changes, call 911 immediately.
Tips for safer Lexapro use
Lexapro can be a safe and effective treatment if it is taken correctly. Always take Lexapro as it is prescribed, at the correct time, and in the correct dose. Never take more than is prescribed, as this can increase the risk of harm.Â
People who are on other medications should discuss this with the prescribing doctor before starting Lexapro treatment, as dosage adjustments may be necessary to ensure safe and effective treatment.Â
It is not advised to use alcohol or illicit substances while on Lexapro treatment, as this can increase the risk of harm.
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