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Lexapro (escitalopram oxalate) is an antidepressant medication used to treat depression and anxiety. Although it is considered a safe medication with few serious side effects, it can be dangerous in overdose, particularly when it is combined with other substances. As such, Lexapro should always be taken exactly as prescribed, and doses should not exceed recommended amounts.
- Lexapro (escitalopram) is an antidepressant classed as a selective serotonin reuptake inhibitor (SSRI).
- SSRIs, such as Lexapro, are safe medications when taken as prescribed and are unlikely to cause severe or fatal effects, unless they are misused.
- Lexapro overdose is unlikely to be fatal, but it can cause serious effects that require medical attention.
Can you overdose on Lexapro?
Yes, you can overdose on Lexapro, which can cause a range of mild to severe symptoms and (in rare cases) death. [1]
A drug overdose occurs when an individual takes a dangerous or excessive dose of a prescribed or illicit substance. In some cases, overdoses can be life-threatening, while in others, they may be manageable with or without medical attention.
Lexapro is an antidepressant medication containing escitalopram oxalate. It works to increase the levels and activity of the neurotransmitter serotonin, which can help to treat depression and anxiety.
Taking too much Lexapro can result in an overdose, as a high dose can cause severe serotonin toxicity and poisoning. [2]
How much Lexapro is too much?
A typical daily dosage of Lexapro is 10 mg, up to a maximum of 20 mg per day. A dangerous dose of Lexapro can be anything higher than this, and may differ from person to person. [1]
SSRIs are relatively safe in overdose. For example, SSRI doses of up to 30 times the recommended daily dose have been found to result in very few or minor symptoms. Excessive doses, more than 75 times the daily dose, can cause dangerous and severe effects. [3]
Symptoms of Lexapro overdose
Lexapro overdose can cause symptoms such as: [1][4]
- Dizziness
- Insomnia
- Nausea and vomiting
- Changes in heart rate and breathing
- Weakness
- Seizures
- Loss of consciousness
Overdose symptoms are likely to be more severe with higher doses or when other substances are taken concurrently. [1]
Risk of serotonin syndrome
Serotonin syndrome can occur with Lexapro treatment, and the risk may be higher in overdose cases. Serotonin syndrome is a potentially life-threatening condition that occurs when there is too much serotonin in the body. Signs of serotonin syndrome can include: [1][2][5]
- Shaking
- Fever
- Agitation
- High temperature of over 38°C
- Rigidity
- Impaired coordination
- Seizures
- Delirium
- Hallucinations
Serotonin syndrome may require urgent medical attention to prevent serious or fatal consequences. [5]
Causes and risk factors for overdose
What is considered a dangerous dose of Lexapro might vary from person to person and can depend on factors including: [1]
- Physical health: Certain conditions can impact how the body metabolizes or responds to Lexapro. For example, impaired liver functioning can increase the risk of overdose, and a history of seizures might increase the risk of seizures in overdose.
- Age: Children and older adults may be more at risk of severe overdose.
- Other substances or medications: Using Lexapro with other substances can increase the risk of overdose or adverse effects. For example, concomitant use of other serotonergic medications can increase the risk of serotonin syndrome.
Anyone taking more Lexapro than they have been prescribed is at risk of overdose.
The risk of intentional overdose
Intentional overdose can occur with antidepressant medications, such as Lexapro. Suicidal thoughts are not uncommon in the context of depressive disorders. Additionally, some antidepressants, including Lexapro, may cause an increase in suicidal thoughts and behavior, particularly at the start of treatment and in younger people. [1]
People presenting with a Lexapro overdose may be assessed for suicidal ideation to determine if the overdose was intentional.
Preventing Lexapro overdose: Tips for safe use
To prevent Lexapro overdose, always take Lexapro as it has been prescribed, at the correct time and in the correct dose. If you miss a dose, take it when you remember, unless it is close to the next dosage time, then skip it. Never take a double dose if a dose is missed. If you accidentally take too much, contact a medical professional for advice.
All medications should be stored in a safe place, away from children and animals.
When to seek help: Signs it's time to talk to a professional
People taking Lexapro may require professional advice and support in the case of the following:
- Suicidal ideation: Thoughts of harming oneself or suicide should be reported to a doctor immediately, allowing for necessary treatment changes and monitoring.
- Ongoing or worsening side effects: If side effects worsen or continue for longer than a few weeks or months, it may be necessary to change the dosage or medication. The prescribing doctor can review the treatment plan and make necessary changes.
- Signs of abuse: Although Lexapro is not considered a drug of abuse, there are some reports of antidepressants being misused or abused alongside other substances to create enhanced effects. This can increase the risk of overdose and adverse effects. [6]
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