By Naomi Carr

Last updated: 23 April 2024 & medically reviewed by Morgan Blair

Like other antidepressants, Lexapro (escitalopram) is known to cause both physical and psychological side effects. These side effects may occur when Lexapro is taken in the prescribed amount; often becoming more severe if the drug is abused.

Lexapro can cause several side effects, including nausea, drowsiness, dizziness, insomnia, and dry mouth. It can also cause a risk of severe side effects that may require treatment or a change of medication.[1]

Lexapro (Escitalopram) Side Effects

Common side effects of Lexapro

It is usual to experience some side effects when commencing Lexapro treatment. Often, these side effects will be alleviated within a few weeks as the body adjusts to the medication. Common side effects of Lexapro include: [1][2][6]

  • Nausea

  • Vomiting

  • Diarrhea

  • Constipation

  • Stomach pain

  • Sweating

  • Fatigue

  • Drowsiness

  • Dry mouth

  • Dizziness

  • Decreased appetite 

  • Muscle pain

  • Insomnia

  • Vivid or unusual dreams

  • Shaking

  • Sneezing

  • Flu-like symptoms

Severe side effects of Lexapro

In some cases, side effects of Lexapro can be severe or persistent and may require treatment or a change of medication. Severe side effects of Lexapro can include: [1][2][6]

  • Hallucinations

  • Rash or hives

  • Fever

  • Confusion

  • Severe cognitive impairments

  • Extreme changes in heart rate or blood pressure

  • Persistent vomiting or diarrhea

  • Trouble breathing

  • Chest pain

  • Seizures: This risk may be higher in those with a history of seizures.

  • Mania: Lexapro could cause the onset of mania or hypomania, particularly in those with a history of mania or bipolar disorder.

  • Serotonin syndrome: If combined with other serotonergic medications, Lexapro could cause serotonin syndrome.

  • Unusual bleeding: Unexplained bruising or bleeding can occur when taking Lexapro, particularly when combined with NSAIDs or other blood-thinning medications.

Lexapro and suicidal ideation

Lexapro can cause new or worsening suicidal ideation, particularly in those under 24 years old. Generally, this is more likely to occur within the first few months of a new treatment. [1]

If the individual taking Lexapro or their family members notice any concerning changes in mood and behavior, including thoughts of self-harm or suicide, it is important to seek the advice of a professional. They can provide appropriate support, such as close monitoring of adverse effects and changes in mood and behavior throughout treatment. [6]

Lexapro discontinuation syndrome

Although Lexapro is not addictive, some physical dependence can occur with prolonged use, which can lead to the onset of withdrawal symptoms or discontinuation syndrome when stopping treatment, particularly if stopped abruptly. [2]

Discontinuation syndrome can include changes in mood and behavior, sensory disturbances, headaches, and insomnia. Because of this, a gradual dose reduction is recommended when discontinuing treatment. [1]

Why do people abuse Lexapro?

Lexapro is not a commonly abused substance, as it does not cause a feeling of euphoria or ‘high’ and it is not habit forming. However, some people misuse the medication by taking more than they are prescribed or taking it along with other substances to enhance the effects. [4][5]

Although Lexapro does not cause the development of addiction, individuals may experience withdrawal symptoms when coming off Lexapro, which could contribute to its misuse in some cases. [1][5]

Lexapro overdose

Typically, an overdose of Lexapro will not be fatal, even in significantly large doses, although serious adverse effects may occur. Signs of a Lexapro overdose include: [1][2]

  • Nausea and vomiting

  • Drowsiness

  • Dizziness

  • Rapid heartbeat

  • Weakness

  • Seizures

  • Loss of consciousness

People taking Lexapro may be at risk of accidental or intentional overdose. Additionally, the risk of overdose may be increased if Lexapro is combined with other substances, including alcohol. In the event of an overdose, call 911 immediately. [1]

Getting treatment for Lexapro dependence

As Lexapro is not often associated with abuse or addiction, it is not typically necessary to receive detox or rehabilitation treatment when ending Lexapro use. However, if Lexapro is misused or abused alongside additional substances, these services may be required to manage addictive behaviors, reduce use, and provide psychosocial support. [4]

Individuals taking Lexapro as prescribed should receive regular monitoring and reviews throughout their treatment. If it is deemed appropriate or necessary to discontinue Lexapro treatment, the prescribing doctor will likely advise on a safe cessation process. This will involve a gradual dose reduction over several weeks to help prevent or reduce the severity of withdrawal symptoms. [1]

As Lexapro is used to treat mood and anxiety disorders, during and following discontinuation individuals should ensure that they receive adequate psychological support. Changes in mood and behavior can occur during cessation and may require monitoring and intervention. Similarly, it is important to continue to manage any ongoing mental health symptoms following the discontinuation of medicinal treatment. [3]

Often, therapeutic intervention is beneficial, either as a lone treatment or alongside medications. Various types of therapies can be utilized, including: