Taking Lexapro? Here’s What to Expect in the First Week

Lexapro (escitalopram) is an antidepressant that is used for the treatment of depression and anxiety. When you start taking Lexapro, you may experience nausea, diarrhea, difficulty sleeping, and drowsiness during the first week.

This article will cover what to expect when starting treatment with Lexapro, such as side effects that most commonly emerge in the first week.

Uses of Lexapro

Lexapro is a medication approved by the Food and Drug Administration (FDA) for short-term and long-term treatment of MDD and short-term treatment of GAD. 

Lexapro belongs to a large class of medications known as antidepressants. Based on how it works, Lexapro can be further classified as a selective serotonin receptor reuptake inhibitor (SSRI).

This medication works by increasing how much serotonin, a neurotransmitter, is available in the brain. Serotonin is involved in many processes of the body, including memory, sleep, and controlling internal body temperature. How much serotonin you have can also affect your emotions. 

Lexapro also has some off-label uses and may be prescribed to treat obsessive-compulsive disorder (OCD) and panic disorder (PD).

How Will I Feel in the First Week of Starting Lexapro?

When starting Lexapro for depression, you may experience more energy. You may also have different side effects, especially during the first week, as your body adjusts to the medication.

Side effects you might expect to have when starting Lexapro:

• Dry mouth
• Decreased appetite
• Indigestion
• Nausea
• Difficulty sleeping
• Drowsiness
• Diarrhea
• Constipation
• Decreased sexual desire (libido)
• Increased sweating

These side effects will likely go away as your body adjusts to the medication and the increased serotonin levels in your brain. They also usually occur with higher doses. Therefore, you may need a decreased dose if the side effects don't disappear.

However, consult your healthcare provider first and never try to adjust your dose on your own. If these side effects persist for more than a few weeks, talk to your healthcare provider to find a dose that you can tolerate. 

Lexapro and other antidepressants may also worsen depression and increase suicidal thoughts, especially in children and young adults. If you start having more suicidal thoughts after starting Lexapro, you should talk to your healthcare provider immediately. 

When Will I Get Used to Lexapro?

It may take a few days or weeks for your body to get used to Lexapro. Typically, Lexapro takes about six to eight weeks for the medication to take full effect. As your body gets used to the active ingredient in Lexapro, you should experience fewer side effects.

How Long Will Lexapro Take to Start Working?

Lexapro and other antidepressants usually take a while before you notice any significant changes.

You may experience improvements in sleep, energy, and appetite within the first two weeks. On average, it takes about six to eight weeks to feel the full effects of Lexapro.

It is important to continue taking it even if you begin to notice improvements. Never stop taking your medication on your own, even if you feel as though it's not working. Talk to your healthcare provider first before making any decisions.

Withdrawal can happen when stopping Lexapro treatment. This can cause:

• Flu-like symptoms
• Nausea
• Difficulty sleeping
• Increased anxiety

You should talk to your healthcare provider before deciding to quit your medication. If you feel it isn't working, your provider can help you find alternative options. Sometimes, it takes time to find a treatment that better suits you.

Are There Any Severe Side Effects to Watch for?

While Lexapro is generally a well-tolerated medication, some serious side effects can occur. Serotonin syndrome is a rare but potentially life-threatening syndrome that can occur when you have too much serotonin. This usually occurs within 24 hours of having your Lexapro dose increased or if you are given another medication that increases serotonin.

The following are common signs of serotonin syndrome:

• Restlessness or anxiety
• Confusion
• Diarrhea
• Vomiting 
• Sweating
• Muscle stiffness
• Shivers 

You should seek immediate medical help if you suddenly experience these symptoms. 

Another serious side effect is increased suicidal thoughts in children and young adults. This is usually within the first few weeks of starting Lexapro or after a dose change. Contact your healthcare provider immediately if you notice any sudden mood changes.

Lexapro may also increase your risk of bleeding and bruising, especially if you are taking a blood thinner like Jantoven (warfarin) or nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil and Motrin (ibuprofen) or Aleve (naproxen sodium).

Some people may have an allergic reaction to the active ingredient in Lexapro. An allergic reaction might cause difficulty breathing, a rash, or swelling of the face, tongue, eyes, or mouth.

When to See a Healthcare Provider

It is normal to experience some side effects, such as difficulty sleeping, diarrhea, constipation, and dry mouth, while taking Lexapro. However, if these side effects persist, talk to your healthcare provider about your options. They may recommend a dose change or switching to a different medication.

Pay attention to signs of potentially more serious reactions, such as suicidal thinking or signs of serotonin syndrome. Seek immediate medical attention or guidance if these side effects occur.

Summary

Lexapro is an antidepressant SSRI for treating major depressive disorder and generalized anxiety disorder.

Side effects are common, especially in the first few weeks of starting Lexapro. However, as your body adjusts to the medication, these side effects should resolve. Side effects like dry mouth, decreased appetite, and nausea, among others, are common.

Severe side effects you may experience while taking Lexapro are serotonin syndrome and an increase in suicidal thoughts. You should seek help immediately if you notice signs of these side effects occurring and follow up with your healthcare provider. 

Lexapro may help improve your sleep, appetite, and energy levels within the first two weeks. However, it usually takes six to eight weeks for you to experience the full benefits of Lexapro. It is important to continue taking your medication as directed by your healthcare provider unless your healthcare provider tells you to stop.

The author would like to recognize and thank Cody Ryan Thomas for contributing to this article.