Escitalopram oral tablet is a generic drug prescribed for depression and generalized anxiety disorder. Escitalopram belongs to the selective serotonin reuptake inhibitor (SSRI) drug class.

  1. Escitalopram oral tablet is available as both a generic and brand-name drug. Brand name: Lexapro.
  2. Escitalopram is also available as an oral solution.
  3. Escitalopram is used to treat depression in adults and children ages 12 years and older and generalized anxiety disorder in adults.

Escitalopram oral tablet is a prescription drug that’s available as the brand-name drug Lexapro. It’s also available as a generic drug. Generic drugs usually cost less. However, they may not be available in all the same strengths or forms as the brand-name version. Talk with your doctor to see if the generic version will work for you.

Escitalopram is also available as an oral solution. This article focuses on the oral tablet form of escitalopram.

Why it’s used

Escitalopram is used to treat major depressive disorder, commonly called depression, in adults and children ages 12 years and older. It’s also used to treat generalized anxiety disorder in adults.

Note that the Food and Drug Administration (FDA) has also approved Lexapro, the brand-name version of this drug, to treat generalized anxiety disorder in children ages 7 years and older. At this time, the FDA has not approved escitalopram for this use.

Escitalopram may be used as part of a combination therapy. This means you may need to take it with other medications.

How it works

This drug belongs to the class of drugs called selective serotonin reuptake inhibitors (SSRIs). These drugs are often used to treat similar conditions. Escitalopram increases the amount of a natural substance in your brain called serotonin. This substance helps maintain mental balance.

Escitalopram can cause mild or serious side effects. The following list contains some of the key side effects that may occur while taking escitalopram. This list does not include all possible side effects.

For more information on the possible side effects of escitalopram or tips on how to manage a bothersome side effect, talk with your doctor or pharmacist.

More common side effects

The more common side effects of this drug in adults are slightly different from the more common side effects in children.

More common adult side effects can include:

In addition to these side effects, more common side effects in children can include:

  • increased thirst
  • atypical increase in muscle movement or agitation
  • unexpected nosebleeds
  • difficulty urinating
  • heavy menstrual periods
  • possible slowed growth rate and weight change

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or do not go away, talk with your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Severe allergic reactions. Symptoms can include:
    • difficulty breathing
    • swelling of your face, tongue, eyes, or mouth
    • rash, hives, or blisters (alone or with fever or joint pain)
  • Seizures or convulsions.
  • Suicidal thoughts and behaviors. For more information, see the “Escitalopram warnings” section.
  • Serotonin syndrome. Symptoms can include:
    • agitation, hallucinations, coma, or other changes in mental status
    • coordination problems or muscle twitching (overactive reflexes)
    • racing heartbeat
    • high or low blood pressure
    • sweating or fever
    • nausea, vomiting, or diarrhea
    • muscle rigidity
  • Low sodium levels in your blood. Symptoms can include:
    • headache
    • confusion
    • difficulty concentrating
    • thinking or memory problems
    • weakness
    • unsteadiness (which can lead to falls)
    • seizures
  • Manic episodes. Symptoms can include:
    • greatly increased energy
    • severe difficulty sleeping
    • racing thoughts
    • reckless behavior
    • unusually grand ideas
    • excessive happiness or irritability
    • excessive talking or speech that is faster than usual
  • Changes in appetite or weight.
  • Visual problems. Symptoms can include:
    • eye pain
    • changes in vision, such as blurred vision or double vision
    • swelling or redness in your eyes or discoloration of skin around your eyes

Escitalopram can interact with several other medications. Different drug interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.

The list that follows discusses medications that can interact with escitalopram. It does not contain all drugs that may interact with escitalopram.

Before taking escitalopram, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Blood thinners

Escitalopram can thin your blood a little. Taking escitalopram with blood thinners increases your risk of bleeding. Examples of blood thinners include:

Migraine drugs

Certain migraine drugs called triptans may have a similar effect to escitalopram. Taking them with escitalopram could increase your risk of side effects. Examples of migraine drugs include:

  • almotriptan
  • eletriptan (Relpax)
  • frovatriptan (Frova)
  • naratriptan
  • rizatriptan (Maxalt)
  • sumatriptan (Imitrex)
  • zolmitriptan (Zomig)

Psychiatric drugs

Certain psychiatric drugs may work similarly to escitalopram. Taking them together may increase your risk of side effects. Examples of these drugs include:

  • Monoamine oxidase inhibitors (MAOIs). You should not take an MAOI with escitalopram or within 2 weeks of stopping escitalopram unless your doctor suggests it. Also, you should not start escitalopram if you stopped taking an MAOI in the last 2 weeks unless directed to do so by your doctor. Taking them within 2 weeks of each other increases your risk of serotonin syndrome. Examples of these drugs include:
    • isocarboxazid (Marplan)
    • phenelzine (Nardil)
    • tranylcypromine (Parnate)
  • Pimozide (an antipsychotic drug). You should not take escitalopram if you also take pimozide.
  • Antidepressant drugs. Examples of these drugs include:
  • Drugs that affect the central nervous system. Examples of these drugs include:

Drugs to reduce stomach acid

Taking these drugs with escitalopram may increase levels of escitalopram in your body and increase your risk of side effects. An example of these drugs is cimetidine (Tagamet HB).

Water pills

Certain water pills can decrease sodium levels in your body. Escitalopram may also decrease sodium. Taking water pills with these drugs may increase your risk of low sodium levels. Examples of these drugs include:

Serotonergic drugs

Taking serotonergic drugs with escitalopram may increase your risk of serotonin syndrome, which can be fatal. If you take any of these drugs, your doctor will start you on a lowered dosage of escitalopram and monitor you for signs of serotonin syndrome. Symptoms can include agitation, sweating, muscle twitches, and confusion. Serotonergic drugs include:

Taking the supplements tryptophan and St. John’s wort during escitalopram treatment may also increase your risk of serotonin syndrome.

As with all medications, the cost of escitalopram can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Drug coupons: You can visit Optum Perks for price estimates of escitalopram. These estimates are based on the use of Optum Perks coupons. Note: Optum Perks coupons cannot be used with any insurance copays or benefits.

Financial and insurance assistance: If you need financial support to pay for escitalopram, or if you need help understanding your insurance coverage, help is available.

Consider looking into websites that offer cost resources and information. Two such organizations are Medicine Assistance Tool and NeedyMeds.

For tips that can lower the cost of your medications, see this article about saving money on prescriptions.

Escitalopram oral tablet comes with several warnings.

FDA warning: Suicide

This drug has a boxed warning. This is the most serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

Suicide warning: Escitalopram, like many antidepressants, can increase the risk of suicidal thinking and behavior when you take it to treat depression or other psychiatric disorders. This risk is higher in children, teenagers, and young adults, especially within the first few months of treatment or when a doctor changes the dose. If you take escitalopram, you, your family members, caregivers, and your doctor should pay attention to any unusual changes in your mood, behaviors, thoughts, or feelings.

Serotonin syndrome

A serious condition called serotonin syndrome may occur when you take this drug. It happens when your levels of a natural brain chemical called serotonin are dangerously high. It’s most likely to occur if you take this drug with other drugs that increase your levels of serotonin. (For examples, see “Serotonergic drugs” in the “Escitalopram may interact with other medications” section.)

Serotonin syndrome causes symptoms such as:

If you experience symptoms of this syndrome, seek emergency medical care right away.

Stopping the drug quickly

If you stop taking this drug too quickly, you may have withdrawal symptoms. Withdrawal may occur when you suddenly stop taking a drug that your body has become dependent on. (With dependence, your body becomes used to a drug and needs it to function as usual.)

Withdrawal symptoms include:

  • irritability
  • agitation
  • anxiety
  • high or low mood
  • feeling restless
  • changes in sleep habits
  • headache
  • sweating
  • nausea
  • dizziness
  • electric shock-like sensations
  • shaking
  • confusion

You should not stop taking escitalopram without speaking with your doctor first. They will lower your dose slowly to prevent these withdrawal side effects.

Bleeding

Using escitalopram can increase your risk of bleeding if you also take aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), warfarin (Jantoven), or other anticoagulants. Speak with your doctor or pharmacist if you notice any bleeding or unusual bruising.

Allergies

Escitalopram can cause a severe allergic reaction. Symptoms can include:

  • difficulty breathing
  • swelling of your face, tongue, eyes, or mouth
  • rash, hives, or blisters (alone or with fever or joint pain)

If you have an allergic reaction, call your doctor right away. You can also call America’s Poison Centers at 800-222-1222 or use its online tool. However, if your symptoms are severe, call 911 or go to the nearest emergency room.

You should not take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Alcohol interaction

Drinking alcohol while taking escitalopram can increase your risk of sleepiness or dizziness. If you drink alcohol, talk with your doctor about how much is safe, if any, to consume while taking escitalopram.

Warnings for people with certain health conditions

People with a history of suicidal thoughts or behaviors: This drug can increase the risk of suicidal thoughts and behavior. This risk is higher in children, teenagers, and young adults. Tell your doctor if you have a history of suicidal thoughts or behaviors.

People with glaucoma: This drug may dilate your pupils (make them wider), which may trigger a glaucoma attack. Tell your doctor if you have glaucoma before taking this drug.

People with bipolar disorder: Let your doctor know if you have a history of bipolar disorder. If you have a history of this condition, taking this drug alone may trigger a mixed or manic episode.

People with seizure disorders: This drug may cause seizures. If you have ever had a seizure, notify your doctor before taking this drug. Taking this drug can increase your risk of having more seizures.

People with heart problems: Taking this drug may cause a prolonged QT interval. This is an issue with your heart rhythm that may cause your heartbeat to be atypical. Your risk of QT interval prolongation is greater if you have heart disease. Talk with your doctor before taking this drug.

Warnings for other groups

For those who are pregnant: Talk with your doctor if you’re pregnant or plan to become pregnant.

Research in pregnant animals given the drug has shown adverse effects on the fetus. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

This drug should only be used if the potential benefit justifies the potential risk.

For those who are breastfeeding: Escitalopram may pass into breast milk and may cause side effects in a child who is breastfed. Talk with your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

For older adults: Older adults (ages 65 years and older) have a greater risk of lowered sodium levels. Because this drug can decrease sodium levels, older adults may have an even higher risk of low sodium levels.

For children: Children who take drugs like escitalopram may have a decreased appetite and weight loss.

When to call the doctor

Call your doctor if your mood changes suddenly. Call your doctor right away or call 911 in an emergency if you have any of the following symptoms, especially if they are new, worsening, or worry you:

  • suicidal thoughts or behavior
  • acting on dangerous impulses
  • acting in an aggressive or violent manner
  • new or worsening depression
  • new or worsening anxiety or panic attacks
  • feeling agitated, restless, angry, or irritable
  • difficulty sleeping
  • an increase in activity or talking more than you usually do

The escitalopram dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re using escitalopram to treat
  • your age
  • the form of escitalopram you take
  • other medical conditions you may have

Typically, your doctor will start you on a low dosage and adjust it over time to reach the dosage that’s right for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Forms and strengths

Brand: Lexapro

  • Form: oral tablet
    • Strengths: 5 milligrams (mg), 10 mg, 20 mg
  • Form: oral solution (not being marketed at this time)
    • Strength: 5 mg/5 milliliters (mL)

Generic: escitalopram

  • Form: oral tablet
    • Strengths: 5 mg, 10 mg, 20 mg
  • Form: oral solution
    • Strengths: 5 mg/5 mL

Although this article focuses on escitalopram oral tablet, the dosages below also apply to escitalopram oral solution.

Dosage for major depressive disorder

Adult dosage (ages 18 years to 64 years)

The usual dosage is 10 mg to 20 mg once per day.

Child dosage (ages 12 to 17 years)

The usual dosage is 10 mg to 20 mg once per day.

Child dosage (ages 0 to 11 years)

It hasn’t been confirmed that this drug is safe and effective for people younger than age 12 years.

Older adult dosage (ages 65 years and older)

  • If you’re an older adult, your liver may not work as well as it used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects.
  • Your doctor may start you on a lowered dose or a different medication schedule. This can help keep levels of this drug from building up too much in your body.
  • The recommended dosage is 10 mg once per day.

Special considerations

Liver problems: If you have liver problems, the recommended dosage is 10 mg once per day.

Dosage for generalized anxiety disorder

Adult dosage (ages 18 years to 64 years)

The usual dosage is 10 mg to 20 mg once per day.

Child dosage (ages 0 to 17 years)

The Food and Drug Administration (FDA) has approved Lexapro, the brand-name version of escitalopram, to treat generalized anxiety disorder in children ages 7 years and older. However, the FDA has not approved escitalopram for this use. Also, it hasn’t been confirmed that Lexapro is safe and effective for people younger than age 7 years.

The typical dosage of Lexapro for this use is 10 mg to 20 mg once per day.

Older adult dosage (ages 65 years and older)

  • If you’re an older adult, your liver may not work as well as it used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This increases your risk of side effects.
  • Your doctor may start you on a lowered dose or a different medication schedule. This can help keep levels of this drug from building up too much in your body.
  • The recommended dosage is 10 mg once per day.

Special considerations

Liver problems: If you have liver problems, the recommended dosage is 10 mg once per day.

Escitalopram oral tablet is used for long-term treatment. It comes with risks if you do not take it as prescribed.

If you stop taking the drug suddenly or do not take it at all: You may experience withdrawal symptoms if you stop taking escitalopram rapidly. You should not stop taking escitalopram on your own before speaking with your doctor. If you need to stop taking the drug, they will gradually reduce the dose to help avoid withdrawal symptoms.

If you miss doses or do not take the drug on schedule: Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much: You could have dangerous levels of the drug in your body. Signs and symptoms of an overdose of this drug can include:

  • dizziness
  • high or low blood pressure
  • sleep problems
  • nausea or vomiting
  • fast heart rate
  • seizures
  • coma

If you think you’ve taken too much of this drug, call your doctor right away. You can also call America’s Poison Centers at 800-222-1222 or use its online tool. However, if your symptoms are severe, call 911 or go to the nearest emergency room.

What to do if you miss a dose: Take your dose as soon as you remember. But if you remember just a few hours before your next scheduled dose, take only one dose. Never try to catch up by taking two doses at once. This could result in dangerous side effects.

How to tell if the drug is working: You should experience improvement in your condition. However, you may not notice any difference in your condition for the first few weeks. It takes time for escitalopram to begin to work well. Sometimes this can take up to 2 months.

Keep these considerations in mind if your doctor prescribes escitalopram oral tablet for you.

General

  • You can take this drug with or without food. Taking it with food may help to reduce indigestion.
  • You can cut or crush the 10-mg and 20-mg tablets. You can’t cut or crush the 5-mg tablets.

Storage

  • Store escitalopram at room temperature between 59ºF and 86°F (15ºC and 30°C). Keep it away from high temperatures.
  • You should not store this medication in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to refill it. Your doctor will write the number of authorized refills on your prescription.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, you should not put it into a checked bag. Keep it in your carry-on bag.
  • You don’t need to worry about airport X-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • You should not put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

Your doctor will monitor your mood. Your doctor will watch for sudden changes in mood, behaviors, thoughts, or feelings. If your child is taking escitalopram, in addition to such changes, their doctor will also monitor them for changes in height and weight.

There are other drugs available to treat your condition. Some may be a better option for you than others. Talk with your doctor about other drug options that may work for you.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.