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Lexapro (escitalopram) is an FDA-approved medication for long-term anxiety treatment. Learn more about how this medication works and its side effects.
Lexapro is the brand name for escitalopram, a commonly prescribed antidepressant medication. It belongs to a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Although it’s approved by the Federal Drug Administration (FDA) for treating generalized anxiety disorder (GAD) and depression, it can also be used off-label for conditions like social anxiety disorder or panic disorder.
Maybe you have issues sleeping or focusing because your mind is restless with worries. Or perhaps anxious thoughts cast a cloud over your interactions with loved ones. A doctor might prescribe Lexapro as a treatment to try out. The drug has been well studied, and it’s often chosen as a first-line option because it’s generally effective for many people and tends to have fewer side effects than other medications.
If you’ve just been prescribed Lexapro or think it might be a helpful medication for you, it’s essential to learn more about its benefits and limitations.
Lexapro works by increasing the availability of a brain chemical called serotonin. Serotonin plays a crucial role in regulating your emotions and moods. Higher levels of it can make you feel happier and more emotionally balanced. Lower levels are often linked to higher anxiety and depression.
Lexapro doesn’t lead to drastic changes overnight. Expect to wait a few weeks as your brain adjusts to the change in serotonin levels. Gradually, you’ll notice your worries and cycles of rumination decrease, and your overall sense of well-being will improve.
For generalized anxiety disorder, your doctor might start you with a dose of 10 mg per day—or perhaps even 5 mg if you seem sensitive to the effects of medication. If the starting dose doesn’t seem to improve your anxiety, your doctor might suggest moving up to 20 mg per day. Your doctor’s decision may also be influenced by factors such as your medical history and any coexisting conditions.
A qualified psychiatrist can determine the right starting dose for you. You can start looking for one by reviewing our list of the best online psychiatry platforms.
The best time to take Lexapro will depend on your reaction to the medication. For instance, if the drug leaves you feeling drowsy, you’ll want to take it at night. However, if your anxiety is at its worst during the day, you should consider taking the medication first thing in the morning.
Regardless of the time of day you choose, remember that consistency is key. Taking it at the same time every day helps to maintain a steady amount of the drug in your system. Sticking to a schedule also makes it more likely that you’ll remember to take it each day.
While some anxiety relief medications, such as benzodiazepines, are fast-acting, SSRIs have a more gradual effect. You may begin to notice the initial benefits within two to four weeks, with the full benefits becoming apparent after six to eight weeks.
It’s important to be patient with the process and schedule regular follow-ups with your provider. If you don’t see any improvement at week six or week eight, your doctor will either increase your dosage or suggest an alternative medication.
The common side effects of Lexapro include:
In most cases, these early side effects will fade over time as your body adjusts to the medication. If the effects persist or worsen, reach out to your doctor.
In rare cases, Lexapro can also lead to severe side effects. The medication might trigger suicidal thoughts in certain young adults under the age of 25. Manic episodes, abnormal heart rhythm, and seizures are also rare but possible effects.
Before giving you a prescription, your doctor will consider whether you’re taking other substances that won’t mix well with escitalopram. For instance, monoamine oxidase inhibitors (MAOIs) are a class of drugs that also affect your serotonin. So, if you mix an MAOI with Lexapro or other SSRIs, you put yourself at risk of serotonin syndrome—also known as serotonin toxicity. Drinking alcohol or taking supplements like St. John’s Wort can cause similar issues.
If you are pregnant or breastfeeding, you and your provider can weigh the risks and benefits of Lexapro and decide on alternative approaches if necessary. Your doctor may suggest a lower dosage or closely monitor your health.
Use the following tips to get the most out of Lexpro while reducing the risk of adverse effects.
Monitor your side effects and mood changes. For instance, if you experience fatigue or brain fog after taking your medication in the morning, take note of this issue. You can even keep a written record of these changes, so you can share them with your doctor.
Combine Lexapro with therapy. Instead of relying entirely on medication to manage your anxiety, look for a therapist who can offer you more mental health tools and strategies. For instance, they might guide you through cognitive behavioral therapy (CBT) practices that involve identifying and challenging anxious thoughts.
Taper off your usage. If you decide that Lexapro isn’t for you, talk to your doctor about gradually decreasing your dosage. If you suddenly stop taking it, you risk withdrawal symptoms, including irritability, headaches, and insomnia.
If you determine that Lexapro isn’t right for you, you can explore other options with your provider’s guidance. They might suggest you try out one of the following anxiety medication alternatives.
Different SSRIs. Lexapro isn’t the only SSRI. Others include Zoloft (sertraline), Prozac (fluoxetine), and Paxil (paroxetine). Each comes with different side effect risks and can vary in effectiveness depending on the patient. For example, Paxil is more likely to cause weight gain compared to other SSRIs.
Serotonin-norepinephrine reuptake inhibitors (SNRIs). SNRIs affect serotonin as well as another chemical in your body called norepinephrine. This class of drugs, which includes Cymbalta (duloxetine) and Effexor (venlafaxine), may have more side effects than SSRIs, but they can also be more effective for certain individuals with anxiety. So, if SSRIs don’t improve your symptoms, your doctor might try an SNRI next.
Benzodiazepines. These drugs, which include Xanax (alprazolam) and Valium (diazepam), offer a short-term solution for anxiety. They work within minutes, so they’re useful if you struggle with intense but situational anxiety. Benzodiazepines can be addictive, so your provider may not recommend them if your goal is long-term anxiety management.
Beta-blockers. Beta-blockers work quickly and address the physical symptoms of anxiety. For instance, a beta-blocker such as propranolol can help reduce the uncomfortable feeling of a racing heartbeat or sweating when anxiety arises.
When managing anxiety, it’s best to take multiple approaches, and medication is just one path forward. Lifestyle changes, such as being more physically active and getting better sleep, can significantly reduce your stress levels.
Psychotherapy is another approach that, when combined with medication, can lead to better mental health. Finding a therapist who understands you and makes you feel comfortable is important. Fortunately, there are plenty of therapy platforms that can match you with a provider. Explore our reviews of popular online therapy services to weigh your options.
Last updated or reviewed on December 4, 2025Learn about common side effects, risks, and taking medication responsibly
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