Escitalopram (Lexapro): what to expect when starting

By the Medsmingle Team · Updated 13 November 2026

This is a prescription medicine. Only take it if it has been prescribed for you, and follow your doctor’s and pharmacist’s instructions.

Escitalopram (Lexapro) is an SSRI antidepressant used for depression and generalized anxiety disorder. Side effects and response vary between people.

How long does it take to work?

Sleep, energy or appetite may improve in 1 to 2 weeks, but the full effect on mood and anxiety usually takes 4 to 6 weeks. Keep taking it even if you don’t notice a change at first.

Common side effects

• Nausea, upset stomach
• Headache
• Trouble sleeping or feeling sleepy
• Sweating
• Sexual side effects, such as lower libido or delayed orgasm

Many early side effects ease within 2 weeks. Tell your doctor if they don’t.

Important safety information

• Don’t stop suddenly. Stopping quickly can cause dizziness, irritability and flu-like symptoms. Your doctor will reduce the dose gradually.
• Suicidal thoughts: Antidepressants carry a warning about increased suicidal thoughts or behavior in children, adolescents and young adults, particularly early in treatment or after dose changes. Contact a clinician urgently for new or worsening symptoms; seek emergency help if there is immediate danger.
• Serotonin syndrome (rare): agitation, fever, fast heartbeat, muscle twitching. Get urgent help.

Interactions

• Other antidepressants, triptans for migraine, tramadol and St John’s wort (serotonin syndrome risk)
• Blood thinners and NSAIDs (bleeding risk)
• Alcohol can worsen drowsiness and mood

Frequently asked questions

Should I take escitalopram in the morning or at night?

Either. If it keeps you awake, take it in the morning; if it makes you sleepy, take it at night.

How long will I need to take it?

Usually at least 6 to 12 months after you feel better. Your doctor will help decide.

For questions about a prescription or symptoms, speak with your own doctor or pharmacist. For website enquiries, contact our team.

This article is for general information only and isn’t a substitute for advice from a doctor or pharmacist.

Source and further reading

MedlinePlus patient medicine information. Read the leaflet for your specific medicine; this overview does not list every warning or interaction.