Is 20 mg of Lexapro more effective than 10 mg?

Key takeaways

• Lexapro (escitalopram) is a selective serotonin reuptake inhibitor (SSRI) used to treat depression and anxiety. Most adults and children start at 10 milligrams (mg) per day, with a maximum dose of 20 mg.
• Clinical trials show that both 10 mg and 20 mg doses can be effective for depression, but the higher dose doesn’t necessarily provide additional benefit. Your doctor may increase your dose after several weeks if you show little improvement or keep you at 10 mg if it’s working well.
• Lexapro typically takes 1 to 2 weeks to reach full strength in your bloodstream and up to 8 weeks to fully improve depression symptoms. If you have concerns about your dosage or experience severe side effects, talk with your doctor about adjusting your treatment plan.

Lexapro (escitalopram) is a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI). It can be used to treat depression and anxiety. Like many medication, it comes in different strengths. However, a higher strength doesn’t necessarily mean it will be more effective.

Let’s take a look at two different Lexapro dosages, the factors that can affect your dosage, and how doctors decide which one is right for you.

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What’s the difference between Lexapro dosages?

Lexapro comes in three strengths: 5 milligrams (mg), 10 mg, and 20 mg. The starting dosage for most adults and children is 10 mg per day, and the maximum dosage is 20 mg per day. The 5 mg dose is typically reserved for older adults or people who are very sensitive to the medication.

However, for Lexapro, a higher dosage isn’t necessarily more effective. Clinical trials of Lexapro in adults with depression found that both the 10 mg and 20 mg dosages were effective, but that there was no particular increased benefit with the 20 mg dose.

Doctors will use the following factors to decide which dose you should take:

• Treatment response: If you show low or no improvement after 4 to 6 weeks on 10 mg, the doctor may consider increasing the dose. If 10 mg is working well, there may be no need to increase the dose.
• Side effects: If you experience severe side effects at 20 mg, your doctor might reduce the dose to 10 mg.
• Symptom severity: For severe depression or anxiety, doctors may start with 10 mg but increase to 20 mg sooner if the condition is debilitating. For mild to moderate symptoms, 10 mg is often sufficient, and increasing the dose may not provide additional relief.

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When will my dose be increased?

According to Lexapro’s prescribing information, adult dosages can be increased after at least one week. Children’s dosages can be increased after 2 weeks for anxiety or 3 weeks for depression.

However, your doctor may prefer to monitor you for several weeks to see how you respond to the 10 mg dosage before increasing it. This allows you to see how well the medication works for you and whether you’ll experience any side effects.

Lexapro may take some time to take effect, so it’s important not to be discouraged if you don’t see significant improvement straight away.

Your doctor may decide not to increase your dose at all. Higher doses may increase the likelihood of side effects like:

• insomnia or sedation
• sexual dysfunction
• weight changes
• increased anxiety or agitation

The increased risk of suicidal thoughts and behaviors may be more common after dose changes. This means that if the 10 mg dose seems to be effective for you, your doctor might decide not to increase it to 20 mg.

Learn more about Lexapro’s dosages

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How long does Lexapro take to work?

Lexapro doesn’t usually have an immediate effect. It typically takes 1 to 2 weeks of consistent use to reach its full strength in your bloodstream. However, the exact timing for you to notice symptom changes may differ depending on various factors, such as:

• symptom severity
• your tolerance to the drug
• other treatments you are taking at the same time
• your exact condition

For the treatment of depression, Lexapro may take up to 8 weeks to work for symptoms like reduced motivation or low mood. For anxiety disorders, Lexapro may also take a few weeks to reduce symptoms effectively.

This doesn’t mean you won’t experience relief as you start taking Lexapro. You may start noticing a gradual change within the first 2 weeks. You may need to wait longer to feel the full effects of the medication.

This is why doctors may wait some time before deciding to increase your dose.

Next steps: Questions to ask your doctor

If you have any concerns about your dosage, here are some questions you may consider asking your doctor:

• How long should I stay on this dose before considering a change?
• What are the expected benefits of this dose?
• Are there signs or symptoms I should monitor to assess if this dose is working?
• What are the potential benefits of 20 mg vs. 10 mg?
• What side effects should I watch for at this dose?

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Disclaimer: While Optum Perks strives for factual, comprehensive, and current information, this article is not a substitute for a licensed healthcare professional’s expertise. Always consult a doctor before taking or discontinuing any medication. Drug information is subject to change and may not cover all uses, directions, precautions, warnings, interactions, reactions, or adverse effects. The lack of a warning does not guarantee a drug’s safety, effectiveness, or appropriateness for all patients or specific uses.