Escitalopram

Medically reviewed by Dena Westphalen, PharmD on April 14, 2023
Written by Alex Brewer, PharmD, MBA

This article describes escitalopram oral tablet’s uses and dosage, ways to save on cost, and more. Below you’ll find coupon options for escitalopram.

Boxed warning: Risk of suicidal thoughts and behaviors

Escitalopram has a boxed warning about the risk of suicidal thoughts and behaviors in people age 24 years and younger. Boxed warnings are serious warnings from the Food and Drug Administration (FDA).

For details, see the “Warnings for escitalopram” section below.

Escitalopram may cause mild or serious side effects. More common mild side effects of escitalopram oral tablet and possible serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age and overall health and any other medications you take.

To learn more about escitalopram oral tablet’s side effects, see this article or ask your doctor or pharmacist. You can also read the prescribing information for escitalopram oral tablet.

Mild side effects

More common mild side effects reported with escitalopram oral tablet are listed below.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Escitalopram oral tablet’s mild side effects include:

• insomnia (trouble sleeping)
• nausea
• sweating more than usual
• fatigue (low energy)
• sleepiness
• weakness
• feeling anxious
• shaking
• appetite loss
• mild allergic reaction*

* For details about this side effect, see the “Warnings for escitalopram” section below.

Serious side effects

Serious side effects of escitalopram oral tablets are listed below. With many drugs, serious side effects are possible but not common.

If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

Escitalopram oral tablet’s serious side effects include:

• serotonin syndrome (high levels of serotonin in your body)
• increased risk of bleeding
• seizures or convulsions
• low blood sodium (salt) level
• sexual side effects, such as decreased libido (sex drive), inability to orgasm, and erectile dysfunction
• withdrawal symptoms, if treatment is suddenly stopped
• boxed warning: risk of suicidal thoughts and behaviors in young adults and adolescents*
• severe allergic reaction*

* For details about this side effect, see the “Warnings for escitalopram” section below.

Suicide prevention

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

• Call the 988 Suicide and Crisis Lifeline at 988.
• Text HOME to the Crisis Textline at 741741.
• Not in the United States? Find a helpline in your country with Befrienders Worldwide.
• Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you are not in the same household, stay on the phone with them until help arrives.

For some medications, certain things may affect how the drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Before you take escitalopram, ask your doctor to check for possible interactions. They can check for interactions these items may cause with escitalopram. Be sure to tell them about any of the following you take or use:

• prescription medications
• over-the-counter medications
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for escitalopram” section below.

Below you’ll find answers to a few commonly asked questions about escitalopram oral tablets.

How does escitalopram compare with other similar drugs, such as citalopram or sertraline?

Escitalopram (Lexapro), citalopram (Celexa), fluoxetine (Prozac), and sertraline (Zoloft) all belong to a group of drugs called selective serotonin reuptake inhibitors (SSRIs). These drugs are all approved to treat major depressive disorder (commonly called depression) in adults. Escitalopram is also used to treat depression in children 12 years and older.

In addition to depression, escitalopram is approved to treat generalized anxiety disorder. Sertraline is also approved to treat obsessive-compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD), premenstrual dysphoric disorder, and social anxiety disorder. And fluoxetine can be used for OCD, panic disorder, and bulimia nervosa.

To learn more about how escitalopram compares with other drugs that treat your condition, talk with your doctor or pharmacist.

Can escitalopram be used for OCD?

Possibly. Escitalopram is not approved to treat obsessive-compulsive disorder (OCD). However, doctors may prescribe the drug off-label for this use. Off-label use is when a drug is prescribed to treat a condition other than its approved uses.

To learn more about possible off-label uses for escitalopram, including treating OCD, talk with your doctor.

Does escitalopram cause long-term side effects?

Yes, escitalopram can cause long-term side effects.

Long-term side effects are those that start either:

• during treatment and continue for a long time, possibly after stopping treatment, or
• after you’ve taken the drug for a long time or after ending treatment

Possible long-term side effects reported with escitalopram include:

• Increased risk of bleeding. This risk applies throughout treatment with escitalopram but goes away once treatment is stopped.
• Low blood sodium (salt) level. A low blood sodium level can occur at any time while taking escitalopram. This side effect can sometimes be managed without stopping escitalopram. However, your doctor might stop your treatment if your symptoms are serious.
• Sexual side effects. These can include decreased libido, inability to orgasm, and erectile dysfunction. Sexual side effects can develop at any time while taking escitalopram, and may last throughout treatment with escitalopram. They may be managed by stopping treatment with escitalopram or by trying certain treatments.

Talk with your doctor or pharmacist if you have more questions about possible long-term side effects with escitalopram.

How does escitalopram work? And how long does it take to start working?

Escitalopram works by increasing levels of serotonin in the brain. It’s not exactly understood how this works to treat conditions such as depression.

It can take several weeks before escitalopram starts working to treat symptoms of your condition. If you’ve been taking escitalopram as prescribed for at least 8 weeks and you don’t feel the drug is working for you, talk with your doctor.

Escitalopram’s half-life is 27 to 32 hours. This means it usually takes about 5.5 to 6.5 days for the drug to clear your system after your last dose.

Is there a best time of day to take escitalopram? What should I do if I miss a dose of escitalopram?

No, there’s no one best time of day to take escitalopram oral tablet. However, it’s a good idea to try to take your dose at the same time every day. Take your doses as instructed by your doctor.

If you miss an escitalopram dose, take it as soon as you remember. But if it’s the next day or nearly time for your next dose, skip the missed dose. Take your next dose as scheduled. Do not take more than one dose of escitalopram at once.

Can escitalopram tablets be crushed, split, or chewed?

Escitalopram tablets come scored and may be split in half. But the drugmaker hasn’t stated whether the tablets may be crushed or chewed. So, do not crush or chew escitalopram without first speaking with your pharmacist or doctor.

Your doctor can offer tips on how to swallow pills if you’re having trouble with escitalopram tablets.

The dosage of escitalopram oral tablet your doctor prescribes may vary based on your condition and certain other factors. Talk with your doctor about the dosage you should take.

Taking escitalopram

Escitalopram oral tablets are taken by mouth.

Your doctor will talk with you about how to take escitalopram oral tablets. They’ll explain how much to take and how often. Always follow your doctor’s recommendation.

Escitalopram oral tablets can be taken with or without food.

See the “Common questions about escitalopram” section for information on missed doses and the best time to take this drug.

Overdose of escitalopram

You should not take more escitalopram than your doctor prescribes. For some drugs, doing so may lead to serious side effects or overdose.

If you think you’ve taken too much escitalopram, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

The Food and Drug Administration (FDA) approves prescription drugs such as escitalopram for certain conditions. Approved uses for escitalopram oral tablet are described below.

Use for depression

Doctors may prescribe escitalopram oral tablet for treating major depressive disorder, which is also called clinical depression or depression. It’s used for this purpose in adults, as well as children ages 12 years and older. Escitalopram is usually prescribed as a long-term treatment.

Depression is a mood disorder that causes feelings such as sadness, anger, or loss, which interfere with your everyday activities. Although feeling down at times is normal, people with depression experience feelings like this constantly or on a regular basis.

Use for anxiety

Doctors may prescribe escitalopram oral tablet for treating generalized anxiety disorder (GAD). It’s used for this purpose in adults. It may be prescribed as a long-term treatment.

GAD causes excessive anxiety that continues for months. This causes symptoms such as trouble concentrating, irritability, fatigue (low energy), and insomnia (trouble sleeping).

Information about escitalopram and pregnancy and breastfeeding is described below.

Escitalopram and pregnancy

There are risks to using escitalopram during pregnancy, and there are also risks to not treating depression while pregnant.

If you’re planning a pregnancy or can become pregnant, talk with your doctor about your depression treatment options during pregnancy. Together, you can discuss the risks and benefits of your treatment options, and decide whether or not you should take escitalopram during pregnancy.

Escitalopram and breastfeeding

In general, escitalopram oral tablets are considered safe to take while breastfeeding. That said, check with your doctor about whether they feel it’s safe for you specifically. Escitalopram can cause side effects in a child who is breastfed, including:

• restlessness or agitation
• difficulty feeding or gaining weight
• excessive sleepiness

You and your doctor can determine whether the benefits of breastfeeding while taking escitalopram outweigh the risks.

Escitalopram should not be taken or should be used cautiously by certain people. Precautions for taking this drug are described below.

Boxed warning: Risk of suicidal thoughts and behaviors in young adults and adolescents

Escitalopram has a boxed warning about the risk of suicidal thoughts and behaviors. Boxed warnings are serious warnings from the Food and Drug Administration (FDA).

Like other antidepressant drugs, escitalopram causes a short-term increased risk of suicidal thoughts and behaviors when used in children and adults age 24 years or younger. No suicide attempts were reported in escitalopram’s studies, but suicide attempts have been reported since the drug was approved for use.

Depression, anxiety, and other mental health conditions are more likely to cause suicidal thoughts and behaviors than escitalopram and other antidepressants.

It’s important to note that antidepressants, including escitalopram, lower the risk of suicidal thoughts and behaviors in adults age 25 years and older.

This risk is thought to be highest during the first few months of taking escitalopram, as well as any time the dosage is changed. This risk may go down over time with continued escitalopram treatment, if the drug works to treat your condition.

While taking escitalopram, it’s important to watch for changes in your behaviors, thoughts, or moods. If you feel comfortable doing so, it’s also helpful to let a close family member or friend know you’re taking escitalopram. They can help monitor for these changes in you.

You should immediately contact your doctor or emergency medical help if you have symptoms such as:

• new or worsening anxiety or depression
• thoughts about death or suicide
• aggressive, hostile, or violent behavior
• feeling very irritated, restless, or agitated
• panic attacks
• other unusual changes to your behavior or mood

To learn more, talk with your doctor or pharmacist.

Other warnings

Escitalopram could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether escitalopram oral tablets are a safe option for you.

Tell your doctor about your overall health and any past health conditions before you take escitalopram oral tablets. Health conditions and other factors you and your doctor should discuss include:

• bipolar disorder or mania
• bleeding problems, such as hemophilia
• heart problems, such as heart failure or high blood pressure
• kidney problems, such as chronic kidney disease
• liver problems, such as cirrhosis
• low blood sodium (salt) level
• a history of stroke
• seizures or a history of seizures

Allergic reaction

Escitalopram can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to escitalopram or any of its ingredients, your doctor will likely not prescribe escitalopram. They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems

If you have an allergic reaction to escitalopram, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

You may be able to save money on your prescription for escitalopram oral tablets by using our Perks discount coupons. These can be found at the end of this article.

If you have questions about how to pay for escitalopram, talk with your doctor or pharmacist. You can also learn more about the cost of escitalopram in this article.

Note: Optum Perks coupons cannot be used with insurance copays or benefits.

This article describes escitalopram oral tablet’s uses and dosage, ways to save on cost, and more. Let your doctor know if you have questions about escitalopram or would like more details about it.

Here’s a list of some possible questions you may want to ask your doctor:

• How does escitalopram compare with similar drugs that may treat my condition, and how will we decide which treatment is best for me?
• Does my health history place me at higher risk for side effects if I take escitalopram?
• Do any of my medications interact with escitalopram and increase my risk of side effects?
• If I have side effects from taking escitalopram, can I try a lower dosage instead?

• Escitalopram- escitalopram tablet, film coated. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/3fdf5482-9945-4014-82d5-054209fe46de/spl-doc
• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm

Disclaimer: Optum Perks 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.