Escitalopram
A widely used antidepressant for depression and anxiety disorders. Taken once a day. Usually well tolerated.
Brand names
- Lexapro, Esipram, plus generic brands sold as escitalopram
How it works
A selective serotonin reuptake inhibitor (SSRI): it stops nerve cells soaking serotonin back up, so more is available to carry signals. Benefit starts after 2 to 4 weeks, with full effect by 6 to 8 weeks.
Used for
- Major depression (TGA-approved)
- Generalised anxiety disorder, panic disorder, social anxiety disorder and obsessive-compulsive disorder (TGA-approved)
Side effects
How often, from the official product information. Bold = serious.
Very common more than 1 in 10
- Headache
- Nausea
Common 1 in 10 to 1 in 100
- Poor sleep, drowsiness, dizziness
- Tingling, tremor, vivid dreams
- Anxiety, restlessness
- Sexual problems (desire, orgasm, erection)
- Diarrhoea, constipation, vomiting
- Dry mouth, sweating, yawning
- Aches, tiredness, fever, sinusitis
- Appetite change, weight gain
Uncommon 1 in 100 to 1 in 1,000
- Teeth grinding, agitation, panic
- Confusion, fainting, fast heartbeat
- Ringing ears, taste or vision changes
- Bowel bleeding, nosebleeds
- Rash, itch, hives, hair loss
- Heavier or irregular periods
Rare 1 in 1,000 to 1 in 10,000
- Anaphylaxis
- Aggression, hallucinations or feeling detached
- Serotonin syndrome
- Slow heart rate
Frequency not known reported, rate unclear
- Low sodium, low platelets, bruising
- Bleeding after birth
- Suicidal thoughts, mania
- Seizures, abnormal movements
- Long QT, dangerous heart rhythms
- Hepatitis, angioedema
- Urine retention, prolonged erection
Get help urgently if
- Fever, sweating, shaking, muscle jerks, confusion or a racing heart (possible serotonin syndrome)
- Thoughts of suicide or self-harm: Lifeline 13 11 14, or 000
- Fainting, a racing irregular heartbeat, or bleeding from the bowel
Good to know
- Heart rhythm (QT): risk rises with dose. Maximum 20 mg, or 10 mg if over 65. Avoid other QT-prolonging medicines.
- Serotonin syndrome is more likely with tramadol, triptans, St John’s wort or other antidepressants. Never use with an MAOI.
- Bleeding is more likely with anti-inflammatories (NSAIDs), aspirin or blood thinners.
- Low sodium (confusion, unsteadiness) is more likely in older people.
- Stopping: taper over at least 1 to 2 weeks to avoid dizziness, “brain zaps” and poor sleep.
- Under 25s: suicidal thoughts can increase early on or after a dose change. Thoughts of self-harm: see your doctor now or call Lifeline 13 11 14.
- Pregnancy or breastfeeding: discuss with your doctor. Avoid alcohol; take care driving at first.
Information only. Not a recommendation or endorsement of any product. Whether a medicine suits you depends on your health and other medicines, so talk to your doctor or pharmacist. In an emergency, call 000.
More information
maladywise.com/drugs/escitalopram/