What are the long term side effects of Lexapro?

Lexapro Long Term Side Effects

Escitalopram (brand name Lexapro) is a commonly prescribed selective serotonin reuptake inhibitor (SSRI) used to treat depression and anxiety. While many people benefit from its mood-lifting effects, it’s important to understand potential long-term side effects. This overview is based on reputable sources such as FDA labeling, Mayo Clinic, and peer-reviewed studies.

1. Weight Changes

• Weight gain

• Some users report gradual weight gain over months to years.
• Possible causes include changes in appetite, metabolism, or activity levels.
  • Weight loss
• Less common, but early treatment can reduce appetite in some individuals.
  • Managing weight
• Regular exercise, balanced diet, and routine weight checks can help you stay on track.

2. Sexual Dysfunction

• Reduced libido (sex drive)
• Delayed orgasm or anorgasmia (inability to reach orgasm)
• Erectile dysfunction in men
Sexual side effects are among the most frequently reported long-term issues with SSRIs. They can affect relationships and quality of life. If you experience persistent problems, talk to your doctor—adjusting the dose or switching medications may help.

3. Emotional Blunting (“Numbing”)

• Feeling emotionally “flat” or less able to feel both positive and negative emotions
• Difficulty empathizing or reacting to everyday events
Some people describe this as “not feeling like themselves.” If emotional blunting becomes distressing, discuss alternatives or dose adjustments with your physician.

4. Sleep Disturbances

• Insomnia (trouble falling or staying asleep)
• Daytime drowsiness or fatigue
• Vivid dreams or nightmares
These effects can fluctuate over time. Good sleep hygiene—consistent bedtime, limited screens before bed, and a relaxing routine—often helps. If sleep problems persist, your doctor may suggest timing your dose differently or adding a sleep-targeted therapy.

5. Gastrointestinal Issues

• Nausea or upset stomach
• Diarrhea or constipation
• Loss of appetite
GI symptoms usually improve after the first few weeks, but a smaller percentage of people report ongoing digestive changes. Staying hydrated, eating smaller meals, and taking Lexapro with food can reduce discomfort.

6. Cognitive Effects

• Difficulty concentrating or “brain fog”
• Memory lapses
• Slower thinking speed
These symptoms tend to be mild for most, but if they interfere with daily tasks or work performance, bring them up with your healthcare provider.

7. Movement-Related Side Effects

• Tremors or shakiness
• Akathisia (inner restlessness, inability to sit still)
• Muscle stiffness or twitches
Movement issues can emerge weeks to months into treatment. In many cases, lowering the dose or adding a small dose of a supportive medication can ease symptoms.

8. Cardiovascular Considerations

• QT interval prolongation (a change on an ECG tracing)

• Rare, but may increase risk of abnormal heart rhythms in susceptible individuals.
  • Changes in blood pressure or heart rate
  If you have existing heart conditions or take other QT-prolonging drugs, your doctor may monitor you more closely.

9. Bleeding Risk

• SSRIs can interfere with platelet function, raising bruising or bleeding risk.
• The effect is modest but noteworthy, especially if you’re on blood thinners or regularly take NSAIDs (ibuprofen, aspirin).
Let any specialists (dentist, surgeon) know you’re taking Lexapro before procedures.

10. Hyponatremia (Low Sodium)

• Particularly in older adults, SSRIs can cause your body to hold onto water, diluting blood sodium levels.
• Symptoms include headache, confusion, weakness, and seizures in severe cases.
Your doctor may check sodium levels periodically if you’re over 65 or have other risk factors.

11. Bone Health

• Some research links long-term SSRI use to slightly reduced bone mineral density.
• Over years, this could raise fracture risk, especially in postmenopausal women and the elderly.
Adequate calcium, vitamin D, weight-bearing exercise, and bone density scans (if recommended) help counteract this risk.

12. Discontinuation Syndrome

• Flu-like symptoms (fatigue, muscle aches)
• Dizziness, “brain zaps,” irritability, insomnia
Stopping Lexapro abruptly after long-term use often triggers these symptoms. To minimize risk, always taper slowly under medical supervision.

13. Rare but Serious Concerns

• Serotonin Syndrome (when combined with other serotonergic drugs): high fever, rapid heartbeat, agitation.
• New or worsening suicidal thoughts, especially under age 25.
• Seizures (very uncommon at standard doses).
If you experience any sudden, severe symptoms—high fever, chest pain, thoughts of self-harm—seek immediate medical attention.

Tips for Managing Long-Term Use

• Regular Check-Ins

• Schedule follow-up visits every 3–6 months.
• Discuss mood, side effects, sleep, weight, and sexual health.
  • Lifestyle Measures
• Balanced diet, regular exercise, adequate sleep.
• Mindfulness or cognitive behavioral therapy to complement medication.
  • Medication Review
• Evaluate the ongoing need for Lexapro every 1–2 years.
• Consider dose reduction or drug holiday only under doctor guidance.

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Need help sorting out your symptoms? Try a free, online symptom check, using the doctor approved Ubie Symptom Checker.

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When to Talk to a Doctor
Always consult your healthcare provider if you notice:
• Symptoms that are severe, worsening, or life-threatening
• New mood swings, thoughts of self-harm, or suicidal ideation
• Signs of a serious allergic reaction (rash, swelling, difficulty breathing)
• Any unexplained bleeding, seizures, or chest pain

This information is intended to empower you, not alarm you. Discussing any concerns with your doctor ensures you get the safest, most effective treatment for your long-term well-being.