Lexapro Side Effects: Why Your Body Reacts & Medical Next Steps

If you've been prescribed Lexapro, you may be wondering about Lexapro side effects and why your body feels different after starting it. That's a completely normal concern.

Lexapro (generic name: escitalopram) is a selective serotonin reuptake inhibitor (SSRI). It's commonly prescribed for depression and anxiety disorders and is considered safe and effective for many people. But like all medications that affect brain chemistry, it can cause side effects—especially in the first few weeks.

The good news? Most side effects are mild and improve with time. The key is understanding what's happening in your body and knowing when to speak with a doctor.

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Why Does Lexapro Cause Side Effects?

Lexapro works by increasing levels of serotonin, a brain chemical that affects:

• Mood
• Sleep
• Appetite
• Digestion
• Sexual function
• Energy levels

When serotonin levels change, your brain and body need time to adjust. This adjustment period—usually the first 2 to 4 weeks—is when Lexapro side effects are most likely to appear.

Your nervous system is essentially recalibrating.

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Common Lexapro Side Effects

Many people experience mild side effects early on. These often improve within a few weeks.

Most Common Side Effects

• Nausea
• Headache
• Dry mouth
• Increased sweating
• Fatigue or drowsiness
• Insomnia
• Dizziness
• Diarrhea or constipation
• Increased anxiety during the first 1–2 weeks

These happen because serotonin affects not only your brain but also your digestive tract and nervous system.

Sexual Side Effects

Sexual side effects are among the most common long-term concerns with SSRIs, including Lexapro.

• Decreased libido
• Difficulty achieving orgasm
• Delayed ejaculation
• Erectile dysfunction

These may persist for some people and should be discussed openly with a doctor. There are options if this becomes problematic.

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Why Anxiety Can Feel Worse at First

It may sound surprising, but some people feel more anxious when starting Lexapro.

This happens because:

• Serotonin shifts can temporarily increase nervous system stimulation
• Your brain hasn't yet adapted to the medication
• The calming effects take longer to develop than the activating effects

This early activation typically settles within 1–2 weeks. If anxiety becomes severe or unmanageable, contact your doctor promptly.

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Less Common but Serious Lexapro Side Effects

While rare, certain reactions require immediate medical attention.

1. Serotonin Syndrome (Rare but Serious)

This occurs when serotonin levels become dangerously high. Risk increases if Lexapro is combined with other serotonin-boosting medications.

Symptoms may include:

• High fever
• Muscle stiffness
• Confusion
• Rapid heart rate
• Shivering
• Agitation

This is a medical emergency. Seek urgent care if these symptoms appear.

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2. Suicidal Thoughts (Especially in Young Adults)

In adolescents and young adults under 25, antidepressants may increase suicidal thoughts in the early weeks of treatment.

Watch for:

• Worsening depression
• Sudden mood changes
• New irritability
• Thoughts of self-harm

This does not mean Lexapro is unsafe. It means close monitoring is important—especially early on.

If there are thoughts of self-harm, seek immediate medical care.

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3. Low Sodium (Hyponatremia)

More common in older adults, this condition can cause:

• Confusion
• Headache
• Weakness
• Seizures (rare)

If you experience confusion or severe symptoms, speak to a doctor right away.

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4. Heart Rhythm Changes

Lexapro can slightly affect heart rhythm (QT prolongation), especially at higher doses or in people with heart conditions.

Your doctor may monitor this if you have risk factors.

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How Long Do Lexapro Side Effects Last?

For most people:

• Mild side effects improve within 2–4 weeks
• Sexual side effects may last longer
• Serious reactions are uncommon but require immediate attention

If side effects continue beyond a month or worsen, your doctor may:

• Adjust the dose
• Change the timing (morning vs. night)
• Switch medications
• Add another treatment

Never stop Lexapro suddenly without medical guidance.

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What Happens If You Stop Lexapro Suddenly?

Stopping abruptly can lead to discontinuation symptoms, including:

• Dizziness
• Brain "zaps"
• Irritability
• Nausea
• Flu-like symptoms
• Mood swings

These are not dangerous in most cases, but they can be uncomfortable.

Always taper slowly under medical supervision.

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When Should You Speak to a Doctor?

You should contact your doctor if:

• Side effects are severe or worsening
• You experience suicidal thoughts
• You notice heart palpitations
• You develop confusion or high fever
• Sexual side effects are affecting your quality of life
• You feel no improvement after 6–8 weeks

If symptoms feel life-threatening or extreme, seek emergency care immediately.

It's always better to ask than to guess.

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What You Can Do Right Now

If you're experiencing Lexapro side effects, consider these practical steps:

✅ Give It Time (If Symptoms Are Mild)

Many side effects fade within weeks.

✅ Take With Food

This can reduce nausea.

✅ Adjust Timing

• Take in the morning if it causes insomnia
• Take at night if it causes drowsiness

(Confirm changes with your doctor.)

✅ Avoid Alcohol

Alcohol can worsen side effects and reduce effectiveness.

✅ Check Your Symptoms

If you're currently on antidepressants and unsure whether what you're experiencing is normal, Ubie's free AI-powered symptom checker can help you understand your symptoms and decide if you need medical attention.

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Why You Shouldn't Panic About Lexapro Side Effects

It's important to be informed—but not alarmed.

Lexapro has been widely studied and prescribed for decades. For many people, it significantly improves quality of life.

Side effects don't mean the medication is "wrong" for you. They mean your body is adjusting.

However, persistent or serious symptoms should never be ignored.

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Questions to Ask Your Doctor

When discussing Lexapro side effects, consider asking:

• Are these symptoms expected at this stage?
• Should my dose be adjusted?
• How long should I wait before reassessing?
• Are there alternatives if this doesn't improve?
• Is there a way to manage sexual side effects?

Open communication leads to better outcomes.

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The Bottom Line

Lexapro side effects are common but often temporary.
They happen because your brain and body are adapting to changes in serotonin.

Most people experience:

• Mild digestive issues
• Temporary anxiety
• Headache or fatigue

Less common but serious symptoms—like serotonin syndrome or suicidal thoughts—require immediate medical care.

If something feels off, trust your instincts and speak to a doctor. If symptoms could be serious or life-threatening, seek emergency help right away.

You deserve treatment that improves your life—not uncertainty about what's happening in your body.