Escitalopram: What it does and who it helps
Escitalopram is a commonly prescribed SSRI antidepressant used for major depression and generalized or social anxiety. If you’re thinking about it or just started, you probably want straight answers: how fast it works, what side effects to expect, and how to use it safely. This page gives clear, practical tips you can use when talking with your doctor or pharmacist.
How escitalopram works and when it's used
Escitalopram increases serotonin levels in the brain, which helps lift mood and reduce anxiety. Clinical trials show it helps many people with depression and several anxiety disorders. Doctors also prescribe it off-label for panic attacks and OCD sometimes, but always check with your prescriber about your specific condition.
People usually notice some improvement in sleep, appetite, or anxiety within 2–4 weeks. For full benefit, most need 6–8 weeks of consistent use. If you don’t feel better by then, talk to your doctor — they may adjust the dose or switch medications.
Practical tips: dosing, side effects, interactions, and stopping
Typical starting dose for adults is 10 mg once daily. Some start at 5 mg (older adults or sensitive patients) and doctors may go up to 20 mg if needed. Take it at the same time each day. Food doesn’t matter.
Common side effects include nausea, sleep changes, dry mouth, sweating, headache, and reduced sexual desire or trouble reaching orgasm. These often ease after 1–3 weeks. If a side effect is severe or persistent, call your doctor.
Watch for serious warning signs: sudden high fever, fast heartbeat, severe agitation, or muscle stiffness could be serotonin syndrome when combined with other serotonergic drugs (like MAOIs, tramadol, triptans, or St John’s wort). Also be aware of increased bleeding risk if you take blood thinners or NSAIDs. Older adults may get low sodium (hyponatremia) — watch for weakness, confusion, or dizziness.
Don’t mix escitalopram with MAO inhibitors. Tell your doctor about all meds and supplements. Some drugs (strong CYP2C19 inhibitors like omeprazole) can raise escitalopram levels and may need dose changes.
If you stop escitalopram suddenly, you can get withdrawal symptoms: dizziness, electric-shock sensations, irritability, sleep trouble, or flu-like symptoms. To avoid this, taper slowly over weeks as your doctor advises. Pregnant or breastfeeding? Talk to your clinician about risks and alternatives — sometimes continuing treatment is safer than stopping.
Questions to ask your prescriber: How long before I expect benefits? What side effects should I report right away? How should we taper if I stop? Are there interactions with my other meds? Keep a short symptom diary for the first 8 weeks so you and your doctor can track progress.
Escitalopram helps many people, but the right use matters. If something feels off, get medical advice rather than guessing. Small changes in dose or timing can make a big difference.
