As a result, some individuals may report that the antidepressant or anxiolytic effect of Lexapro was noticed immediately after treatment initiation. In attempt to better understand how serotonergic antidepressants work, researchers conducted a study in which Lexapro was administered to participants who agreed to undergo neuroimaging scans in the form of magnetic resonance imaging. Researchers discovered that a single dose of Lexapro 20 mg significantly alters connectivity throughout the entire brain in hours post-administration.
More specifically, researchers noted that Lexapro administration substantially decreased neural connectivity within a majority of cortical and subcortical regions, yet increased neural connectivity within the cerebellum and thalamus — all in under 4 hours. It was concluded that a single dose of Lexapro exerts rapid connectivity changes that encompass the entire brain.
Perhaps it is changes in neural connectivity facilitated by Lexapro that might yield rapid responses experienced by a subset of users. Realize that there might be additional explanations other than those provided as to why Lexapro may require a reasonable amount of time to start working. In certain Lexapro users, it is likely that 5-HT1A receptors need to decrease i.
Until 5-HT1A receptor downregulation occurs, a subset of users may not notice Lexapro working. The chief reason 5-HT1A receptors require time to downregulate is related to genomic signaling.
When Lexapro inhibits the reuptake of serotonin in the brain, extracellular serotonin levels increase and stimulate 5-HT1A receptors to a greater extent than pre-treatment. The stimulation of 5-HT1A receptors by Lexapro should temporarily decrease the firing rates of serotonin-containing i.
That said, as Lexapro continues interacting with 5-HT1A receptor sites over a longer-term e. Once 5-HT1A receptors have downregulated, or decreased in population, serotonin-containing neurons become disinhibited whereby their firing rates dramatically increase. Increased firing rates of serotonergic neurons bolsters activation of postsynaptic serotonin receptors, possibly leading Lexapro users to derive therapeutic benefit — or report that the drug has begun working.
Another reason Lexapro may require more time than expected to start working is related to a delay in its induction of neuroplasticity. Though Lexapro induces neuroplastic changes within the brain by increasing BDNF and stimulating hippocampal neurogenesis and gliogenesis, these neuroplastic changes typically do not occur immediately. For concentrations of BDNF to significantly increase and hippocampal neurogenesis and gliogenesis to occur — it is thought that Lexapro needs to be administered for a reasonable duration of 4 to 8 weeks.
When Lexapro has been administered for 1 to 2 months, gene signaling will have occurred such that the medication will have facilitated the growth of new brain cells and tissue in the hippocampus. The upregulation of BDNF coupled with hippocampal remodeling may be what contributes most substantially to the therapeutic effect derived from Lexapro — for a subset of users.
Once the neuroplastic changes have occurred e. A person initiating treatment a low dose of Lexapro e. Essentially, a 20 mg dose of Lexapro might exert 2-fold greater serotonin reuptake inhibition than a 10 mg dose. Additionally, longer-term neurophysiologic adaptations to Lexapro such as 5-HT1A receptor downregulation and hippocampal neurogenesis may occur at a faster rate in high dose users. A psychiatrist or medical doctor may recommend gradually titrating the dosage upwards i.
Nevertheless, know that low or subclinical dosing in the first few weeks of Lexapro treatment might be a reason as to why the medication can take a while to start working. There are a variety of influential variables that probably determine how long it takes for a Lexapro user to notice that the medication is working. A Lexapro user with high self-awareness who initiates treatment at a therapeutic dose e.
The initial dose of Lexapro that you use for treatment may determine how quickly the drug begins working. This is because at higher doses, Lexapro provides more substantial serotonin reuptake inhibition than at lower doses. For example, a 20 mg dose of Lexapro should provide double the serotonin reuptake inhibition of a 10 mg dose such that extracellular serotonin signaling will greater — contributing to a more pronounced effect.
Additionally, it is thought that neurophysiologic adaptations that require time such as 5-HT1A receptor downregulation and hippocampal remodeling might occur at a quicker rate in persons who start treatment with a high dose — compared to a lower one.
Once you're feeling better it's likely that you'll continue to take escitalopram for several more months to prevent the symptoms returning. You'll need to discuss with your doctor the pros and cons of continuing to take escitalopram for longer than a few months.
The decision will depend on the type and severity of your symptoms, whether it's a one-off problem or one that keeps coming back, how well escitalopram works for you, and whether you have had any bad side effects.
If you have been feeling better for 6 months or more, your doctor may suggest coming off escitalopram. Your doctor will probably recommend reducing your dose gradually over several weeks, or longer if you have been taking escitalopram for a long time. This is to help prevent any extra side effects you might get as a reaction to coming off the medicine.
Do not stop taking escitalopram suddenly or without talking to your doctor first. A few people may get sexual side effects, such as problems getting an erection or a lower sex drive.
In some cases these can continue even after stopping the medicine. Speak to your doctor if you are worried. But sometimes people respond better to one antidepressant than to another.
Escitalopram and citalopram are both medicines used to treat depression. Escitalopram can make you feel less hungry, so you may lose weight when you first start taking it. If you start to have problems with your weight while taking escitalopram, talk to your doctor or pharmacist.
Some people find they can't concentrate properly while they're taking escitalopram. It might be best to stop driving and cycling for the first few days of treatment until you know how this medicine makes you feel. Escitalopram will not affect any type of contraception, including the combined pill or emergency contraception.
There's some evidence that escitalopram can reduce the quality of sperm, but it's not known whether this reduces male fertility. The effect should reverse once you stop taking the medicine. Speak to your doctor if you're concerned. For women, there's no firm evidence to suggest that taking escitalopram will reduce your fertility. But speak to a pharmacist or doctor if you're trying to get pregnant.
They may want to review your treatment. The good effects of escitalopram may, after a while, improve your sex life as your mood lifts and you become interested in life and relationships again. Sexual side effects usually pass after the first couple of weeks. However, very rarely, they can be long lasting and may not get better even after stopping the medicine.
If these happen and are a problem for you, go back to your doctor to see if there's another treatment you can try. You can drink alcohol while taking escitalopram, but it may make you feel sleepy. It might be best to stop drinking alcohol until you see how the medicine makes you feel. Antidepressants, including escitalopram, are just one of several approaches to treating depression or anxiety.
If you're interested in any of these treatments, talk to your doctor. Cannabis can also make drowsiness worse with escitalopram, especially in people who have just started taking it. Methadone can increase the risk of side effects in people taking escitalopram. Talk to your doctor if you think you might use recreational drugs while taking escitalopram. Page last reviewed: 14 December Next review due: 14 December Escitalopram On this page About escitalopram Key facts Who can and cannot take escitalopram How and when to take it Side effects How to cope with side effects Pregnancy and breastfeeding Cautions with other medicines Common questions.
About escitalopram Escitalopram is a type of antidepressant known as a selective serotonin reuptake inhibitor SSRI. Help us improve our website Can you answer a quick question about your visit today? It usually takes 4 to 6 weeks for escitalopram to work. Side effects such as feeling sick nausea and headache are common. Efficacy of escitalopram in the treatment of social anxiety disorder: A meta-analysis versus placebo. Eur Neuropsychopharmacol. Long-term use of escitalopram and a high level of carcinoembryonic antigen.
Korean J Fam Med. Escitalopram for the treatment of major depression and anxiety disorders. Expert Rev Neurother. A comparative review of escitalopram, paroxetine, and sertraline: are they all alike? Int Clin Psychopharmacol. National Library of Medicine. Updated February 15, Your Privacy Rights. To change or withdraw your consent choices for VerywellMind.
At any time, you can update your settings through the "EU Privacy" link at the bottom of any page. These choices will be signaled globally to our partners and will not affect browsing data. We and our partners process data to: Actively scan device characteristics for identification. I Accept Show Purposes. Table of Contents View All. Table of Contents. What Is Lexapro? Before Taking Lexapro. Lexapro Dosage. How to Take and Store Lexapro. Lexapro Side Effects. Lexapro Warnings and Interactions.
Taking your medication as prescribed will ensure that you experience its full effectiveness. An Overview of Lexapro Withdrawal. Was this page helpful? Thanks for your feedback! Sign Up. What are your concerns? Combined use of aspirin, nonsteroidal anti-inflammatory drugs e.
This may include symptoms such as gums that bleed more easily, nose bleed, or gastrointestinal bleeding. Some cases have been life threatening. To date, there are no known problems associated with long term use of escitalopram. It is a safe and effective medication when used as directed. Escitalopram should not be taken with or within 2 weeks of taking monoamine oxidase inhibitors MAOIs.
Escitalopram may increase the effects of other medications that can cause bleeding e. Sleep, energy, or appetite may show some improvement within the first weeks. Improvement in these physical symptoms can be an important early signal that the medication is working.
Depressed mood and lack of interest in activities may need up to weeks to fully improve. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide.
This risk may persist until significant remission occurs. In short-term studies, antidepressants increased the risk of suicidality in children, adolescents, and young adults when compared to placebo. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age Adults age 65 and older taking antidepressants have a decreased risk of suicidality.
Patients, their families, and caregivers should be alert to the emergence of anxiety, restlessness, irritability, aggressiveness and insomnia.
All patients being treated with antidepressants for any indication should watch for and notify their health care provider for worsening symptoms, suicidality and unusual changes in behavior, especially during the first few months of treatment. Last Updated: January This information is being provided as a community outreach effort of the College of Psychiatric and Neurologic Pharmacists.
This information is for educational and informational purposes only and is not medical advice. This information contains a summary of important points and is not an exhaustive review of information about the medication.
Always seek the advice of a physician or other qualified medical professional with any questions you may have regarding medications or medical conditions. Never delay seeking professional medical advice or disregard medical professional advice as a result of any information provided herein. The College of Psychiatric and Neurologic Pharmacists disclaims any and all liability alleged as a result of the information provided herein. Search Close Menu.
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