Escitalopram

Escitalopram is an antidepressant. It improves your mood so you feel better.

You can only get escitalopram on prescription.

It comes as tablets.

Other names for escitalopram include:

  • Etalopro
  • Esciprex
  • Escitalpro
  • Lexapro

Escitalopram is not the same medicine as citalopram. 

Uses of escitalopram

Escitalopram is a kind of antidepressant known as an SSRI (selective serotonin reuptake inhibitor).

These work by increasing levels of a mood-enhancing chemical in your brain called serotonin.

Usually you will be prescribed escitalopram to treat depression.

Your GP might also recommend it for:

Get emergency help

You might need to go to an emergency department (ED) if you get serious side effects, take too much or have a serious allergic reaction (anaphylaxis).

If you take too much

Immediate action required: Phone your GP or go to an ED if you take too much escitalopram and:

  • are agitated
  • get sick (vomit)
  • are dizzy or pass out
  • have low blood pressure
  • are shaking
  • have a faster heart rate
  • have seizures (fits)

Do not drive yourself. Get someone else to drive or call 999 or 112 for an ambulance.

Bring the escitalopram packet or leaflet plus any remaining medicine.

Serious allergic reactions

A serious allergic reaction after taking escitalopram is rare.

Immediate action required: Call 112 or 999 or go to an ED if:

  • you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
  • you are wheezing
  • you have trouble breathing or talking
  • your mouth, face, lips, tongue or throat start swelling

Serious side effects

Immediate action required: Go to your nearest ED straight away or phone a GP if you have:

  • a headache, trouble focusing, memory problems, not thinking clearly, weakness, seizures or losing your balance
  • thoughts about harming yourself or ending your life
  • a high temperature (above 38 degrees Celsius) with agitation, confusion, trembling and twitching - these may be signs of a rare condition called serotonin syndrome
  • problems peeing
  • seizures (fits)
  • yellowing of the skin and the white in the eyes
  • a fast or irregular heart beat or faint
  • sudden swelling of skin, nose or mouth
  • severe dizziness or passing out
  • weight gain or loss
  • changes in your periods such as heavy bleeding, spotting or bleeding between periods
  • painful erections that last longer than 4 hours - this may happen even when you are not having sex
  • signs of bleeding from the gut such as vomiting blood, dark vomit, coughing up blood, blood in your pee, black or red poo
  • bleeding from the gums or bruises that appear without a reason or that get bigger
  • any bleeding that is very bad or that you cannot stop

Check if you can take escitalopram

You can be prescribed escitalopram if you're 18 or over. But escitalopram is not suitable for some people.

Talk to your GP before taking escitalopram if you:

  • have had an allergic reaction to any medicine
  • have epilepsy
  • have a heart problem
  • have a low heart rate plus you have had severe diarrhoea and vomiting for a long time or take water tablets (diuretics)
  • have liver or kidney problems
  • have low sodium (salt) levels
  • bruise or bleed easily
  • are having electroconvulsive treatment
  • have ever taken any other medicines for depression
  • have ever had eye problems, such as glaucoma
  • are pregnant or trying to become pregnant
  • are breastfeeding 

See the patient information leaflet that comes with your medicine for a full list of conditions to check with your GP.

Pregnancy and breastfeeding

Do not take escitalopram if you are pregnant or breastfeeding, unless you have talked to your GP about the risks involved.

Escitalopram can affect an unborn baby and cause side effects for babies.

You should also talk to a GP or pharmacist before taking escitalopram if you're trying for a baby or think you might be pregnant.

Contraception and fertility

Escitalopram does not affect contraceptive pills or the morning after pill. It will not affect a woman's fertility.

Sperm quality in men might be reduced temporarily while you are taking escitalopram, but there is not much evidence to support this. Talk to your GP if you have concerns.

Diabetes and escitalopram

Monitor your blood sugar more often for the first few weeks of treatment if you have diabetes. 

Escitalopram can make it more difficult to keep your blood sugar stable.

Your GP may adjust your diabetes treatment if necessary.

When you start taking escitalopram

Concentrating may be more difficult while you're taking escitalopram.

You should stop driving and cycling until you know how this medicine makes you feel. Do not operate machinery while taking escitalopram.

How and when to take escitalopram

Always take your medicine exactly as your GP tells you to.

You'll usually take escitalopram once a day. Try to stick to the same time every day. 

You can reduce the chance of bad side effects if you take escitalopram in the evening. That way you're asleep when the level of medicine in your body is highest.

If you have trouble sleeping, take it in the morning instead of the evening.

You can take escitalopram with or without food.

Dosage of escitalopram

Usually you will be prescribed a daily dose of between 5mg to 10mg of escitalopram.

Your GP might start you on a lower dose and then increase to a maximum dose of 20mg a day.

Lower doses for liver problems

Your GP will not prescribe you more than 10 mg escitalopram if you have liver problems.

How long it takes to work

Do not stop taking escitalopram after a week or 2 because you feel it is not helping.

Usually it takes between 4 to 6 weeks to feel the full effect.

You might feel worse during the first few weeks of treatment before you begin to feel better. If you feel worse, talk to your GP.

Talk to your GP if you do not feel any better after 6 weeks.

How long you will need to take escitalopram

Once you feel better you'll probably continue to take escitalopram for several more months. 

This is to prevent the symptoms returning. 

Your GP can talk to you about the pros and cons of taking escitalopram for longer than a few months.

Any decision about continuing on escitalopram will depend on your situation, including:

  • if you have a one-off problem or one that keeps coming back
  • how well your body responds to escitalopram  

Escitalopram is safe to take for a long time, even years.

Stopping taking escitalopram

Do not stop taking escitalopram suddenly unless your GP tells you to. You can get side effects when you stop or withdrawal symptoms.

Your GP might recommend reducing your dose of escitalopram gradually over several weeks. This can reduce your chance of unpleasant withdrawal symptoms.

If you forget to take it

Never take 2 doses to make up for forgotten doses.

If you do forget to take a dose, and you remember before you go to bed, take it straight away.

If you only remember during the night, or the next day, leave out the missed dose and carry on as usual.

If you forget doses often, it may help to set an alarm to remind you.

You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

Side effects

Side effects such as feeling sick and headaches are common. They are usually mild and go away after a couple of weeks.

Keep taking your escitalopram but talk to your GP or pharmacist if side effects bother you or do not go away.

Side effects can include:

  • dry mouth
  • sweating a lot
  • being unable to sleep
  • feeling sleepy
  • feeling tired or weak

Weight loss and gain and escitalopram

Escitalopram can make you feel less hungry, so you may lose weight when you first start taking it. Later, you may gain a little weight as your appetite returns. 

Talk to your GP or pharmacist if you start to have problems with your weight while taking escitalopram.

Sex and escitalopram

The positive effects of escitalopram may improve your sex life. This might happen as you become interested in life again.

Negative effects may include:

  • men getting painful erections, problems with getting an erection and problems with ejaculating
  • women having some vaginal bleeding and not reaching orgasm the same as before
  • a lower sex drive

Sexual side effects should pass after the first couple of weeks.

Talk to your GP about treatment options if sexual side effects do not stop and this is a problem for you.

Taking escitalopram with other medicines

Tell your GP or pharmacist if you are taking any other medicines, have recently taken or might take any other medicines. This includes herbal remedies, vitamins or supplements.

Some medicines and escitalopram can interfere with each other. This can increase your chance of side effects.

Talk to your GP or a pharmacist before starting on escitalopram if you are taking:

  • any medicines that affect your heartbeat - as escitalopram can speed up or change your heartbeat
  • any other medicines for depression - some rarely used antidepressants can interact with escitalopram to cause very high blood pressure

See the patient information leaflet that comes with your medicine for a full list of medicines that can interfere with escitalopram.

Escitalopram and St John's wort

Do not take St John's wort, the herbal remedy for depression, while you are being treated with escitalopram. This will increase your risk of side effects.

Alcohol and escitalopram

It's usually OK to drink alcohol while taking escitalopram, but it's best not to. It may make you sleepy.

You should stop drinking alcohol until you see how the medicine makes you feel.

Recreational drugs and escitalopram

Talk to your GP if you think you might use recreational drugs while taking escitalopram.

You might be putting yourself in danger if you take escitalopram with:

  • stimulants like ecstasy, MDMA or cocaine
  • hallucinogens like LSD
  • novel psychoactive substances

Taking methadone with escitalopram can increase the risk of side effects.

Taking cannabis with escitalopram can:

  • give you a fast heartbeat
  • make drowsiness worse, especially if you have just started taking escitalopram

Finding your patient information leaflet online

Your patient information leaflet (PIL) is the leaflet that comes in the package of your medicine. 

Information:

To find your PIL online, visit the Health Products Regulatory Authority (HPRA) website

  1. In the ‘Find a medicine’ search box, enter the brand name of your medicine. A list of matching medicines appears.
  2. To the right of your medicine, select ‘PIL’. A PDF of the PIL opens in a new window. 

You can also:

  1. Select the brand name of your medicine.
  2. Scroll down to the Documents section.
  3. From the Package Leaflet line, select PDF version. A PDF of the PIL opens in a new window. 

If your PIL is not on the HPRA website, the European Medicines Agency (EMA) website opens in a new window when you select ‘PIL’.

You can find your PIL on the EMA website.

Finding your PIL on the EMA website

If your PIL is not on the HPRA website, you will be sent to the European Medicines Agency (EMA) website.

To find your PIL on the EMA website:

  1. In the Medicines search box, enter the brand name of your medicine and the word ‘epar’. For example: ‘Zoely epar’. A list of matching medicines appears.
  2. Select the ‘Human medicine European public assessment report (EPAR)’ for your medicine
  3. From the table of contents, select Product information.
  4. Select the EPAR – Product Information link for your medicine. A PDF opens in a new window. The PIL information is in Annex III of the PDF under ‘labelling and package leaflet’

This content was fact checked by a pharmacist, a GP, the National Medication Safety Programme (Safermeds) and the Health Products Regulatory Authority (HPRA).

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This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 123.

Page last reviewed: 24 September 2021
Next review due: 24 September 2024

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