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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 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:

Check if you can take escitalopram

Most adults can take escitalopram if prescribed. But it's not suitable for some people.

Talk to your GP before taking escitalopram if you:

  • have had an allergic reaction to any medicine
  • have epilepsy or are having electroconvulsive treatment - escitalopram may increase your risk of having a seizure
  • have a heart problem - escitalopram can give you an irregular heartbeat or make your heart beat faster
  • have a low heart rate and 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
  • 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.

Non-urgent advice: Find your patient information leaflet

Your patient information leaflet is the leaflet that comes with your medicine. You can find a digital version of the leaflet online.

Non-urgent advice: Talk to a GP or pharmacist

before taking escitalopram if you're:

  • trying for a baby
  • pregnant
  • breastfeeding

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.

But it's important that depression and anxiety are well treated during pregnancy as these can affect you and your baby's wellbeing. Depression and anxiety can sometimes get worse during pregnancy, and after your baby is born.

Talk to your doctor if you become pregnant. They will help you weigh up the risks and benefits so you can decide on the best treatment for you and your baby.

Contraception and escitalopram

Escitalopram does not affect contraceptive pills or the morning after pill.

Fertility and escitalopram

Escitalopram 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

You may find it harder to concentrate 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.

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

You will usually be prescribed a daily dose of between 5mg and 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 10mg of escitalopram if you have liver problems.

If you forget to take it

If you 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.

Never take 2 doses to make up for forgotten doses.

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.

If you take too much

The amount of escitalopram that can lead to an overdose varies from person to person.

Emergency action required: Go to an emergency department (ED) or contact your GP immediately if:

  • you take more than your prescribed dose of escitalopram

Do not drive yourself. Get someone else to drive or call 122 or 999 for an ambulance.

Take the escitalopram packet or the leaflet inside it, plus any remaining medicine, with you.

How long it takes to work

It usually takes between 4 and 6 weeks to feel the full effect of escitalopram.

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

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.

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

Important

Do not stop taking escitalopram suddenly unless your GP tells you to.

Your GP might recommend reducing your dose of escitalopram gradually over a few weeks. This is to reduce your chance of unpleasant withdrawal symptoms.

These can include:

  • dizziness
  • feeling sick
  • numbness or tingling in the hands or feet
  • trouble sleeping
  • feeling agitated or anxious
  • headaches
  • shaking

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.

Common side effects

There are things you can do to help cope with common side effects:

Feeling sick (nausea)

Try taking escitalopram with or after food. It may also help if you avoid rich or spicy food.

Headaches

Make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller.

Headaches should usually go away after the first week of taking escitalopram. Talk to your doctor if they last longer than a week or are severe.

Dry mouth

Chew sugar-free gum or suck sugar-free sweets.

Sweating a lot

Try wearing loose clothing and using a strong anti-perspirant. If this does not control the problem, talk to your GP. You may need to try a different antidepressant.

Trouble sleeping

Take escitalopram first thing in the morning.

Feeling sleepy

Take escitalopram in the evening and cut down the amount of alcohol you drink. If this does not help, talk to your GP. Do not drive, ride a bike or use tools or machinery if you're feeling sleepy.

Feeling tired or weak

Stop what you're doing and sit or lie down until you feel better. Do not drive, ride a bike or use tools or machinery if you're feeling tired. Do not drink alcohol as it will make you feel worse.

Serious side effects

Emergency action required: Go to your nearest ED straight away or contact a GP urgently 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
  • problems peeing
  • seizures (fits)
  • yellowing of the skin and the white in the eyes
  • a fast or irregular heart beat or fainting
  • sudden swelling of skin, nose or mouth
  • severe dizziness or passing out
  • painful erections that last longer than 2 hours
  • 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 within 10 minutes

Non-urgent advice: Make an appointment to see your GP if:

  • you lose or gain weight without trying
  • you get changes in your periods, such as heavy bleeding, spotting or bleeding between periods

Serious allergic reactions

A serious allergic reaction after taking escitalopram is rare.

Emergency 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

See the patient information leaflet that comes with your medicine for a full list of side effects.

Non-urgent advice: Find your patient information leaflet

Your patient information leaflet is the leaflet that comes with your medicine. You can find a digital version of the leaflet online.

Report side effects

You can report any suspected side effects to the Health Products Regulatory Authority (HPRA): report an issue - hpra.ie

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, 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.

Non-urgent advice: Find your patient information leaflet

Your patient information leaflet is the leaflet that comes with your medicine. You can find a digital version of the leaflet online.

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.

Non-urgent advice: Find your patient information leaflet

Your patient information leaflet is the leaflet that comes with your medicine. You can find a digital version of the leaflet online.

Escitalopram and St John's wort

Do not take St John's wort, the herbal remedy for depression, while you are taking 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

Fact check

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

Page last reviewed: 5 June 2024
Next review due: 5 June 2027

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