Lexapro for anxiety: Benefits, side effects, and considerations

Lexapro for anxiety: Benefits, side effects, and considerations

Discover how Lexapro (Escitalopram) can effectively manage anxiety disorders. Learn about benefits, side effects, precautions, and more from Talkiatry's mental health experts.

Reviewed by:
Austin Lin, MD
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September 28, 2023
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Key takeaways

If you’re struggling with anxiety your doctor may have recommended you start a medication such as Lexapro. Medications can be helpful for reducing the symptoms of anxiety, but you may have mixed feelings about starting a medication—especially if you’re new to taking them. Are there side effects? When will you feel better? Will you still feel like yourself? Our team of expert psychiatrists is here to help.  

In this article we’ll answer all your questions about taking Lexapro for anxiety including its benefits, side effects, and other things you’ll want to take into consideration.  

Lexapro (escitalopram) for anxiety

Lexapro (escitalopram) is an SSRI (selective serotonin reuptake inhibitor) and it’s commonly prescribed and  Food and Drug Administration (FDA) -approved to treat common mental health conditions including generalized anxiety disorder (GAD) and depression (major depressive disorder). Doctors may also use it to treat panic disorder, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD).  

Lexapro, or another  SSRI, is often the first type of medication that doctors will prescribe for anxiety. This is because, compared to other types of anxiety medications, SSRIs like Lexapro are generally well tolerated and are effective in relieving symptoms. If you start Lexapro and find it’s not working for you—don't get discouraged. Everyone responds differently to medications and there are several other types of medications that can be used to treat anxiety including other types of SSRIs (like citalopram (Celexa or paroxetine (Paxil)), SNRIs (like duloxetine), MAOIs (monoamine oxidase inhibitors), and TCAs. Chat with your doctor about these other options.  

Interested in learning more about different treatment options? Read more about how Talkiatry treats anxiety.

How does Lexapro work?  

Lexapro works by increasing levels of serotonin in your brain. Serotonin is a type of neurotransmitter or chemical messenger that is mostly known for regulating your emotions—including feelings like satisfaction, happiness, and optimism. But serotonin also plays a role in anxiety, sleep, digestion, cognition, and memory, among other things.  

So exactly how does Lexapro boost levels of brain serotonin? Normally, once serotonin does its job of sending a chemical message, it gets absorbed by nerve cells. Lexapro prevents some of this absorption from happening so that your brain has more serotonin available where needed.  


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What’s the difference between Lexapro and other SSRIs?

Lexapro is a brand name for escitalopram—the active ingredient in Lexapro. It belongs to a class of drugs called SSRIs, all of which work to increase levels of serotonin in the brain. But not all SSRIs are the same. SSRIs can contain different active ingredients. For example, Zoloft contains the active ingredient sertraline. Depending on the active ingredient, different SSRIs may be FDA-approved to treat different conditions. They also may come with different side effects. Your doctor will work with you to determine which medication might be best for you.  

To learn more about how it compares to other medications, check out these articles: Lexapro vs Wellbutrin and Lexapro vs Prozac

Potential side effects and considerations

As with any medication, Lexapro comes with the possibility of side effects. When people do experience side effects, they are usually mild and go away as their body adjusts to the medication.  

The most common side effects of Lexapro include:

  • Trouble sleeping
  • Sweating
  • Decreased sex drive
  • Sexual dysfunction: delayed orgasm or inability to have an orgasm
  • Delayed ejaculation  
  • Drowsiness or tiredness
  • Sleepiness  
  • Nausea
  • Weight gain

If you experience any of the above side effects or anyone worsening symptoms while taking Lexapro, chat with your doctor. They may suggest adjusting your dose. It’s important to continue taking your medication as directed and to attend all follow-up appointments so you and your doctor can monitor your reaction to the medication. Stopping Lexapro abruptly can lead to an adverse reaction and be dangerous.  

Rare but serious side effects include:

  • Increased risk of suicidal thoughts or actions (particularly in young adults)  
  • Serotonin syndrome or too high of serotonin levels
  • Discontinuation syndrome (withdrawal symptoms caused by stopping medication abruptly)
  • Seizures
  • Manic episodes (in people with bipolar disorder)
  • Low sodium levels in the blood (hyponatremia)
  • Increased risk of bleeding
  • Visual problems in people with certain eye problems
  • Allergic reaction

These side effects are rare, and your doctor will discuss them with you ahead of time as well as ways to reduce your risk of experiencing them—for example Lexapro may not be recommended if you have been diagnosed with or have a family history of bipolar disorder or are taking certain medications. If you do experience any of these side effects while taking Lexapro, reach out to your doctor right away or seek emergency medical attention. Side effects such as serotonin syndrome can be life-threatening if not treated.  

Lexapro isn’t right for everyone, so it’s important to talk with your doctor before taking Lexapro or any other prescription medication. Before you are prescribed a medication, your doctor will go over your health history, family history, any medications you’re currently taking, as well as any current symptoms you are experiencing. All of this information will help your doctor determine which medication may help safely and effectively manage your anxiety symptoms.


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Is Lexapro a good choice for anxiety?

Lexapro is a safe and effective treatment for anxiety. If you’re living with an anxiety disorder or think you might be, reach out to a healthcare provider like a primary care doctor or psychiatrist. They can help you navigate your different treatment options so you can start feeling better.  

Lexapro may not be a good choice for you if:

  • You are taking other medications such as blood thinners, st. john’s Wort, or MAOIs. Certain medications may increase your risk for serious side effects.  
  • You have other medical conditions such as seizure disorder, bipolar disorder, glaucoma, high blood pressure, or kidney or liver disease.
  • You are pregnant, planning to become pregnant, or are breastfeeding.

Before prescribing a medication, your doctor will conduct a thorough evaluation to help you make a safe and informed choice about your treatment.

Related: How To Get Anxiety Medication

How long does it take for Lexapro to work for anxiety?

If Lexapro is recommended for you, you can expect to start feeling relief from some of the symptoms of anxiety in a few weeks, although in some cases it may take longer. You may find it helpful to keep track of your symptoms, logging them before and after you start the medication. This information will help you and your doctor make decisions about your medication such as adjusting the dose, or exploring other treatment options.

Want to learn more about whether or not your medication is working for you? Check out: Signs your Antidepressant dose is Too Low or Too High

What is the difference between Lexapro for depression and Lexapro for anxiety?

Although Lexapro is referred to as an ‘antidepressant,’ it is  FDA-approved to treat both depression and generalized anxiety disorder (GAD). In both cases, they will likely start you on a small dose and increase slowly based on how you respond to the medication. It is typical to be started on a dose of 5 mg or 10 mg if you’ve taken an antidepressant before.

What is the difference between Lexapro and Zoloft?

Lexapro and Zoloft are both a kind of antidepressant called an SSRI. So what’s the difference? While both Lexapro and Zoloft work in the same way (that is—they both enhance the level of serotonin that is available in your brain), they are made with different active ingredients.  

The active ingredient in Zoloft is sertraline and the active ingredient in Lexapro is escitalopram. These two medications will come with slightly different side effects and are FDA-approved to treat slightly different conditions.  

Zoloft is approved to treat depression, panic disorder, and obsessive-compulsive disorder (OCD). Lexapro is FDA-approved to treat depression and generalized anxiety disorder (GAD).  

The bottom line

Although Lexapro is classified as an ‘antidepressant’, it is also FDA-approved to treat generalized anxiety disorder (GAD). Because of its safety and effectiveness, Lexapro is commonly prescribed for generalized anxiety disorder and is considered a ‘first-line treatment’ along with therapy, meaning doctors tend to prescribe this medication before trying other options.  

Keep in mind, Lexapro isn’t right for everyone. Treatment plans are highly individualized and your doctor will take into account your health history, family history, current symptoms, and any medications or supplements you’re currently taking.  

If you’re experiencing anxiety or think you might be, take the first step and make an appointment with a health professional like a psychiatrist or primary care doctor.  

Getting started with Talkiatry  

At Talkiatry, you can see an expert psychiatrist from the comfort of home and have your first visit in days. To get started, take our online, free 10-minute assessment. We’ll let you know if Talkiatry is a good fit and match you with a psychiatrist that takes your insurance.  

Talkiatry is a national psychiatry practice that provides in-network, virtual care. Co-founded by a patient and a triple-board-certified psychiatrist, Talkiatry has over 300 doctors, 60 insurance partners, and first visits available in days. We treat patients with anxiety disorders, depression, trauma, ADHD, and more.

The information in this article is for informational and educational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.  

Sources

Encephale | Efficacy and tolerability of escitalopram in anxiety disorders: a review

Iranian Journal of Public Health | Happiness & Health: The Biological Factors- Systematic Review Article

Escitalopram (Lexapro) | NAMI: National Alliance on Mental Illness

Lexapro Fact Sheet | Food and Drug Administration (FDA)

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Frequently asked questions

Does Talkiatry take my insurance?

We're in network with major insurers, including:

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The best way to get a detailed estimate of your cost is to contact your insurance company directly, since your cost will depend on the details of your insurance.  

For some, it’s just a co-pay. If you have an unmet deductible it could be more.  

Call the number on your insurance card and ask about your plan’s coverage for outpatient psychiatric services.

What kind of treatment does Talkiatry provide?

At Talkiatry, we specialize in psychiatry, meaning the diagnosis and treatment of mental health conditions. Your psychiatrist will meet with you virtually on a schedule you set together, devise a treatment plan tailored to your specific needs and preferences, and work with you to adjust your plan as you meet your goals.

If your treatment plan includes medication, your psychiatrist will prescribe and manage it. If needed, your psychiatrist can also refer you to a Talkiatry therapist.

What's the difference between a therapist and psychiatrist?

Psychiatrists are doctors who have specialized training in diagnosing and treating complex mental health conditions through medication management. If you are experiencing symptoms of a mental health condition such as depression, anxiety, bipolar disorder, PTSD, or similar, a psychiatrist may be a good place to start.  

Other signs that you should see a psychiatrist include:  

  • Your primary care doctor or another doctor thinks you may benefit from the services of a psychiatrist and provides a referral    
  • You are interested in taking medication to treat a mental health condition  
  • Your symptoms are severe enough to regularly interfere with your everyday life

The term “therapist” can apply to a range of professionals including social workers, mental health counselors, psychologists, professional counselors, marriage and family therapists, and psychoanalysts. Working with a therapist generally involves regular talk therapy sessions where you discuss your feelings, problem-solving strategies, and coping mechanisms to help with your condition.

How does Talkiatry compare to face-to-face treatment?

For most patients, Talkiatry treatment is just as effective as in-person psychiatry (American Psychiatric Association, 2021), and much more convenient. That said, we don’t currently provide treatment for schizophrenia, primary eating disorder treatment, or Medication Assisted Treatment for substance use disorders.

Who can prescribe medication?

All our psychiatrists (and all psychiatrists in general) are medical doctors with additional training in mental health. They can prescribe any medication they think can help their patients. In order to find out which medications might be appropriate, they need to conduct a full evaluation. At Talkiatry, first visits are generally scheduled for 60 minutes or more to give your psychiatrist time to learn about you, work on a treatment plan, and discuss any medications that might be included.

About
Austin Lin, MD

Dr. Austin Lin is a double board-certified adult and addiction psychiatrist who has been in practice for over 9 years. At the center of Dr. Lin’s clinical approach is a strong emphasis on establishing trust and using a collaborative approach to help patients develop an individualized and cohesive plan so that they are able to achieve their goals.

Dr. Lin's practice focuses on medication management. Typically, he offers this in conjunction with supportive therapy, motivational interviewing, and/or cognitive behavioral therapy in 30-minute follow-up visits. Occasionally, Dr. Lin may recommend that additional therapy is needed and ask that you bring a therapist into your care team in order to provide the best outcome.

Dr. Lin received his medical degree from St. George’s University School of Medicine. He went on to complete his residency in psychiatry at Harvard South Shore, an affiliate of Harvard Medical School, where he served as Chief Resident and earned his 360° Professionalism award. He then had additional training in Addiction Psychiatry through his fellowship at the University of Texas Southwestern Medical Center. After completing training, Dr. Lin has worked as an Addiction Psychiatrist and Director of Adult Services in the Trauma and Resilience Center (TRC) at the University of Texas Health Science Center at Houston (UTHealth). He specialized in treating patients with a history of depression, anxiety, trauma, and substance use disorders.

Dr. Lin has held an academic appointment at UTHealth, and he has spent his professional career supervising and teaching medical students and psychiatry residents.



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