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Best Time of Day to Take Lexapro and Other Tips

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Lexapro (generic drug escitalopram) is an antidepressant medication used to treat generalized anxiety disorder and major depressive disorder in adults and children 12 years of age and older. 

In this article, we will discuss some important tips for taking Lexapro, including the best time to take it, possible side effects, interactions with other medications, and more.

What is Lexapro? How does it work?

Lexapro (escitalopram oxalate) belongs to a group of antidepressant medications called selective serotonin reuptake inhibitors (SSRIs). They are prescription drugs available in oral dosage forms, including tablets and oral solutions. 

SSRIs (selective serotonin reuptake inhibitors) work by increasing the levels of serotonin in the central nervous system. Serotonin is a natural substance that plays a key role in mood regulation and mental balance.

A healthcare professional may prescribe an SSRI to treat a wide variety of mental health conditions. Lexapro is FDA-approved to treat major depressive disorder (MDD) in adults and children 12 years and older. Lexapro is also indicated for the treatment of generalized anxiety disorder (GAD) in adults.

In addition to MDD and GAD, Lexapro has been used off-label for the following conditions: panic disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), binge eating disorder such as bulimia nervosa, and premenstrual dysphoric disorder (PMDD). Not commonly known, Lexapro is used off-label to prevent depression in stroke survivors.

What is the antidepressant medication Lexapro used to treat? 

Lexapro is used to treat depression and anxiety. It may also be used off-label to treat obsessive-compulsive disorder, insomnia, and vasomotor symptoms of menopause, such as hot flashes and night sweats, among other off-label uses discussed above. 

What is the usual Lexapro dose?

Lexapro is available as a tablet and oral solution (liquid) to take by mouth. Lexapro dosage depends on the condition and demographic (adult vs. pediatric). However, the average dose of Lexapro is 10 mg by mouth once daily. The maximum recommended dose is typically 20 mg per day, though it can be a lot higher; for example, the dose can be increased up to 60 mg daily to treat patients with OCD who did not respond to the lower dose after 8 weeks, as long as they can tolerate the medication. Your doctor may start you on a lower dose and increase the prescribed dose after one week. 

When should you take Lexapro?

You can take Lexapro in the morning or evening, with or without food. This medication is usually taken once a day. Try to take Lexapro at around the same time every day. This will help you remember to take it. Not everyone has sleeping problems with Lexapro or other SSRIs, but If you experience trouble falling asleep, you should set up a reminder on your phone or use a pill organizer. 

Take Lexapro exactly as prescribed by your healthcare provider. Follow the instructions on your prescription label carefully. Do not take more or less of the medication or take it more or less frequently than prescribed.

Keep in mind that it can take several weeks (up to 6 to 8 weeks) to experience the full effects of Lexapro. However, some people may notice an improvement in your mood and depression symptoms after 1 to 2 weeks. Inform your doctor if you notice worsening symptoms of depression during Lexapro (escitalopram) treatment. Do not stop taking escitalopram suddenly—this can lead to withdrawal symptoms.

Why should you take Lexapro in the morning?

You should take Lexapro in the morning if you have trouble sleeping while on this medicine. If this is the case and you take Lexapro at bedtime, it may cause insomnia. On the other hand, if Lexapro does not affect your sleep, you can take it at any time of the day. Try to stick to the same time every day for the best results.  

Does Lexapro work better at night?

Lexapro may or may not work better at night. In some people, antidepressants, especially SSRIs like Lexapro, can cause insomnia (inability to fall asleep or stay asleep). On the other hand, in some people, Lexapro and other antidepressants may help with insomnia symptoms. 

Some randomized controlled trials have found that perimenopausal and postmenopausal women with hot flashes benefit from Lexapro. By improving vasomotor symptoms, Lexapro may improve sleep quality in postmenopausal women. Lexapro has also been found to reduce sleep problems in some people with major depressive disorder and generalized anxiety disorder.

Approximately 75% of adults with depression symptoms suffer from insomnia. Therefore, if you are on Lexapro and are experiencing sleep problems, Lexapro may be the culprit. However, it is best to discuss your sleep problems with your doctor as soon as possible since medical conditions causing anxiety and depressed mood can also cause insomnia. 

It may take trial and error to see how Lexapro affects you to determine what time of the day is best to take this medicine. If this medicine causes insomnia, try taking it in the morning. Ask your doctor or pharmacist about different tips for switching Lexapro from night to morning.

Rest assured that there are different options for SSRIs and SNRIs (serotonin and norepinephrine reuptake inhibitors), so you can discuss their risks and benefits with your doctor. SNRIs are another class of antidepressants that are closely related to SSRIs. Lexapro, among other SSRIs, is effective and well-tolerated by most people. However, keep in mind that maintaining a healthful lifestyle, along with taking medications regularly, is essential for the best treatment outcomes.  

What are the possible side effects of Lexapro?

Common side effects of Lexapro include:

  • Gastrointestinal symptoms like nausea (extremely common), diarrhea, and constipation
  • Dry mouth, increased thirst, increased sweating 
  • Insomnia
  • Drowsiness, dizziness, unusual tiredness
  • Yawning
  • Shaky feelings due to increased muscle movements
  • Decreased appetite and weight loss
  • Runny nose, sneezing, flu-like symptoms
  • Decreased sex drive, and impotence in men

Tell your doctor if these side effects are severe or do not go away in a few days. Contact your doctor without delay. You should seek emergency medical attention if you develop signs and symptoms of an allergic reaction, such as skin rash, hives, itching, swelling, or trouble breathing and swallowing. 

Does Lexapro cause weight gain?

Weight changes are a possible side effect of Lexapro. Some people can gain weight on this medicine, and others might lose weight. Weight changes can also occur indirectly if you begin to eat more as your anxiety and depression ease. Eating a healthy diet and getting regular exercise can help offset any weight changes caused by Lexapro.

How to have the best results while taking Lexapro?

Here are some tips on the safe use of Lexapro:

Best Time of Day to Take Lexapro

You can take Lexapro in the morning or evening; however, if you are having trouble sleeping while on this medicine, it may help to take it in the morning. 

Missed Dose

If you miss a dose of Lexapro, take it as soon as you remember. However, if it is nearly time for your next dose, skip the missed dose and take the next dose according to your regular dosing schedule. Do not double the amount to make up for a missed one.

To have the best outcomes, you should take this medication regularly. Also, keep in mind that it may take up to 8 weeks for Lexapro to have the complete effects; therefore, you should not discontinue after one week without consulting your healthcare provider.

Side Effects

Lexapro can make you dizzy and drowsy and may affect your movements, thinking, and judgment. Do not drive or operate hazardous machinery. You should wait until you know how this medication affects you to perform any activity that requires focus and mental alertness. Remember that alcohol can worsen the drowsiness side effect caused by this medication.

Medical Conditions

Taking Lexapro may not be suitable for people with certain medical conditions. To make sure Lexapro is safe for you, tell your healthcare professional if you have ever had  

heart disease, liver disease, kidney disease, recent stroke, high blood pressure, glaucoma, seizures, sexual dysfunction, and bleeding disorders. Discuss with your doctor if you have a history of suicidal thoughts and drug addiction or misuse of pain medications.

Your healthcare provider will perform the bipolar disorder screening before starting Lexapro. Bipolar disorder can initially present with depressive symptoms. Even though there is no well-established data for patients presenting with depression due to bipolar disorder and those at high risk, it is believed that starting Lexapro on these patients may precipitate mixed or manic episodes.

Drug Interactions

Lexapro can interact with other medications and lead to serious adverse effects. Drug interactions can reduce the efficacy of medications or intensify their side effects. 

Serotonin syndrome is a concern caused by interactions between Lexapro and other drugs. Give your doctor a complete list of your medications, including prescription medications, over-the-counter products, and herbal supplements, to avoid dangerous drug interactions.

You should not take Lexapro if you have taken any monoamine oxidase inhibitors within 14 days before or 14 days after. Monoamine oxidase inhibitors (MAOIs) are serotonergic drugs, meaning they can affect the serotonin levels in the body. Combining Lexapro and an MAOI can lead to serotonin syndrome, which can be fatal if left untreated. The following MAO inhibitors are approved to treat depression: isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Emsam), and tranylcypromine (Parnate). Linezolid is an MAO inhibitor that is used to treat infection. 

Avoid taking Lexapro if you are taking citalopram (Celexa) or pimozide this is also applied to other SSRIs and SNRIs (serotonin and norepinephrine reuptake inhibitors).  

Seek medical attention right away if you have symptoms of serotonin syndrome, such as agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Other medications to watch out for are blood thinners such as warfarin and any medications that can make you drowsy; examples are opioid pain medicines, anxiety, and sleep medications, treatment for seizures, and muscle relaxers. 

Withdrawal Symptoms

Do not stop taking Lexapro suddenly, as this can lead to withdrawal symptoms. Ask your doctor how to lower the dose of Lexapro slowly. Remember, it can take up to 8  weeks to get the full benefits of Lexapro. Tell your doctor if you do not notice any improvement in your mood after this time period.

Suicidal Thoughts

People taking antidepressant medications, especially young adults between the age of 18 and 24, can develop suicidal thinking and actions. Children under 18 are also at risk. Call your doctor immediately if you notice any sudden changes in mood or suicidal thoughts. Make sure your family members know to contact your doctor if you are unable to seek care for yourself.

Serotonin Syndrome

Taking Lexapro can put you at risk of a rare but potentially life-threatening condition called serotonin syndrome (too much serotonin in the body). The risk is higher if you are taking other medications for antidepressant therapy that can also increase serotonin levels; some drug classes to watch out for are discussed above. Signs and symptoms include fever, confusion, fast heart rate, sweating, and muscle spasms or stiffness. Seek emergency medical care if you develop these symptoms. 

Use During Pregnancy

Lexapro can cause problems in newborn babies, especially if taken during the last few months of the pregnancy. Before starting this medication, tell your doctor if you are pregnant or breastfeeding.

 

References:

  1. https://medlineplus.gov/druginfo/meds/a603005.html
  2. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021323s047lbl.pdf
  3. https://reference.medscape.com/drug/lexapro-escitalopram-342961
  4. https://pubmed.ncbi.nlm.nih.gov/22433978/
  5. https://pubmed.ncbi.nlm.nih.gov/22057726/
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181883/