Quick Facts
Generic NameEscitalopram
Brand NameLexapro
Drug ClassSSRI
FDA Approved2002
Starting Dose5–10mg/day
Typical Range10–20mg/day
Max Dose20mg/day
Half-Life27–32 hours
MetabolismCYP2C19 (major), CYP3A4
Generic Available2012
What Is Lexapro?
Escitalopram (brand name Lexapro) is a selective serotonin reuptake inhibitor (SSRI) prescribed for depression, generalized anxiety, panic disorder, and other psychiatric conditions. Most SELECTIVE SSRI — purest serotonin mechanism. Cleanest side effect profile. Fewest drug interactions in class. Simple dosing (10–20mg). Multiple meta-analyses rank it among the most effective AND best-tolerated antidepressants. S-enantiomer of citalopram with superior efficacy.
At Psychiatry Telemed, escitalopram is prescribed and monitored by board-certified psychiatrists who understand the nuances of SSRI pharmacology — selecting the right dose, managing side effects, monitoring drug interactions, and optimizing your treatment through consistent monthly medication management appointments.
Escitalopram (Lexapro) — SSRI medication for psychiatric care
ManufacturerLundbeck / Allergan (originally Forest)
How Lexapro Affects Neurotransmitters
How Lexapro Works
Escitalopram is the S-enantiomer of citalopram — the most selective SSRI available. Its exquisite selectivity for the serotonin transporter, with virtually no activity at other receptor sites, translates to the cleanest side effect profile and fewest drug interactions of any SSRI.
Efficacy: Lexapro vs. Comparators
Efficacy Comparison
Response & remission rates vs. comparators (Cipriani et al. meta-analysis)
Data from published meta-analyses. Individual response may vary.
Conditions Treated with Lexapro
Depression
FDA-approved for MDD. Most selective SSRI with cleanest side effect profile.
Learn About DepressionGeneralized Anxiety
FDA-approved for GAD. First-line with excellent tolerability.
Learn About Generalized AnxietyConsidering Lexapro?
Board-certified psychiatrists can determine if escitalopram is right for you.
Dosage Information
| Indication | Starting Dose | Typical Range | Maximum |
|---|---|---|---|
| Depression | 5–10mg/day | 10–20mg/day | 20mg/day |
| Generalized Anxiety | 5–10mg/day | 10–20mg/day | 20mg/day |
| Panic Disorder | 5–10mg/day | 10–20mg/day | 20mg/day |
| Social Anxiety | 5–10mg/day | 10–20mg/day | 20mg/day |
Brain Regions Targeted by Lexapro
Side Effects
Like all medications, escitalopram has potential side effects. Most are mild, occur early in treatment, and resolve within 1–2 weeks. Your psychiatrist monitors at every appointment.
Common Side Effects
NauseaHeadacheInsomniaDiarrheaDrowsinessDry Mouth
Less Common
SweatingSexual DysfunctionFatigueTremorAppetite Changes
Serious (Seek Immediate Help)
Serotonin SyndromeSuicidal Thoughts (under 25)QTc Prolongation (dose-dependent)HyponatremiaAbnormal Bleeding
Side Effect Profile: Lexapro vs. Class Average
Side Effect Profile
Incidence rates from FDA prescribing information vs. class average
Percentages from clinical trial data. Actual experience may differ.
⚠️ FDA Black Box Warning
Antidepressants may increase suicidal thinking in young adults under 25.
Drug Interactions
Major Interactions
MAOIs (contraindicated), CYP2C19 inhibitors (increase levels), pimozide, QTc-prolonging drugs
CYP Metabolism
Substrate of CYP2C19 and CYP3A4. Does NOT significantly inhibit any CYP enzymes. Fewest pharmacokinetic interactions of any SSRI.
Alcohol
Avoid alcohol during escitalopram treatment. Both affect the CNS, increasing sedation and impairing judgment.
Generic Versions & Cost
Generic escitalopram available since 2012. Approximate cost: $4–10/month. FDA-certified bioequivalent to brand-name Lexapro.
Starting Lexapro: What to Expect
First Weeks
Escitalopram is typically started at 5–10mg/day and increased gradually. Common initial side effects usually improve within 1–2 weeks. Full therapeutic benefit develops over 4–8 weeks.
When to Contact Your Psychiatrist
Contact your psychiatrist for: worsening depression/anxiety, thoughts of self-harm, unusual agitation, severe side effects, or any concerning changes.
Stopping Lexapro Safely
Never stop escitalopram abruptly. Your psychiatrist will develop a gradual tapering schedule to minimize discontinuation effects.
Timeline: When Lexapro Starts Working
Timeline to Effectiveness
Expected improvement trajectory over the first 8 weeks
Based on clinical trial data. Full therapeutic effects may take 6–8 weeks.
Get Lexapro from a Board-Certified Psychiatrist
At Psychiatry Telemed, escitalopram is prescribed following comprehensive evaluation. All Florida via HIPAA-compliant telepsychiatry. 1–3 days. $200 eval, $100 follow-up.
Frequently Asked Questions
Prescribed for depression, generalized anxiety, panic disorder, social anxiety.
Typically 2–4 weeks for initial improvement, 4–8 weeks for full benefit.
Common: nausea, headache, insomnia, diarrhea, drowsiness. Most resolve within 1–2 weeks.
No. Not habit-forming but should not be stopped abruptly — gradual tapering recommended.
Most SELECTIVE SSRI — purest serotonin mechanism. Cleanest side effect profile. Fewest drug interactions in class. Simple dosing (10–20mg). Multiple meta-analyses rank it among the most effective AND
Alcohol should be avoided — increases sedation, impairs judgment, and may worsen symptoms.
Resources
Medical Disclaimer: Educational only. Consult a psychiatrist before starting/stopping medication. Crisis: call 988 or 911.
Last reviewed: