Lexapro Side Effects in Women

By Craig Sorkin, DNP, APN
Medically reviewed checkmarkMedically reviewed
May 23, 2022

Nobody is immune to depression or anxiety.

However, women are about twice as likely as men to develop depression or anxiety during their lifetime.

Additionally, women may be more prone to experience heightened symptoms (such as pain, disturbed sleep, and decreased appetite and energy) from either condition.

While not everyone needs or desires medication to manage mental health, women may respond better to certain types of medications for depression and anxiety. 

One common medication for these health conditions is the antidepressant escitalopram oxalate (Lexapro).

Though effective, this selective serotonin reuptake inhibitor (SSRI) also comes with possible side effects and may not be appropriate for women in different stages of life.

In this article, I’ll explore how Lexapro specifically affects women, including common and serious side effects.

I’ll also discuss the use of Lexapro during pregnancy and breastfeeding, ways to minimize potentially negative effects, and when to see a doctor about anxiety, depression, or Lexapro side effects or concerns.

Lexapro Side Effects in Women

Lexapro is approved by the Food and Drug Administration (FDA) for the treatment of major depressive disorder and generalized anxiety disorder.

Lexapro works by slowing how quickly the brain clears serotonin.

Serotonin is a neurotransmitter that supports a good mood and feelings of well-being.

When serotonin levels are too low, it can lead to mood disorders, anxiety, depression, and a poor quality of life.

Like any medication, Lexapro can cause various side effects, some of which are more serious than others.

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Common side effects

Common side effects of Lexapro include:

More serious side effects

Lexapro and other SSRIs have a smaller chance of causing serious side effects or problems compared to other drug classes of antidepressants.

Still, in some cases, it can cause severe adverse events.

These are more likely to occur at higher doses or if there is an interaction with another medication.

The most common serious side effects include:

  • Problems with electrolyte balance in the body (hyponatremia)
  • Altered mental status
  • Seizures
  • Coma
  • QT prolongation
  • Heart rhythm problems
  • Serotonin syndrome

Serotonin syndrome can be life-threatening. It is most likely to occur if Lexapro is paired with other drugs or substances that affect serotonin, like other antidepressant medicines.

If you notice any of the following symptoms, seek care at an emergency department:

  • High heart rate
  • High blood pressure
  • Dizziness
  • Flushing
  • Nausea
  • Vomiting
  • Diarrhea
  • Agitation
  • Hallucinations
  • Tremors
  • Muscle stiffness
  • Fever

Drug interaction side effects

Lexapro can interact with other medications and substances, including prescription drugs, over-the-counter (OTC) medicines, and supplements such as:

  • Pimozide
  • Monoamine oxidase inhibitors (MAOIs)
  • Stimulants
  • Blood thinners
  • Opioid pain relievers
  • Anti-nausea medications
  • Other antidepressants
  • Other anti-anxiety medications
  • Medications for migraines
  • Medications for Parkinson’s disease
  • St. John’s wort
  • Alcohol

Also do not take Lexapro if you have:

  • Hypersensitivity or allergy to any ingredients in escitalopram (Lexapro) or citalopram (Celexa)
  • Bipolar disorder or bipolar mania
  • Seizure disorder
  • Liver disease or disorder
  • Kidney disease
  • Heart disease
  • High blood pressure
  • Bleeding or clotting disorders

Lexapro and Pregnancy

If you are pregnant or thinking about becoming pregnant, talk to your healthcare provider if you take Lexapro.

Escitalopram is rated class C for pregnancy, which means that definite risks have not been identified but also cannot firmly be ruled out.

Some risks of Lexapro during pregnancy include:

  • Withdrawal symptoms in the infant
  • Respiratory distress
  • Irritability
  • Poor feeding
  • Congenital birth defect (slightly increased risk)

On the other hand, untreated depression during pregnancy can lead to complications that may include or increase the risk of:

  • Fetal growth problems
  • Low birth weight
  • Premature birth
  • Postpartum complications in the mother
  • Post-birth complications in the baby, including developmental delays

A healthcare provider can help you decide if the benefits of Lexapro outweigh the potential risks.

If you decide that you want to stop the medication before you get pregnant or when you find out that you are pregnant, work with your doctor to taper your dose.

Stopping Lexapro suddenly can increase the chance of withdrawal symptoms.

Lexapro while breastfeeding

Not all antidepressants are safe to use while breastfeeding, but Lexapro can be under certain circumstances, such as:

  • Dosage that is 20 milligrams (mg) or lower
  • Infant is older than 2 months

If you are taking Lexapro while breastfeeding, watch for signs that Lexapro may be affecting your child.

These include:

  • Drowsiness
  • Restlessness
  • Agitation or fussiness
  • Poor feeding
  • Problems gaining weight

Avoiding Lexapro Side Effects

It is not always possible to avoid all potential side effects from Lexapro or other antidepressant medications.

But there are things you can do to decrease the chances of having worse side effects:

  • Take your prescription as directed. Dosage and timing are incredibly important with antidepressants like Lexapro.
  • Lexapro can take several weeks to fully take effect. While you are waiting for it to work, do not mix other medications or substances, like alcohol, to provide symptom relief. Even if you cannot feel Lexapro working in the first few weeks, it is fully in your system.

Minimizing side effects

Side effects of Lexapro may be more noticeable when dosages are higher, so your healthcare provider will start you on a low dose and gradually increase if needed.

To minimize any side effects, tell your healthcare provider and pharmacist all of the prescriptions, OTC medicines (like ibuprofen or aspirin), and herbs or supplements that you take, even if you take them infrequently.

Also avoid consuming grapefruit juice while taking Lexapro, since it can increase how much medication your body retains.

This can lead to symptoms of a higher dose than you are actually taking, which can increase the potential for side effects.

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When to See a Doctor

If you have symptoms of anxiety or depression and this affects your daily functioning, speak to a healthcare provider to explore your treatment options.

Even if you are pregnant or trying to conceive, you can still receive treatment.

Your healthcare provider will help you understand risks versus benefits.

If you take Lexapro and experience side effects that worsen, or you do not notice improvements after several weeks, contact your healthcare provider.

They may adjust your dosage or change medications.

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Frequently Asked Questions

What are the most common side effects of Lexapro?
Lexapro affects people differently. Some common side effects include changes in appetite, nausea or vomiting, weight gain, headache, and sleep problems. Your healthcare provider will explain what symptoms you may expect and what to do if they do not improve with time or worsen.
What are serious side effects of Lexapro?
Serious side effects of Lexapro can occur, but in many cases, they happen because of drug interactions, taking the medication incorrectly, or underlying health conditions. Lexapro can cause electrolyte imbalances or altered mental status. In people who are susceptible, it may increase the risk of seizure or QT prolongation, a heart condition. If taken with other drugs or substances that affect serotonin levels, it can cause serotonin syndrome, which can be life-threatening. Take Lexapro as directed and follow your doctor’s instructions. Do not suddenly stop taking Lexapro, as this can increase the risk of withdrawal symptoms.
Do Lexapro side effects go away?
Many patients notice more side effects when they first start taking Lexapro. As your body adjusts to the medication, side effects may lessen with time, typically after a few weeks. If side effects worsen or do not go away and significantly interfere with your quality of life, talk to your healthcare provider. They may reduce your dosage, or switch you to a different medication that may have fewer or different side effects.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

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Craig Sorkin, DNP, APN

Craig Sorkin, DNP, APN is a board certified Family Nurse Practitioner with over 15 years experience. He received his Undergraduate and Graduate degrees from William Paterson University and his doctoral degree from Drexel University. He has spent his career working in the Emergency Room and Primary Care. The last 6 years of his career have been dedicated to the field of digital medicine. He has created departments geared towards this specialized practice as well as written blogs and a book about the topic.