Best Time To Take Lexapro For Anxiety & Other Things To Know 2023

In recent years, about 1 in 5 adults^[1] in the United States reported treatment for mental health. If you or someone close to you has started taking Lexapro (escitalopram oxalate) you may be wondering: “When is the best time to take escitalopram for anxiety?” To best answer this question, it is helpful to discuss how the medication works and its potential side effects. With this knowledge, you will be more able to use Lexapro comfortably and effectively. Let’s get started!

What Is Lexapro?

Lexapro belongs to a class of medications called selective serotonin reuptake inhibitors, or SSRIs. These medications are also commonly called antidepressants, a term that can be confusing for individuals who may be using the medication to treat anxiety. Many antidepressants have also been shown to improve the management of anxiety symptoms and are widely used for this purpose.

Lexapro is FDA-approved for the management of:

• Major Depressive Disorder (MDD)
• Generalized Anxiety Disorder (GAD)^[2]

Lexapro is also commonly used to support patients managing several other conditions. These are considered “off-label” and include:

• Panic Disorder^[3]
• Post Traumatic Stress Disorder (PTSD)
• Obsessive Compulsive Disorder (OCD)
• Social Anxiety Disorder (SAD)^[4]
• Premenstrual Dysphoric Disorder (PMDD)^[5]
• Vasomotor Symptoms of Menopause (i.e. hot flashes)

Multiple types of therapy are available and can be effective^[6] in their own right for these conditions. Regular sessions with a therapist are often combined with the use of medications like Lexapro for additional support.

How Does Lexapro Work?

Mechanism Of Action Of Lexapro

Our bodies use neurotransmitters such as serotonin to transmit signals or information along neural pathways. These signals help define our mood, our responses to stress, and how we feel. Lexapro causes serotonin to build up by slowing down the reuptake of the serotonin nerve cells’ release, which is why it is considered a selective serotonin reuptake inhibitor. This increase in serotonin levels helps with the management of anxiety^[7] and depression^[8] symptoms.

Selective Serotonin Reuptake Inhibitors May Have A Delayed Effect 

When starting Lexapro, it is essential to be aware that the medication can take several weeks to become effective. Research shows that your individual genetics^[9] can play a role in how well the medication may work for you, and how likely side effects may be. It is best to give the medication up to four to six weeks to work so your body will have a chance to fully regulate serotonin receptors.

Lexapro Common Dosage

Lexapro dosage when treating anxiety will be defined by your doctor. A common approach is to “start low and go slow,” meaning lower doses of the medication are often used early in therapy and may be increased if needed for additional support.

Lexapro is available in 5mg, 10mg, and 20mg tablets.

• 10mg is a common starting dose for anxiety.
• 20mg is the maximum recommended dose.

Package insert instructions suggest a minimum of one week before a dose increase, but many clinicians opt to schedule an appointment four to six weeks after starting therapy. This allows Lexapro to start working after the first few weeks on a regular dosing schedule, and gives you a chance to get a better feel for how well the medication has been working for you.

Lexapro Side Effects

Some individuals prefer to use supplements for managing anxiety symptoms. It is important to ensure these are reputable brands as they do not require rigorous review by the FDA to enter the market. Researching brands like HUM is helpful prior to use.

Lexapro is considered a generally well-tolerated medication. There are potential side effects to be aware of, however. These effects do not occur for everyone but do happen for a significant number of individuals.

Suicidal Thoughts

Use of Lexapro has been associated with suicidal thoughts. It is important to note that the conditions Lexapro is being used to treat are also associated with suicidal ideation, particularly when left untreated. Regardless of whether or not you are using medication, it is important to know that you and the people you care about are not alone.

Confidential, professional support is available for free 24 hours a day, 7 days a week in the United States by dialing 988 or visiting 988lifeline.org.

Gastrointestinal Effects, Such As Nausea Or Diarrhea 

These effects may be self-limiting, meaning they can go away on their own after an adjustment period. If any effects on your stomach are unbearable or last beyond the first week of use, it is helpful to notify a healthcare professional for additional assistance.

Insomnia (Difficulty Sleeping)

Getting good sleep while managing anxiety can be difficult enough. If you are having trouble sleeping, taking Lexapro in the morning can help reduce potential sleep disturbances.

Drowsiness 

Initial drowsiness (and sometimes dizziness) can be self-limiting for some patients. If these effects are lingering for a week or more, or if you feel as though you may fall, it is best to call your doctor to discuss these concerns.

Sexual Dysfunction 

Lexapro has been associated with a potential for delayed or absent orgasm and decreased libido (sexual desire) in some individuals. These effects may be more easily missed when discussing treatment during follow-up with your doctor. If this is concerning for you, it is important to bring it up for discussion!

Missed Dose 

Taking the medication every day is important to make sure it remains effective, but it also prevents potential Lexapro withdrawal symptoms. Missed doses or stopping suddenly is associated with dizziness, difficulty concentrating, difficulty sleeping, and other symptoms. If you miss a day, do not double dose – simply resume your normal daily dose.

Drug Interactions 

Serotonin Syndrome 

When Lexapro is combined with other medications that increase serotonin, it is possible for these levels to become too concentrated, potentially leading to serotonin syndrome. The symptoms most often associated with serotonin syndrome^[10] are palpitations (feeling your heart pounding or racing), sweating, and confusion, among others. These symptoms may be more likely to occur if you are taking multiple psychiatric health medications, including certain sleep aids.

Smoking 

Smoking can lower concentrations^[11] of Lexapro in your body, making the medication less effective. The use of nicotine products (including vaping) has also been associated with increased anxiety in some individuals.

Alcohol 

The impact of alcohol use while taking antidepressant medications is not well-defined. Evidence does point to the potential for becoming more heavily intoxicated,^[12] raising concerns about worsening coordination and decision-making. It is helpful to discuss this interaction with your doctor prior to drinking while on Lexapro.

Over-The-Counter Pain Medications

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil), naproxen (Aleve), and aspirin raise the risk of bleeding, particularly when combined with SSRIs like Lexapro. This combination can also increase the risk of stomach ulcers.^[13]

Conclusion

Taking Lexapro consistently each day over time is important to help the medication work while limiting side effects associated with missed doses. The time of day does not impact how well the medication works. Timing does have the potential to impact side effects, and taking Lexapro in the morning limits the potential impact on sleep. This makes morning dosing an effective strategy for many people!

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