How Long Does Lexapro Take to Work?

How long does Lexapro take to work? Lexapro (escitalopram) is an antidepressant, and it usually takes several weeks to feel the full benefit. The National Institute of Mental Health says antidepressants generally take 4 to 8 weeks to work. Some people notice small changes, such as steadier sleep, earlier, while side effects can appear before benefits do.

This article is for adults in Texas who have recently been prescribed escitalopram, or who are a few weeks in and wondering whether it is working. It covers what the medicine is, what to expect over time, common side effects and when to call your prescriber.

This article is general information, not a medical recommendation. Do not start, stop or change any medication without talking to your prescriber.

What is Lexapro and what is it used for?

Lexapro is the brand name for escitalopram, a selective serotonin reuptake inhibitor (SSRI). MedlinePlus, from the National Library of Medicine, lists its uses as treating depression and generalized anxiety disorder, and notes that a prescriber may sometimes use it for other conditions.

SSRIs are one of several classes of antidepressants. MedlinePlus explains that antidepressants are medicines used to treat depression and some other conditions, and that you should never stop taking one on your own.

Your prescriber chooses a medicine based on your symptoms, history, other medicines and health conditions. This article does not cover dosing or compare escitalopram with other medicines; those are questions for your prescriber.

How long does Lexapro take to work for depression and anxiety?

It usually takes several weeks to feel the full benefit. MedlinePlus states that it may take several weeks before you feel the full benefit of escitalopram, and the National Institute of Mental Health (NIMH) says antidepressants usually take 4 to 8 weeks to work.

Change is often gradual rather than sudden. People sometimes notice that others see an improvement, such as more energy or interest, before they feel it themselves. Mood and worry may be the last things to shift.

Everyone responds differently. The NIMH depression guide notes that finding the best treatment may take some trial and error, so if you are unsure whether it is helping, the right step is a conversation with your prescriber, not a change on your own.

What can you expect week by week?

You can expect side effects and small changes first, and a clearer picture of benefit after several weeks. This is a general outline, not a prediction for any one person:

• First one to two weeks: side effects are most likely to show up now. NIMH notes that side effects are generally mild and tend to go away with time.
• Weeks two to four: some people notice early changes in sleep, energy or appetite. Mood may not have shifted yet.
• Weeks four to eight: this is the window NIMH describes for antidepressants to work. It is a common time for a follow-up visit to review progress.
• After that: your prescriber will talk with you about how long to continue and what the plan is if the benefit is partial.

Example: someone might notice in week three that they are sleeping a little better and getting out of bed more easily, even though they still feel low. Results vary, and this is only an illustration.

What are the common side effects?

Common side effects listed by MedlinePlus for escitalopram include nausea, sexual problems, drowsiness, trouble falling or staying asleep, and increased sweating. Many early side effects ease over the first few weeks, but you should tell your prescriber about any that bother you.

MedlinePlus also lists serious side effects that need prompt medical attention. These include signs of an allergic reaction such as rash, hives or swelling of the face or throat; a combination of fever, confusion, fast heartbeat, severe muscle stiffness and agitation; unusual bleeding or bruising; and seizures.

If you have any serious symptom, contact your prescriber right away or seek emergency care. Do not wait for your next scheduled visit.

What is the boxed warning for young people?

Escitalopram, like other antidepressants, carries an FDA boxed warning about suicidal thoughts and actions in young people. MedlinePlus explains that the risk may apply to children, teenagers and young adults under 24, and may be higher in the first few months of treatment and when the dose is increased.

The U.S. Food and Drug Administration (FDA) advises that patients and families watch for new or worsening agitation, irritability, unusual changes in behavior or suicidal thinking, and contact the prescriber if these appear. This is one reason early follow-up visits matter.

How can you get the most from the first weeks? Step by step

You can get the most from the first weeks by taking the medicine as prescribed, tracking how you feel and staying in touch with your prescriber. These steps help most people:

1. Take it exactly as prescribed. Ask your prescriber or pharmacist what to do if you miss a dose.
2. Track a few things daily. Rate mood, worry, sleep and energy from 1 to 10, and note side effects.
3. Keep your follow-up visit. Bring your notes so you can see the trend together.
4. Ask before mixing. Check with your prescriber or pharmacist before adding other medicines, supplements or alcohol.
5. Keep therapy and routines going. Sleep, movement and therapy support recovery while the medicine takes effect.
6. Do not stop suddenly. MedlinePlus warns that stopping escitalopram suddenly may cause withdrawal symptoms such as mood changes, irritability, dizziness and trouble sleeping.

See do I still need therapy if medication is working? for how the two fit together.

What should you ask your prescriber? A checklist

You should ask what to expect, what to watch for and what happens next if it is not helping. MedlinePlus advises asking your doctor or pharmacist any questions you have about your medicine. Useful questions:

• "When should I expect to notice a difference?"
• "Which side effects are common, and which mean I should call you?"
• "What should I do if I miss a dose?"
• "Is it safe to drink alcohol while taking this?"
• "Can I take my other medicines and supplements with it?"
• "When is my next follow-up, and how will we judge progress?"
• "What is the plan if it only helps a little?"

Read what happens at a medication management visit to know what follow-ups usually cover, and how to talk to your therapist or psychiatrist for tips on raising concerns.

If you feel rushed during visits, write your questions down beforehand and bring your daily tracking notes. Asking "how long does Lexapro take to work for someone in my situation?" is a reasonable question, and your prescriber can answer it with your history in mind.

What if it does not seem to be working?

If it does not seem to be working, talk to your prescriber rather than stopping or adjusting it yourself. MedlinePlus advises that you should not stop taking escitalopram without talking to your doctor, because the dose is usually reduced gradually.

It can also help to look back at where you started. If your depression or anxiety was first picked up on a questionnaire, our article on what to do after a positive depression screen explains what a screening result means and what usually happens next.

Your prescriber may review whether enough time has passed, look at side effects, check for other contributors such as sleep, substance use or medical conditions, and consider adding or adjusting therapy. Any medication change is an individual decision made with your prescriber.

When should you get help sooner?

You should get help sooner if you notice serious side effects or worsening mood. MedlinePlus and the FDA both describe warning signs that need prompt contact with a clinician:

• New or worsening thoughts of suicide or self-harm.
• New agitation, panic, restlessness, or acting on dangerous impulses.
• Unusual excitement, very little need for sleep, or racing thoughts.
• Rash, hives, swelling or trouble breathing.
• Fever, confusion, fast heartbeat and muscle stiffness together.
• Seizures, or unusual bleeding or bruising.

For thoughts of suicide, call or text 988. Call 911 for immediate danger or a severe reaction.

Can you get medication follow-up by telehealth in Texas?

Many adults in Texas can have medication follow-up by telehealth. Telehealth.HHS.gov explains that providers must be licensed or legally permitted to practice in the state where the patient is located, and those rules vary by state, so your location during the visit matters.

The Texas Department of Insurance, in a 2021 bulletin, explains that Texas law requires insurers it regulates to cover in-network telehealth services the same as in-person care. Plan types differ, so check your own coverage.

Getting support in Texas

Lyte Psychiatry offers therapy, psychiatric evaluation and medication management in Texas. Lyte Psychiatry offers telehealth visits to patients who are physically located in Texas at the time of the visit. In-person visits are available at Lyte Psychiatry's clinic in Pantego, in the Dallas–Fort Worth area. All Lyte Psychiatry services are available in Spanish.

Most new patients are seen within 1–2 business days. Weekend appointments are limited. Availability, insurance and clinician fit require confirmation. Learn about medication management or telepsychiatry in Texas.

If you are in a mental-health crisis in the United States, call or text 988. Call 911 for immediate danger.

Educational information, not a diagnosis or individual treatment plan.