Last Updated on July 8, 2022 by
Alternative to Meds Editorial Team
Medically Reviewed by Dr Samuel Lee MD
Unfortunately, some of the research and anecdotal evidence collected to date has revealed disturbing trends.
Observed long-term side effects of Lexapro include:
- Weight Gain – For many patients, long term antidepressant treatment goes hand in hand with weight gain. In more extreme cases, this can feed back into a loop of negative feelings about one’s own body and health, exacerbating depressive symptoms and thought patterns.
- Heightened Carcinoembryonic Antigen levels – CEA levels are used as an indicator for certain types of cancer.
- Insomnia – Some users report significant disruption to their sleep patterns after starting a long-term antidepressant regimen.
- Emotional Numbness – While antidepressants can be effective at chilling negative thought patterns like negativity and despair, they can also desensitize your other emotions. Long term antidepressant users sometimes report an inability to feel “real” happiness or even a loss of interest in their close relationships.
- Sexual Dysfunction – A high percentage of antidepressant patients report reduced sex drive and problems with sexual performance.
- Addiction – Long term antidepressant patients sometimes feel concerned that they are becoming addicted or chemically dependent; the sometimes-severe withdrawal episodes experienced by people who attempt to quit SNRIs or SSRIs “cold turkey” validates this concern.
- Suicidal Thought Patterns – One of the most concerning things about Lexapro and other antidepressants in its class is that a significant number of patients actually experience an increase in suicidal thoughts instead of relief from depressive symptoms.
Quitting Lexapro
If you’re already on a high dose of Lexapro or generic escitalopram and have decided to end treatment, never attempt to do so cold turkey. Just as you build up the drug in your system gradually to start achieving its effects, you will need to reduce your dose slowly over time so that your body can adjust.
Unfortunately, withdrawal from Lexapro and other antidepressants can constitute some of their most extreme and unpleasant side effects. Withdrawal can potentially create a scary and drawn-out ordeal for someone who decides Lexapro just isn’t working for them after titrating up to a higher dose, as prescribed by their doctor.
What Are the Mental Side Effects of Lexapro?
The mechanism by which Lexapro and other SNRIs act upon the brain, in simplified terms, is to force the brain to retain certain neurotransmitters. Clinical trials seem to suggest that SNRIs and SSRIs (another common and related class of antidepressant medication) may reduce some symptoms of depression in some patients, but we still lack a solid understanding of why this is. Perhaps more importantly, we don’t understand why it doesn’t work consistently across all patients and for all symptoms.
Because we don’t understand exactly how the inhibition of serotonin-norepinephrine reuptake would regulate someone’s mood in a positive and stabilizing way, we can’t even say definitively that forcing the brain to retain these neurotransmitters can actually reduce the symptoms of depression. That can be an unnerving prospect for patients prescribed these medications.
Measuring the efficacy of these drugs through clinical studies has not yet led to a complete understanding of how they work, nor their long-term side effects. The possibility exists that SNRIs are a risky pharmaceutical “hack” that does not cure depression and anxiety at all, but merely works to mask the symptoms of depression in some patients, and only some of the time.
SNRI treatment is a long-term maintenance project rather than a pharmaceutical “cure” much like an antiviral or antibiotic that you would stop taking after your infection has cleared up. SNRIs are also not a fast-acting medication to manage symptoms when they arise, such as an inhaler for asthma attacks or benzodiazepines for episodes of acute anxiety.
That Lexapro and other SNRIs are prescribed in this way says several alarming things about how they work:
- Lexapro doesn’t really work at all until you’ve been taking it a while and have allowed it to build up in your system.
- Lexapro continues affecting your system daily, even if you aren’t feeling the symptoms of depression and don’t feel the need for medication.
- Lexapro often only works for as long as a patient continues to take it; stopping treatment is also a long-term commitment as withdrawal symptoms can be serious.
- Long-term SNRI treatment often means gradually increasing the dose to adjust for tolerance over time. A patient with serious underlying mental issues may eventually find themselves taking the highest approved dose of Lexapro while no longer feeling any real benefit from it and will then be faced with the equally daunting prospects of switching medications or attempting to get off a high dose of Lexapro.
A 2013 study set out to determine why neurotransmitter targeting medicines like Lexapro left the majority of patients with at least one serious symptom of depression. 2 The study’s conclusions were less than inspiring for those patients using SNRIs or SSRIs and still struggling with symptoms of depression.
Among the study’s key clinical points: “Effective strategies” for dealing with these persistent symptoms were identified as “switching to a different antidepressant” as well as “adding adjunctive medications.” The problem with this approach is self-evident. Patients who feel let down — or even worse off — after trying SNRIs are understandably very hesitant to add additional medications or try another similar strategy.
What Are the Bad Side Effects of Lexapro?
A 2015 project attempted to weigh the clinical value of different antidepressant types against their most notable and commonly reported side effects. 3
Some of the most concerning side effects linked to SNRIs in this paper include:
- Increased anxiety, especially early in the treatment cycle
- Insomnia and general restlessness
- Headaches
- Sexual dysfunction or reduced sex drive
- High blood pressure
Frequently Asked Questions about Lexapro Side Effects
New patients prescribed SNRI treatment will have a great deal of questions. These are the most common.
Q: Will I Gain Weight on Lexapro?
A: As it turns out, yes, it is fairly typical for patients to gain a small to moderate amount of weight when starting SNRI treatment. More uncommonly, starting Lexapro can cause changes in appetite that can also lead to weight changes.
Q: Is Lexapro Hard on the Liver?
A: Unfortunately, many medications can take a toll on the liver, including Lexapro. Even acetaminophen, the active ingredient in Tylenol and one of our most commonly ingested medications, is toxic to your liver. Your liver works hard to keep toxins filtered from your body, and when it must deal with daily doses of chemicals over a long period, the situation can become analogous to the overworked liver of an alcoholic. Remember the long standing wisdom: too much of any medicine constitutes a poison.
Q: Is Lexapro Linked to Dementia?
A: There is currently no data available to conclusively link Lexapro to dementia. However, the powerful way SNRIs work to change brain chemistry has some researchers concerned about the potential for Lexapro and other SNRI drugs to lead to long-term brain damage.
Q: What Should I Avoid While Taking Lexapro?
Besides being a powerful medicine in its own right, there are a number of other medicines and supplements that are best avoided when you’re on an escitalopram regimen.
These include:
- Fentanyl
- Buspirone
- Lithium
- Tryptophan
- Amphetamines (including Adderall)
- St. John’s Wort
- Imitrex
- Tramadol
- Zomig
This is by no means an exhaustive list of medications that can interact with Lexapro. If you’re ever uncertain about taking another prescription drug or over the counter medication while on Lexapro, reach out to your doctor for clarification before making any decisions that could risk your health.
