Drugs Q & A

How Long Does It Take Lexapro (Escitalopram) To Kick In?

What is Lexapro?

Escitalopram, sold under the brand names Cipralex and Lexapro, among others, is a prescription drug used to treat depression in adults and children and teenagers 12 years of age or older. Lexapro is also used to treat generalized anxiety disorder (GAD; excessive worry and tension that disrupts daily life and lasts for 6 months or longer) in adults.

Lexapro belongs to a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). It works by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance.

How long Lexapro (escitalopram) stays in your system?

All-drugs have a “half-life,” which is a term used to describe how long it takes for the amount of medication to decrease to half its starting dose in the body. Lexapro’s half-life ranges from 27 to 32 hours, depending on the person. For example, if a person took a single dose of 10 mg of Lexapro, within 27 to 32 hours, the dosage would be halved to 5 mg, and 27 to 32 hours from that point, the dosage would be halved to 2.5 mg. This will continue to halve until the medication is out of a person’s bloodstream.

Because it takes around five half-lives for a drug to be cleared from your system, and because the half-life of Lexapro is up to 32 hours, it can take up to 160 hours, or roughly six days, to clear Lexapro from your bloodstream. Lexapro is not typically measured in urine screening tests as it is not a controlled substance. 

How long does it take for Lexapro (escitalopram) to work?

Lexapro (escitalopram) comes as a tablet and a solution (liquid) to take by mouth. It is usually taken once a day with or without food. To help you remember to take escitalopram, take it at around the same time every day, in the morning or in the evening. It may take 1 to 4 weeks or longer before you feel the full benefit of Lexapro. Continue to take escitalopram even if you feel well. Do not stop taking escitalopram without talking to your doctor.

If you suddenly stop taking Lexapro, you may experience withdrawal symptoms such as mood changes, irritability, agitation, nausea, dizziness, burning, numbness, or tingling in the hands or feet, anxiety, confusion, headache, sweating, tiredness, and difficulty falling asleep or staying asleep. Your doctor will probably decrease your dose gradually.

Lexapro side effects

The side effects of Lexapro are the same in both men and women. However, the side effects vary slightly for adults and children.

Lexapro side effects in adults can include:

•          anxiety

•          constipation

•          dizziness

•          dry mouth

•          infection

•          loss of appetitive

•          nausea

•          sexual problems, such as decreased sex drive and erectile dysfunction

•          shaking

•          sleepiness

•          sleeping trouble

•          sweating

•          weakness

•          yawning

Lexapro side effects in children and adolescents can include the above, plus:

•          increased thirst

•          abnormal increase in muscle movement or agitation

•          nosebleeds

•          trouble urinating

•          heavy menstrual periods

•          slowed growth and weight change

There have been some cases of decreased appetite and weight loss with the use of Lexapro in children and adolescents. Your child’s doctor may check their height and weight during treatment.

Safety of Lexapro

A small number of children, teenagers, and young adults (up to 24 years of age) who took antidepressants (‘mood elevators’) such as escitalopram during clinical studies became suicidal (thinking about harming or killing oneself or planning or trying to do so). Children, teenagers, and young adults who take antidepressants to treat depression or other mental illnesses may be more likely to become suicidal than children, teenagers, and young adults who do not take antidepressants to treat these conditions. However, experts are not sure about how great this risk is and how much it should be considered in deciding whether a child or teenager should take an antidepressant. Children younger than 12 years of age should not normally take escitalopram, but in some cases, a doctor may decide that escitalopram is the best medication to treat a child’s condition.

You should know that your mental health may change in unexpected ways when you take escitalopram or other antidepressants even if you are an adult over 24 years of age. You may become suicidal, especially at the beginning of your treatment and any time that your dose is increased or decreased. You, your family, or your caregiver should call your doctor right away if you experience any of the following symptoms: new or worsening depression; thinking about harming or killing yourself, or planning or trying to do so; extreme worry; agitation; panic attacks; difficulty falling asleep or staying asleep; aggressive behavior; irritability; acting without thinking; severe restlessness; and frenzied abnormal excitement. Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor if you are unable to seek treatment on your own.

Your healthcare provider will want to see you often while you are taking escitalopram, especially at the beginning of your treatment. Be sure to keep all appointments for office visits with your doctor.

The doctor or pharmacist will give you the manufacturer’s patient information sheet (Medication Guide) when you begin treatment with escitalopram. Read the information carefully and ask your doctor or pharmacist if you have any questions. You also can obtain the Medication Guide from the FDA website.

No matter your age, before you take an antidepressant, you, your parent, or your caregiver should talk to your doctor about the risks and benefits of treating your condition with an antidepressant or with other treatments.

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Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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