Life on Lexapro: FAQ

Happy World Mental Health Day, goons! This day of recognition, established by the World Health Organization, presents an opportunity for government leaders, civil society organizations and others to discuss and raise awareness of mental health services, disparities, and personal stories. If you’ve clicked around here a bit, you know mental health is a common topic I write about. It’s because of readers like you that make me more comfortable sharing my experiences with antidepressants, starting therapy, coping with anxiety, and managing my mental health. Thanks for being part of this tiny corner of the internet with me!

I wanted to dedicate a whole post to some frequently asked questions I’ve received following my previous posts about antidepressants, like the timeline on when I began feeling better, side effects of Lexapro, withdrawal symptoms, and more. I’m sending out a MASSIVE disclaimer here. While I’m so glad we’re connected with similar experiences, our bodies and brains are not the same. That said, I am not licensed to give medical advice and I will not give suggestions on specific medications or treatment plans, because I’m simply not qualified. I’ll only share my personal experiences, so please take any medical-related information from non-medical professionals (hi, me, and all the other randos on your Facebook feed) with a grain of salt and be sure to consult your doc when making decisions about your mental health. Instead, consider this a fun little support group with hugs, cookies, and sleepovers. Cool? Cool.

Q: I’m scared of the side effects of Lexapro. Did you have any weird symptoms?

I started taking Lexapro about five years ago (actually, I take the generic version called escitalopram–same thing). I was a junior in college at the time and did NOT have the energy to deal with any wild symptoms. When starting an antidepressant, it can feel scary to take a medication that could alter the way you feel mentally. So many unknowns…but it also felt a little backwards to be anxious about something that had the potential to help me with my anxiety.

My doctor started me on 5mg for the first week, then I could increase to 10mg, which is the same dosage I still take today. I honestly can’t remember having any significant side effects or strange symptoms when I started. Maybe a little bit of fatigue and headaches, but in hindsight, it was very typical for me to have those symptoms when I was experiencing strong anxiety. I’ve received some questions from readers about weight changes, and scientific research* shows that it’s uncommon for an SSRI itself to cause weight fluctuation. In fact, some scientists believe that if a patient does gain weight after starting an SSRI, it is less likely that it’s caused by the medication itself and more likely due to the lessening of depression symptoms and therefore regaining a normal appetite.

Starting on a small dosage was a very easy transition into antidepressants for me, and an SSRI like Lexapro often takes some time to have a noticeable impact, so super drastic symptoms weren’t likely for me when I started. Your doctor can talk through these worries with you and suggest the right amount to start. Sometimes, it takes a little bit of trial and error to find the sweet spot that works for you.

Q: How long does it take for Lexapro to work?

Like I mentioned above, Lexapro may take some time to make a significant impact on the way you feel. I explained my experience in a bit more detail in this post, written after about three months on medication. From what I’ve learned about SSRIs from my doctor, the standard is about 4-8 weeks to notice some changes, and full effects typically set in within a few months. For some people, it’s a shorter amount of time, for some it’s a little longer. I imagine it depends heavily on your biology, complexity of your anxiety or depression symptoms, and dosage. I know it’s VERY hard to be patient when you want to start feeling better right away, but as long as you keep open communication with your doctor or therapist as you’re adjusting, you’re on the right track.

Q: I’ve been on Lexapro for months. Why don’t I feel better?

You might not be on the right dosage, or maybe Lexapro isn’t for you! Give your doctor a call and discuss how you’re feeling. Chances are, there may be another medication that could be better for you. I’ll also say that Lexapro is not meant to get rid of depression or anxiety completely, as it’ll always be part of the way your brain works, but medication can certainly help improve the way you feel over time and make symptoms much more manageable. From my personal experience, it may also help to stay consistent with other ways to care for your body and brain in conjunction with medication. This could include therapy, a healthy diet, or gentle exercise, for example. I know, it’s super annoying to hear someone say “WhY dOn’T yOu JuSt Do YoGa?” as a suggestion to magically cure you, but there’s something to say about self care and its impact on your mind and body. Add the right medication to that and you could have a winning combination to help you feel a lot better.

Q: Do you feel like Lexapro has changed your personality?

Aside from feeling happier and more like myself, nope! This has been one of the top questions I’ve gotten since my first post about anxiety medication, and I’m happy to say that Lexapro has not turned me into a robot. For me, my initial fear about starting antidepressants was that I’d feel numb or emotionless before feeling any better. However, that hasn’t been my experience at all, and my doctor was able to alleviate this fear by teaching me more about how the medication works in my body. Expressing these concerns with your doctor will help you make the most informed decision on the right medication for you.

Q: Have you ever missed a dose of Lexapro? Did you have any withdrawal symptoms?

Yes, I have definitely missed a couple doses. In fact, I stopped cold turkey for a short period of time (bad Jess). Luckily, Lexapro has a pretty solid half-life of around 30 hours, meaning half of your last dose is still in your body after that amount of time, which can reduce feelings of withdrawal even if you miss a dose. Hallelujaaaah. I never felt any strange withdrawal symptoms, even after forgetting my meds at home during a weekend away. When I was dumb and brave and stopped taking my meds altogether, I did initially have some headaches, anxiety, and fatigue after about a week. Though nothing severe happened, definitely consult your doctor prior to quitting any medication so you have a safe plan to reduce your doses and minimize the possibility of experiencing any un-fun side effects.

I hope this post provided some comfort for all my internet pals who are managing anxiety, depression, or other mental health challenges. The most important thing to know is that you are doing the very best you can, and you are never alone. If I’ve learned anything over the past five years being more vocal about my mental health, it’s that there is a very good chance someone you know may be experiencing something similar. Build your community, lean on friends and family for love and support, and be transparent with your doctor and/or therapist. We’re all in this together.

Love always,

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^*Sources:

Fava M, Judge R, Hoog SL, et al. Fluoxetine versus sertraline and paroxetine in major depressive disorder: changes in weight with long-term treatment. J Clin Psychiatry 2000; 61:863.

Maina G, Albert U, Salvi V, Bogetto F. Weight gain during long-term treatment of obsessive-compulsive disorder: a prospective comparison between serotonin reuptake inhibitors. J Clin Psychiatry 2004; 65:1365.

Hochstrasser B, Isaksen PM, Koponen H, et al. Prophylactic effect of citalopram in unipolar, recurrent depression: placebo-controlled study of maintenance therapy. Br J Psychiatry 2001; 178:304.

Doogan DP, Caillard V. Sertraline in the prevention of depression. Br J Psychiatry 1992; 160:217.