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escitalopram

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Brand names: Lexapro

Selective Serotonin Reuptake Inhibitor (SSRI) Rx

Escitalopram is a medicine used to treat depression and anxiety. It helps to balance chemicals in your brain.

Drug Pricing (NADAC)

Brand Price

$14.05/unit

Generic Price

$0.04/unit

Generic Savings

100%

Generic Available

Yes (17 manufacturers)

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

What it does

Escitalopram is used to treat major depressive disorder (MDD) in adults and children 12 years and older.

Common side effects

Trouble sleeping (insomnia), Problems with ejaculation (mostly delayed ejaculation), Feeling sick to your stomach (nausea)

Key warnings

Antidepressants can increase the risk of suicidal thoughts and behaviors in children, teenagers, and young adults.

How It Works

Escitalopram is a selective serotonin reuptake inhibitor (SSRI). It works by increasing the amount of serotonin in your brain. Serotonin is a chemical that helps regulate mood.

How to Take It

Take escitalopram once a day, either in the morning or evening. You can take it with or without food. The usual starting dose is 10 mg per day. Your doctor may increase the dose to a maximum of 20 mg per day if needed.

Pregnancy & Breastfeeding

Tell your doctor if you are pregnant or plan to become pregnant. Taking escitalopram during pregnancy, especially later in pregnancy, may cause problems for the newborn. There is a pregnancy registry, call 1-844-405-6185.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule.

Storage

Store escitalopram at room temperature, between 68°F and 77°F.

Side Effects (from patient reports)

Based on 70,796 FDA adverse event reports.

Feeling tired
9,199
Feeling sick to your stomach
9,160
Medicine not working
8,597
Head pain
7,114
Loose stools
6,710
Feeling worried or nervous
6,446
Feeling lightheaded
6,088
Feeling sad or hopeless
5,980
Using the medicine for a different condition than approved
5,853
Discomfort
5,649

FDA Adverse Event Report Analysis

Detailed analysis of 134,536 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2003–2025.

Total Reports

134,536

Death-Related Reports

10,908

Hospitalization Reports

42,595

Top Indication

Product Used For Unknown Indication

Gender Distribution

Female 85,584 (69%)
Male 38,533 (31%)

Age Distribution

0–17 3,803
18–44 25,461
45–64 31,873
65–74 14,641
75+ 13,300

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 FATIGUE 9,196
2 NAUSEA 9,164
3 DRUG INEFFECTIVE 8,598
4 HEADACHE 7,114
5 DIARRHOEA 6,709
6 ANXIETY 6,447
7 DIZZINESS 6,087
8 DEPRESSION 5,978
9 OFF LABEL USE 5,853
10 PAIN 5,646
11 FALL 5,401
12 DYSPNOEA 5,273
13 VOMITING 5,090
14 INSOMNIA 4,377
15 ASTHENIA 4,355

Reactions in Death Reports

DEATH 3,121
COMPLETED SUICIDE 2,477
TOXICITY TO VARIOUS AGENTS 869
CARDIO-RESPIRATORY ARREST 692
DYSPNOEA 633
FALL 574
FATIGUE 544
CARDIAC ARREST 532
ASTHENIA 516
NAUSEA 496

Reactions in Hospitalization Reports

FALL 3,035
NAUSEA 2,957
DYSPNOEA 2,659
FATIGUE 2,406
DIARRHOEA 2,372
VOMITING 2,323
ANXIETY 2,251
PNEUMONIA 2,233
ASTHENIA 2,021
DEPRESSION 2,016

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

Antidepressants can increase the risk of suicidal thoughts and behaviors in children, teenagers, and young adults. Watch closely for worsening depression or suicidal thoughts. Escitalopram is not approved for use in children younger than 7 years old.

Known Drug Interactions

7 DRUG INTERACTIONS Table 6 presents clinically important drug interactions with escitalopram. TABLE 6 Clinically Important Drug Interactions with Escitalopram Monoamine Oxidase Inhibitors (MAOIs) Clinical Impact: Concomitant use of SSRIs, including escitalopram, and MAOIs increases the risk of serotonin syndrome. Intervention: Escitalopram is contraindicated in patients taking MAOIs, including MAOIs such as linezolid or intravenous methylene blue [ see Dosage and Administration (2.7) , Contraindications (4) , and Warnings and Precautions (5.2) ] Pimozide Clinical Impact: Concomitant use of...

Mechanism: These two drugs are nearly identical, so taking them together is like taking a double dose of the same medicine.

What to do: You should not take these two medications together.

Intervention: Escitalopram is contraindicated in patients taking MAOIs, including MAOIs such as linezolid or intravenous methylene blue [ see Dosage and Administration (2.7) , Contraindications (4) , and Warnings and Precautions (5.2) ] Pimozide Clinical Impact: Concomitant use of racemic citalopram with pimozide increases plasma concentrations of pimozide, a drug with a narrow therapeutic index, and may increase the risk of QT prolongation and/or ventricular arrhythmias compared to use of racemic citalopram alone [ see Clinical Pharmacology (12.3) ].

Mechanism: Linezolid acts as a special type of medicine that stops the body from clearing serotonin, which can cause a dangerous reaction when mixed with escitalopram.

What to do: This combination is not allowed and should be avoided to prevent serious health problems.

Intervention: Escitalopram is contraindicated in patients taking MAOIs, including MAOIs such as linezolid or intravenous methylene blue [ see Dosage and Administration (2.7) , Contraindications (4) , and Warnings and Precautions (5.2) ] Pimozide Clinical Impact: Concomitant use of racemic citalopram with pimozide increases plasma concentrations of pimozide, a drug with a narrow therapeutic index, and may increase the risk of QT prolongation and/or ventricular arrhythmias compared to use of racemic citalopram alone [ see Clinical Pharmacology (12.3) ]. Intervention: Escitalopram is contraind...

Mechanism: Escitalopram raises the amount of pimozide in your blood, which can cause dangerous heart rhythm issues.

What to do: You should not take these two medicines together.

moderate aspirin

If serotonin syndrome occurs, consider discontinuation of escitalopram and/or concomitant serotonergic drugs [ see Warnings and Precautions(5.2) ] Drugs That Interfere With Hemostasis (NSAIDs, Aspirin, Warfarin, etc.) Clinical Impact: Concomitant use of escitalopram and an antiplatelet or anticoagulant may potentiate the risk of bleeding. Concomitant use with SSRIs, SNRIs or Tryptophan is not recommended ( 7 ) Use caution when concomitant use with drugs that affect Hemostasis (NSAIDs, Aspirin, Warfarin) ( 7 )

Mechanism: Escitalopram can interfere with how blood cells stick together, and aspirin also thins the blood. Combining them makes it much more likely that you will experience bleeding or bruising.

What to do: Use this combination with caution and tell your doctor if you notice any unusual bleeding. They may need to monitor you more frequently.

moderate warfarin

If serotonin syndrome occurs, consider discontinuation of escitalopram and/or concomitant serotonergic drugs [ see Warnings and Precautions(5.2) ] Drugs That Interfere With Hemostasis (NSAIDs, Aspirin, Warfarin, etc.) Clinical Impact: Concomitant use of escitalopram and an antiplatelet or anticoagulant may potentiate the risk of bleeding. For patients taking warfarin, carefully monitor the internationalnormalized ratio [ see Warnings and Precautions (5.7) ]. Concomitant use with SSRIs, SNRIs or Tryptophan is not recommended ( 7 ) Use caution when concomitant use with drugs that affect Hemos...

Mechanism: This combination increases your risk of bleeding because both drugs affect how your blood clots. Escitalopram can also change how your body responds to the blood thinner.

What to do: Your doctor should monitor your blood clotting time (INR) very closely. Seek medical help if you notice signs of bleeding like easy bruising or bloody stools.

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Common Questions

Can I stop taking escitalopram suddenly?
No, you should not stop taking escitalopram suddenly. Talk to your doctor about slowly reducing the dose to avoid withdrawal symptoms.
Can escitalopram cause weight gain?
Weight changes are possible with escitalopram, but it varies from person to person. Talk to your doctor if you are concerned.
Can I drink alcohol while taking escitalopram?
It is best to avoid alcohol while taking escitalopram, as it can worsen side effects.
How long does it take for escitalopram to work?
It may take several weeks for you to feel the full effects of escitalopram.
What should I do if I experience side effects?
Talk to your doctor about any side effects you experience while taking escitalopram.
Can escitalopram be used for other conditions?
Escitalopram is primarily used for depression and anxiety, but your doctor may have other reasons for prescribing it.
Is it safe to take escitalopram with other medications?
Tell your doctor about all the medications you take, including over-the-counter drugs and supplements.
What if I feel worse after starting escitalopram?
Contact your doctor immediately if you feel worse or have any suicidal thoughts.
Does escitalopram interact with any foods?
Escitalopram can be taken with or without food.
How often will I see my doctor while taking escitalopram?
Your doctor will schedule regular checkups to monitor your progress and side effects.
What are the common side effects of escitalopram?
The most commonly reported side effects of escitalopram include Trouble sleeping (insomnia), Problems with ejaculation (mostly delayed ejaculation), Feeling sick to your stomach (nausea), Increased sweating, Feeling tired (fatigue). Based on 70,796 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does escitalopram interact with other medications?
Yes, escitalopram has 12 known drug interactions. Notable interactions include citalopram, linezolid, pimozide. Always inform your doctor about all medications you are taking.
What drug class is escitalopram?
escitalopram belongs to the Selective Serotonin Reuptake Inhibitor (SSRI) drug class. It requires a prescription (Rx). Escitalopram is used to treat major depressive disorder (MDD) in adults and children 12 years and older.
Is there a generic version of escitalopram?
Yes, generic escitalopram is available from 17 manufacturers. The generic costs $0.04 per unit compared to $14.05 for the brand version, saving approximately 100%. Pricing is based on NADAC (National Average Drug Acquisition Cost) data from CMS.
Is escitalopram safe during pregnancy?
Tell your doctor if you are pregnant or plan to become pregnant. Taking escitalopram during pregnancy, especially later in pregnancy, may cause problems for the newborn. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.

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What the FDA Data Shows for escitalopram

The FDA label for escitalopram (sold under brand names such as Lexapro) classifies it as a prescription-only medication in the Selective Serotonin Reuptake Inhibitor (SSRI) class. Escitalopram is used to treat major depressive disorder (MDD) in adults and children 12 years and older. Official labeling lists 8 commonly reported side effects, including Trouble sleeping (insomnia), Problems with ejaculation (mostly delayed ejaculation), Feeling sick to your stomach (nausea).

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 70,796 voluntary reports. The database also lists 12 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated major severity. NADAC pricing from CMS shows a generic unit cost of $0.04 versus $14.05 for the brand — a 100% generic savings.

Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: March 5, 2025

All federal data sources used on this page