Lexapro for anxiety: How does it work?

Woman Suffering from anxiety
Medically reviewed by Dr. Mavra Farrukh

Key Takeaways

  1. Lexapro, a widely prescribed SSRI antidepressant, effectively manages anxiety symptoms by regulating serotonin levels in the brain.
  2. The recommended starting dosage for anxiety is 10 mg daily, with potential adjustments based on individual response, emphasizing the importance of strict adherence to prescribed doses.
  3. Lexapro effectively helps alleviate various anxiety disorders, leading to improved mood, reduced anxiety, better sleep, and increased energy. However, potential side effects and interactions should be carefully considered in consultation with a healthcare provider.


Lexapro, widely prescribed for treating anxiety disorders, is valued for its effectiveness and low chances of side effects. As a selective serotonin reuptake inhibitor (SSRI) antidepressant, it operates by regulating serotonin production and reuptake, potentially alleviating anxiety symptoms. Notably, women are more susceptible to anxiety, with a study revealing a 30.5% likelihood for women and 19.2% for men to develop anxiety disorders over a lifetime.

The World Health Organization’s report identified anxiety disorders as the sixth leading cause of significant disability in developed nations. If you’re struggling with anxiety, your healthcare provider might prescribe Lexapro to help manage symptoms. This blog explores the use of Lexapro for anxiety, its potential benefits, the timeline for effectiveness, and crucial considerations regarding risks and side effects. 

What is Lexapro? 

Lexapro, or escitalopram, is a prescription medication for depression and anxiety that works by restoring the balance of serotonin, a vital natural substance in the brain. Classified as a selective serotonin reuptake inhibitor (SSRI), Lexapro holds FDA approval for depression and generalized anxiety treatment. The active ingredient, escitalopram, serves as the generic counterpart and may be prescribed off-label for conditions like post-traumatic stress disorder (PTSD), premenstrual dysphoric disorder (PMDD), obsessive-compulsive disorder (OCD), and social anxiety disorder. Off-label use involves careful consideration of potential benefits and risks, requiring thorough discussions with healthcare providers.

If you take Lexapro for anxiety, the medication has the potential to enhance your energy, mood, and emotional well-being. However, being aware of associated side effects, such as nausea, vomiting, fatigue, and headaches, is important. While these side effects are typically mild and do not demand immediate medical attention, consult a healthcare professional if you experience such symptoms. Lexapro, as an SSRI, is approved for specific conditions in adults, children over 12 years, and adolescents. Its usage requires supervision due to potential risks of suicidal thoughts and behaviors, along with other health complications. The active ingredient, escitalopram, serves as the generic term for Lexapro, placing it within the class of SSRIs.

You can now get the Lexapro prescription from our healthcare provider within minutes!

How Lexapro Works in the Body for Anxiety?

Lexapro operates within the body by addressing the contributing factor of low serotonin activity, which is believed to be linked to the development of anxiety. As a selective serotonin reuptake inhibitor (SSRI), Lexapro plays a pivotal role in regulating serotonin levels in the brain.

SSRIs, including Lexapro, exert their effects by influencing the activity levels of neurotransmitters in the brain. Neurotransmitters, acting as chemical messengers, facilitate communication between neurons. Serotonin, a key neurotransmitter, influences well-being, happiness, cognition, memory, sleep, digestion, and circulation.

In the typical process, neurons release serotonin, and after transmitting its message, some serotonin attaches to other neurons before being reabsorbed by the releasing neuron. This reabsorption process is known as reuptake. An imbalance in the production and reuptake of serotonin can trigger anxiety.

Lexapro’s Mechanism

Lexapro intervenes by inhibiting serotonin reuptake, allowing more serotonin to remain available for attachment to other neurons. By enhancing serotonin levels in the brain, Lexapro effectively regulates emotions, including satisfaction, happiness, and optimism. Furthermore, serotonin’s ability to regulate various functions such as anxiety, sleep, digestion, cognition, and memory makes us realize its significance.

Boosting Serotonin Levels

Lexapro achieves its objective by impeding the absorption of serotonin by nerve cells after it has fulfilled its role in transmitting chemical messages. This mechanism ensures that the brain retains a greater amount of serotonin where it is needed, ultimately aiding in the management of anxiety and related symptoms.

You can now get the Lexapro prescription from our healthcare provider within minutes!

What is the best dose of Lexapro for severe anxiety?

Determining the most effective dose of Lexapro for severe anxiety involves a comprehensive assessment by your healthcare provider. Factors such as the specific type of anxiety disorder and your overall health condition play a crucial role in this decision-making process. To gauge individual response, doctors often initiate treatment with a smaller dosage.

Recommended Dosage for Generalized Anxiety

For adults grappling with generalized anxiety, the recommended starting dosage of Lexapro is 10 mg once daily, with a maximum limit of 10 mg daily. Adhering to the dosage prescribed by your healthcare provider is essential for your safety while minimizing the potential risks associated with Lexapro, such as discontinuation syndrome and dependence. Whether used for generalized anxiety disorder or depression, Lexapro is typically taken once a day, allowing flexibility in choosing either the morning or evening for administration.

Before commencing Lexapro treatment, it’s imperative to inform your doctor about any other medications you are taking to manage your condition. This information lets your healthcare provider determine the optimal dosage schedule, ensuring compatibility with concurrent medications.

Initial Dosing Strategy

The typical starting dose of Lexapro for anxiety is 10 mg daily. To mitigate the risk of worsening anxiety symptoms during the initial two weeks of treatment, your doctor may start with a lower dose, such as 5 mg, gradually increasing up to the standard 10 mg dosage. This cautious approach aims to optimize the therapeutic benefits while minimizing potential side effects during the early phase of treatment.

How effective is Lexapro for anxiety?

Lexapro demonstrates efficacy in alleviating symptoms of anxiety, proving particularly beneficial for various anxiety disorders, including specific phobias (off-label use), generalized anxiety disorder (GAD) with FDA approval, and panic attacks (off-label use). As a member of the selective serotonin reuptake inhibitors (SSRIs) class, Lexapro plays a crucial role in regulating serotonin levels in the brain.

The positive impact of Lexapro on anxiety extends to various facets of mental well-being. While using Lexapro for anxiety, individuals may experience a reduction in anxiety and panic attacks. Additionally, improvements in mood, sleep quality, emotional well-being, and increased energy levels are commonly reported benefits.

Overall, the effectiveness of Lexapro in managing anxiety underscores its value as a therapeutic option, offering relief from symptoms and contributing to an improved quality of life for those dealing with anxiety disorders.

You can now get the Lexapro prescription from our healthcare provider within minutes!

What should I avoid while taking Lexapro for anxiety?

Certain products may interact with Lexapro, necessitating caution. Notably, the following may interact with Lexapro:

  • Drugs that can cause bleeding, i.e., antiplatelet medications (clopidogrel) and aspirin.
  • NSAIDs (ibuprofen/naproxen)
  • Blood thinners (dabigatran/warfarin)

Certain health conditions or factors may elevate the risk of harm when taking Lexapro, leading to contraindications. If you are taking pimozide (an antipsychotic drug) or monoamine oxidase inhibitors (MAOIs), the risk of irregular heart rhythm or serotonin syndrome is heightened respectively. Additionally, if you’ve had an allergic reaction to Lexapro or its components, your doctor is likely to avoid prescribing Lexapro, considering the potential for another allergic reaction.

While there is no known direct interaction between Lexapro and alcohol, caution is advised. Combining Lexapro with alcohol may amplify similar side effects, such as sleepiness, nausea, and fatigue. Your doctor may recommend abstaining from alcohol during Lexapro treatment to mitigate the risk of intensified side effects or complications.

‍Potential side effects and considerations

Upon initiating Lexapro treatment for anxiety, it is common to experience mild side effects during the initial weeks, including fatigue and headaches. Sexual side effects may also manifest for some individuals. While these mild symptoms do not usually warrant immediate medical attention, it is crucial to be aware of the possibility of serious side effects, some of which can be life-threatening. Serious side effects requiring immediate attention are as follows:

  • Seizures
  • Serotonin syndrome
  • Low salt levels
  • Manic episodes in people with bipolar disorder
  • Vision problems
  • Anxiety symptoms
  • Discontinuation syndrome
  • Suicidal thoughts and behaviors
  • Excessive bleeding

Lexapro is not suitable for everyone, emphasizing the importance of thorough discussions with your doctor before commencing any prescription medication. Your health history, family history, current medications, and symptoms will be considered to determine the appropriateness and safety of Lexapro for managing anxiety symptoms. Regular follow-up appointments and adherence to prescribed doses are crucial aspects of a comprehensive treatment plan. Discontinuing Lexapro abruptly can lead to adverse reactions and should be done under medical supervision.

When to consult a doctor 

Seek immediate medical help if you experience any severe side effects, such as:

  • Black stools
  • Fainting
  • Fast/irregular heartbeat
  • Vomit that resembles coffee grounds
  • Seizures
  • Eye pain/swelling/redness
  • Widened pupils
  • Vision changes (e.g., seeing rainbows around lights at night, blurred vision)
  • Panic Attacks

If you encounter symptoms of a panic attack while taking Lexapro, including chest pain, shortness of breath, hyperventilation, trembling or shakiness, nausea, and sweating, it is crucial to consult your doctor immediately. Discussing these symptoms ensures appropriate medical advice and potential adjustments to your medication.

You can now get the Lexapro prescription from our healthcare provider within minutes!
How long does it take for Lexapro to work for anxiety?

Lexapro gradually increases serotonin levels in the brain, requiring time for adjustment. According to the National Institute of Mental Health (NIMH), individuals typically notice the full benefits of Lexapro within 4 to 6 weeks.

How long should you take Lexapro for anxiety? 

For a first episode of depression or anxiety, Lexapro may be taken for a defined period, such as six months to one year. Chronic mental health conditions may necessitate an extended period of Lexapro use, potentially spanning many years.

What is the difference between Lexapro and Zoloft?

Lexapro treats depression and generalized anxiety disorder, while Zoloft addresses depression, obsessive-compulsive disorder, and various mental health conditions. 

How safe is it to take Lexapro?

Taking Lexapro, particularly if you’re 24 or younger, may initially increase the risk of worsening depression or suicidal thoughts. The highest risk occurs during the first weeks of medication and when dosage changes.

Can you take Zoloft and Lexapro together?

Zoloft and Lexapro, belonging to the same medication group, shouldn’t be taken together as they work similarly. Combining them elevates the risk of side effects without additional benefits.

Is it better to take Lexapro for anxiety in the morning or at night?

Lexapro, an FDA-approved SSRI for anxiety and depression, can be taken at any time, with or without food. The timing can be adjusted based on individual responses, for example, in the morning to mitigate sleep disturbance or with food if nausea occurs. 

How do you feel when Lexapro is working?

Positive signs that Lexapro is effective for depression include improved mood, increased energy, reduced sadness or hopelessness, enhanced interest in activities, better sleep, improved appetite, heightened concentration, and a generally more positive outlook.

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