Disclaimer: None of the information in this article constitutes medical advice. All statements are merely the opinion of the writer(s). We recommend that patients follow their doctor’s guidance in regard to prescription medication.
Lexapro is one of the most commonly-prescribed medications for anxiety and depression. The generic name for this drug is escitalopram, and we will use these two terms interchangeably throughout this article. They are the same chemical compound; Lexapro is just a brand name.
But is Lexapro effective for both anxiety and depression? Does the drug have any side effects? Does it work better than similar drugs like Zoloft? And how do real users respond to Lexapro treatment?
In this article we’ll answer all of these questions and more as we review medical research on Lexapro to determine if it’s likely to be effective for treating depression and anxiety, highlight side effects of the medication and share a real user's review of their first week on the drug.
We'll also compare the effectiveness of Lexapro to that of Zoloft, and explain whether it's safer than the generic version of the drug.
Does Lexapro Work?
Lexapro is FDA-approved to treat both anxiety and depression.
A medical review published in the CNS Drugs Journal analyzed 18 clinical trials on Lexapro for depression and concluded that the drug was an “effective and generally well tolerated treatment.”
Drugs have to go through an extensive development and approval process to be cleared by the Food and Drug Administration (FDA), so while there are some concerns about the long-term safety of certain pharmaceutical drugs, they usually do work on average.
Another extensive medical review of Lexapro for major depressive disorder found that it was significantly more effective than other antidepressant drugs. Lexapro was shown in this study to be not only superior to several other SSRI medications such as Paxil, but also superior to Serotonin/Noradrenaline Reuptake Inhibitors (SNRIs) which is another class of antidepressant.
Lexapro is also prescribed for anxiety. A meta-review of Lexapro for generalized anxiety disorder found that it was effective for both short-term and long-term management of anxiety. The studies assessed by the researchers ranged between 8-76 weeks.
A more specific clinical trial evaluated the efficacy of Lexapro for panic disorder. 366 patients with panic disorder received either Lexapro, Celexa, or placebo in a well designed and double-blinded study.
Lexapro was significantly more effective than placebo in treating panic disorder, and the number of patients reporting zero panic attacks increased with Lexapro use. One significant stat is that the rate of discontinuation of the study due to adverse events was actually lower with Lexapro than with placebo, suggesting the drug’s side effects were negligible in this patient group.
We will conclude from the available research that Lexapro is effective for treating both depression and anxiety.
Real, Unsponsored User Review of Lexapro
One of the most popular YouTube reviews of Lexapro comes from a creator called Hello Miss Romeo. She discusses her experience after using Lexapro with daily updates from her first week using the drug. She discusses the benefits and side effects she experiences.
The video is unsponsored and has over 200,000 views at the time of updating this article:
Lexapro Side Effects
Lexapro does have side effects that are worth considering.
A medical review of Lexapro found that the most common side effects were insomnia, ejaculation disorder, nausea, increased sweating, fatigue and drowsiness.
One patient out of 125 taking Lexapro developed suicidal ideation, and 6 patients out of 544 (slightly over 1%) attempted suicide. However this review only compared the rates of suicidal tendencies between Lexapro and other antidepressants, so it’s hard to tell whether the drug actually increases risk of suicide compared to patients with the same condition that are unmedicated.
It’s also notable that in the above-linked review, patients taking 20 milligrams (mg) of Lexapro were significantly more likely (10% vs. 4%) to drop out of the trial due to uncomfortable side effects than patients taking 10 mg. It may be worthwhile for patients with moderate depression to speak with their doctor about starting on a 10 mg rather than 20 mg dose to minimize side effects.
The FDA does require a black box warning to be listed on Lexapro packaging and materials, indicating that the drug may increase risk of suicidal thinking and behavior.
One side effect of Lexapro that is specific to women is that the drug may have negative effects on fertility. A 2022 meta-study analyzed data on various SSRIs and infertility risk, and the researchers specifically noted that Lexapro appears to have negative effects on female fertility based on early research.
Lexapro Vs. Zoloft
As two of the most popular antidepressant medications, many consumers are curious whether Lexapro or Zoloft are proven to be more effective. There is medical research comparing the two directly.
A review published in the International Clinical Psychopharmacology journal compared studies on both compounds and found that Lexapro “is the first choice judged by combined efficacy and tolerability,” which suggests that Lexapro is not only more likely to work but less likely to have significant side effects.
A 2004 clinical trial tested whether Lexapro or Zoloft was more effective for treating major depression. Lexapro caused a 74% remission in symptoms compared to 77% for Zoloft, but the side effect rate was 11% lower in patients taking Lexapro (45% vs. 56%). This led to researchers concluding that Lexapro was the best option overall.
We believe that patients considering both medications may want to speak with their doctors about Lexapro, because it appears to be as effective if not more effective than Zoloft, and appears to cause fewer side effects.
Should I Take Lexapro Generic?
As mentioned in the intro paragraph of this article, the generic version of Lexapro is escitalopram.
While we generally recommend generic drugs over brand-name drugs, Lexapro actually caused fewer psychiatric hospitalizations when compared to the generic escitalopram in a medical review of generic and brand-name drugs.
The researchers noted that this difference may have been caused by poor study design, but for patients who can access the drugs at the same cost through insurance, we believe these results make Lexapro the superior option.
Does Lexapro Cause Weight Gain?
Lexapro appears to cause a very minor amount of weight gain based on medical research. A medical review published in The International Journal of Neuropsychopharmacology analyzed data from Lexapro patients who had enrolled in clinical trials, and documented average weight gain of 0.31 pounds over the course of 12 weeks. This equates to a potential annualized weight gain of 1.35 pounds.
However, because most adults in industrialized nations tend to gain weight over the course of middle age, it's impossible to determine if this weight gain was directly caused by the drug since it's so moderate and is in line with typical weight gain that may have been experienced without the drug.
A YouTube creator named Sydney Nicole shared her experience with weight gain that she claims was caused by antidepressants including Lexapro in a popular video with over 44,000 views at the time of updating this article.
The video includes pictures of her weight at different stages of her journey with antidepressants:
How Does Lexapro Work?
We believe it’s important for patients to understand how their medications work.
Lexapro is a selective serotonin reuptake inhibitor (SSRI), so it limits re-uptake of serotonin, which is a neurotransmitter that directly influences mood, and seems to be linked to depression. This means that the drug delays biological processing of serotonin, resulting in artificially increased circulating levels in the brain.
Researchers are still unclear on exactly how SSRIs are effective, but the theory is that patients with no mental health issues tend to have higher circulating levels of serotonin than those with depression.
Does Lexapro Cause Withdrawals?
Patients are often curious about whether a prescription medication is likely to cause withdrawals before taking the drug.
Lexapro does cause withdrawals, and this effect is so common that it even has a medical name: escitalopram discontinuation syndrome. A medical review of this syndrome documented the following withdrawal effects and their respective rates: dizziness (44%), muscle tension (44%), chills (44%), confusion (40%), amnesia (28%), crying (28%).
A YouTube creator named Kackie Reviews Beauty published a video explaining her personal experience quitting Lexapro and the withdrawal symptoms:
Our Mental Wellness Platform Recommendation
We recommend a platform called Brightside to patients dealing with mental health issues. It's an online therapy and medication platform that connects patients with licensed doctors and therapists from the comfort of their home.
A medical review published in the Clinical Psychology & Psychotherapy journal found that online therapy was equally effective to in-person therapy for treating depression, anxiety and PTSD. Therapy may be a good first option for patients who want to avoid the side effects of medication.
Brightside also can connect patients with licensed psychiatrists that can prescribe medication. Some patients choose only therapy, some choose only medication, and some choose both. The brand reports that 86% of members feel significantly better within 12 weeks of treatment.
Patients with and without health insurance can use Brightside. For many patients with health insurance, treatment is entirely covered by insurance.
The cost for medication without health insurance is capped at $95/month and the cost for therapy without health insurance is capped at $299/month.
Interested patients can check out Brightside at this link to the brand's website.