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 because they represent the same active drug ingredient.
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 patients rate and describe the effects of Lexapro?
In this article we’ll answer all of these questions and more, as we review medical research on Lexapro to determine if it’s effective for treating depression and anxiety.
We'll also discuss the potential for side effects, feature unsponsored patient reviews and compare Lexapro to another commonly-prescribed anti-anxiety medication called Zoloft to see which drug is clinically shown to be more effective.
Does Lexapro Work?
Lexapro is approved by the Food and Drug Administration (FDA) to treat both anxiety and depression.
This medication is a selective serotonin reuptake inhibitor (SSRI), and we'll explain later in this article how this type of drug works in the body.
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.”
A 2009 meta-study on Lexapro for major depressive disorder found that it was significantly more effective than other antidepressant drugs.
Lexapro was shown in the above-linked 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 on Lexapro for generalized anxiety disorder (GAD) found that the medication was effective for both short-term and long-term management of anxiety. The studies assessed by the researchers ranged between 8-76 weeks.
A clinical trial published in The Journal of Clinical Psychiatry evaluated the efficacy of Lexapro for panic disorder. 366 patients with panic disorder received either Lexapro, Celexa, or placebo pills.
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 may be negligible in patients with panic disorder.
We will conclude from the available research that Lexapro is effective for treating both depression and anxiety, which is unsurprising given that the drug is approved by the FDA for both indications.
Real People Try Lexapro
A YouTube creator named "Hello Miss Romeo" has a video with over 250,000 views that describes her first week on Lexapro:
A YouTube creator named "Housewarmin" claims that Lexapro changed her life, and shares her experience using the medication for 10 months:
Does Lexapro Cause Side Effects?
Lexapro does have the potential to cause side effects, as do most prescription medications.
A medical review on 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, the above-linked 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 who 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 at 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, patients are often curious about whether Lexapro or Zoloft is a more effective option.
There have been medical studies directly comparing the two drugs.
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 better 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.
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 that there was an 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 challenging 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 video with before-and-after images:
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 was associated with fewer psychiatric hospitalizations when compared to the generic escitalopram in a medical review on 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, these results suggest Lexapro is the superior option.
It's worth noting that Lexapro has a significantly higher retail price than its generic alternative at the time of updating this article.
Lexapro currently costs around $450 according to GoodRx.
Escitalopram currently costs around $7 on Cost Plus Drugs.
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 on 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 "Nazaré's Lab" shared their experience with Lexapro withdrawals:
Patients Review Lexapro
Drugs.com is a website that allows prescription medication patients to rate and review the drugs they're taking.
We cannot verify the accuracy or authenticity of any reviews on this site.
At the time of updating this article, Lexapro has been reviewed over 2,000 times on Drugs.com, with an average review rating of 7.5 out of 10 for anxiety and 7.2 out of 10 for depression.
A top positive review on Lexapro for anxiety comes from a user named "oksy" who gave the medication a 10/10 rating, and suggests it's been life-changing:
"In my darkest hours whilst waiting for the drug to kick in I would read all the positive reviews on this website and they gave me confidence that everything would be OK. Without you, I don't know what I would have done. A couple of years later and my life is on track and the future is looking rosy!"
A top negative review on Lexapro for anxiety is written by a user named "Roc" who gave the drug a 1/10 rating, and who claims it caused side effects:
"I started taking Lexapro last night, just 5mg. However, when I woke up today, I felt like an alien. It was a completely out-of-body experience, and it felt like my brain wasn't connected to my body. I can't comprehend how anyone can take this."
A top positive review on Lexapro for depression comes from a user named "KAano" who gave the medication a 10/10 rating, and claims that after experiencing side effects initially they felt better:
"I had awful side effects within the first weeks including waking up shaking, increased anxiety and an increase in suicidal thoughts. In fact I begged the doctor to change me onto something else but he told me to stick with it. After 4 weeks I was absolutely transformed and I still honestly can’t believe the change it made to me. I’m no longer crying everyday, I’ve started enjoying all the things I used to and rediscovering myself."
A top negative review on Lexapro for depression is written by a user named "OnThe..." who gave the medication a 1/10 rating, and claims it caused tinnitus:
"I took Escitalopram (Lexapro) in August 2017 but had to stop after a fortnight due to it causing tinnitus. It's now late February 2023 and I've still got the same ringing in my ears that it caused. I would urge people to think twice."
Our Mental Wellness Picks
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Brightside is an online therapy and medication platform that connects patients with licensed therapists and psychiatrists 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.
Mindbloom is our top alternative mental wellness pick.
Mindbloom offers ketamine therapy, and over 88% of patients experienced relief of anxiety and depression symptoms in a clinical trial on the brand.
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 of serotonin in the brain.
As we detailed in our Prozac review article, 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.
Serotonin may be central to the anxiety response as well, given that this medication is clinically shown to relieve anxiety.
