Body weight changes are a common concern people have when their doctor recommends starting an antidepressant such as Lexapro.
While a few of these medications may cause weight loss, most list weight gain as a possible side effect.
Lexapro appears to cause different effects in different people.
As with any medication, it’s important to discuss the benefits and potential drawbacks with your doctor when choosing an antidepressant.
In this article, I’ll talk about Lexapro in detail. I’ll discuss its uses, how it works, and its connection to the risk of weight gain.
I’ll also talk about other side effects, how to take Lexapro, and precautions before taking it.
Finally, I’ll share when to see a doctor about Lexapro.
What Is Lexapro?
Lexapro is a brand name of the drug escitalopram.
It belongs to a class of medications called selective serotonin reuptake inhibitors (SSRIs).
Lexapro is a newer antidepressant and has fewer side effects than older antidepressants like nortriptyline.
Lexapro uses
Lexapro is only available by prescription.
It is used to treat major depressive disorder and generalized anxiety disorder.
It’s also used off-label to treat obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), social anxiety disorder, panic disorder, premenstrual dysphoric disorder, and hot flashes in menopause.
How Lexapro works
Lexapro is a selective serotonin reuptake inhibitor (SSRI).
SSRIs increase the level of serotonin available in the brain by preventing the reabsorption of serotonin by nerve cells in the brain.
Serotonin is a neurotransmitter (brain chemical) that helps regulate mood, sleep, pain, and digestion, among other things.
Low serotonin levels have been associated with depression and anxiety.
SSRIs help reduce depressive symptoms such as decreased mood, insomnia, and fatigue by making serotonin more available in the brain.
Lexapro and Weight Gain
Weight gain is a common side effect of many antidepressant medications.
But everyone responds to medications differently.
To make things more confusing, Lexapro may cause either weight gain or weight loss.
This may be because serotonin plays a role in appetite regulation, so Lexapro may increase or decrease appetite.
What the research says
Compared with older antidepressants like monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs), SSRIs are less likely to cause weight gain.
Looking specifically at Lexapro, researchers in one study compared people taking escitalopram and nortriptyline (Pamelor, a tricyclic antidepressant).
Study participants taking escitalopram gained, on average, less than a third of a pound in 12 weeks.
Those taking nortriptyline gained almost 10 times as much weight.
Additionally, some people may be more likely than others to gain weight while taking Lexapro.
One study showed that people who smoke, don’t engage in physical activity, and eat a Western diet (high in processed meats, fast food, and snacks) have a greater chance of gaining weight while on any SSRI.
Common Side Effects of Lexapro
Aside from changes in appetite, common side effects of Lexapro include:
- Insomnia
- Sexual dysfunction (such as problems with ejaculation, decreased libido, and difficulty reaching orgasm)
- Nausea
- Increased sweating
- Fatigue
- Drowsiness
- Headache
- Diarrhea
- Dry mouth
- Constipation
- Dizziness
- Stomach pain
- Heartburn
Depression and Weight Changes
Even without medication, depression often leads to weight changes.
It can cause some people to lose all desire for food or feel undeserving of food, leading to weight loss.
Other people may turn to food for comfort or feel less motivated to work out and make healthy meals.
These things can cause weight gain.
How to Take Lexapro
Lexapro comes in tablet or liquid form to be taken orally once daily, with or without food.
Take Lexapro at the same time every day, that way you’re less likely to forget a dose.
If you do forget, take the dose as soon as you remember.
But if it’s close to the time of the next dose, skip the missed dose altogether.
Never take a double dose.
It may take four weeks or longer to see Lexapro’s effects, so don’t worry if you do not immediately see improvements.
Don’t stop taking Lexapro when you feel better.
Doing so may lead to withdrawal symptoms like anxiety, changes in mood, abnormal excitement, irritability, and confusion.
If your doctor thinks you should stop Lexapro, they will gradually decrease your dose.
Lexapro Precautions
Lexapro can cause serious adverse effects if you take it with other medicines or under certain conditions.
To be safe, let your doctor know if:
- You’ve had an allergic reaction to escitalopram or any other medications in the past.
- You’re taking a monoamine oxidase inhibitor (MAOI) or stopped taking one less than two weeks ago.
- You’re taking another SSRI.
- You’re taking any other medicines or nutritional supplements.
- You have epilepsy or are on electroconvulsive treatment.
- You have heart problems.
- You have liver or kidney disease.
- You are pregnant, trying to become pregnant, or breastfeeding.
Some people experience worsened depression and suicidal thoughts after taking Lexapro.
Let your doctor know if your depression gets worse or you feel the urge to self-harm.
If you’re having a mental health emergency, call 911 or go to the nearest emergency room. You can also get free 24/7 support from a suicide and crisis expert by calling or texting 988. If you’d prefer to chat online, you can chat with a suicide and crisis expert by visiting the Lifeline Chat.
When to See a Doctor
If you take Lexapro, your doctor will monitor how you respond.
Contact them if you think you’re having an allergic reaction, which can be life-threatening and cause:
- Trouble breathing
- Wheezing
- Skin rash that comes with swollen, itchy, red, or peeling skin
- Tightness in the throat
- Trouble talking
- Swelling of the mouth, lips, and tongue
Also contact your healthcare provider if you think you’ve taken too much Lexapro.
Lexapro overdose can cause vomiting, shaking, fast heart rate, and seizures.
Lastly, if you experience suicidal thoughts or disturbing thoughts, seek immediate medical attention, or call/text the National Suicide Prevention Lifeline at 988.
It’s free, anonymous, and available 24 hours a day.
How K Health Can Help
Think you might need a prescription for Lexapro (Escitalopram)?
K Health has clinicians standing by 24/7 to evaluate your symptoms and determine if Lexapro is right for you.
Get started with our free assessment, which will tell you in minutes if treatment could be a good fit. If yes, we’ll connect you right to a clinician who can prescribe medication and have it shipped right to your door.
Frequently Asked Questions
K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.
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Antidepressants Cause Minimal Weight Gain. (2014).
https://www.health.harvard.edu/blog/antidepressants-cause-minimal-weight-gain-201406067202 -
Antidepressant Utilization and Incidence of Weight Gain During 10 Years’ Follow Up:Population Based Cohort Study. (2018).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5964332/ -
Changes in Body Weight During Pharmacological Treatment of Depression. (2011).
https://academic.oup.com/ijnp/article/14/3/367/905947 -
Effects of Nefazodone on Body Weight: A Pooled Analysis of Selective Serotonin Reuptake Inhibitor- and Imipramine-Controlled Trials. (2001).
https://pubmed.ncbi.nlm.nih.gov/11379839/ -
Escitalopram. (2022).
https://medlineplus.gov/druginfo/meds/a603005.html -
SSRI Antidepressant Use Potentiates Weight Gain in The Context of Unhealthy Lifestyles: Results From a 4-Year Australian Follow-Up Study. (2017).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5629701/ -
Weight Gain and Antidepressants. (2000).
https://pubmed.ncbi.nlm.nih.gov/10926053/