LEXAPRO FAQs: Starting LEXAPRO / Dosage Issues

Covers uses of Lexapro, difference between Lexapro and other SSRIs, starting dose of Lexapro and related dosage issues.

Below are the answers to frequently asked questions about the SSRI antidepressant LEXAPRO (escitalopram oxalate). The answers are provided by HealthyPlace.com Medical Director, Harry Croft, MD, a board-certified psychiatrist.

As you are reading these answers, please remember these are "general answers" and not meant to apply to your specific situation or condition. Keep in mind that editorial content is never a substitute for the advice of a health care professional regarding your personal situation.

Q: What are the uses for which LEXAPRO is being prescribed?

A: LEXAPRO has been approved by the FDA in the U.S. for the treatment of depression and generalized anxiety disorder (GAD) in adults.

Q: What is the difference between LEXAPRO and other SSRIs and other antidepressants? How does one determine if LEXAPRO or another antidepressant would be best for them?

A: LEXAPRO is very effective in the treatment of depression. Physicians generally choose an antidepressant for a particular patient based upon factors such as side effects for that particular patient, costs, and positive mindset.

In my experience, LEXAPRO has a more favorable side-effect profile, especially regarding sedation and weight gain, than the other SSRIs. However, some patients respond better to one SSRI than another and, as of now, we have no way of knowing in advance which SSRI will work best in a particular patient.

The other advantage of LEXAPRO is "ease of use," which means that most patients seem to respond to the starting dose of 10 mg so that no dose change is necessary in these patients. This is beneficial for most patients because the starting dose is the dose that works over time.

Q: What dose of LEXAPRO should a patient start with and how do you know if the dosage should be increased or decreased? When the dosage is increased or decreased, what does that do to the body and what does it feel like? What are the minimum and maximum dosages?

A: Most patients are started at 10 mg/day. Some patients might be started at 5 mg (especially those with severe anxiety disorder, or who are old or ill from other medical conditions), but most start at one 10 mg tablet. The medication is taken once a day, most commonly in the morning, but some prefer to take it in the evening or at noontime.

For all patients, 10 mg/day is the recommended starting dose of LEXAPRO. 10 mg/day is also the maintenance dose for many patients. If the dose is increased to 20 mg/day, this should occur after a minimum of 1 week. LEXAPRO can be taken morning or evening once daily, with or without food.

Your doctor may suggest a decrease in dosage if you experience side effects that do not go away after approximately 2 weeks. (Most side effects, like nausea, indigestion, diarrhea, headache, slight increase in anxiety, do go away within 2 weeks).

Once the side effects disappear, they usually do not return. However, if your physician recommends increasing your dose, the side effect may return for a brief period of time (usually no more than a day or two).

Last Updated: 14 January 2014
Reviewed by Harry Croft, MD

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