Escitalopram

Pronunciation: ess-sit-AL-oh-pram.

Generic name
escitalopram
Brand names
Lexapro (United States, Australia, New Zealand), Cipralex (United Kingdom, European Union, Canada)
Drug class
Selective serotonin reuptake inhibitor (SSRI) antidepressant
Form
Tablet (5 mg, 10 mg, 15 mg, 20 mg) or oral solution
Route
Oral
Legal status
Prescription-only

Availability and supply rules vary by country

Trade names by country: United States · United Kingdom · Canada · Australia · New Zealand

Australia: Lexapro (5) · Full directory

What escitalopram is and how it works

Escitalopram is a prescription-only SSRI antidepressant. In the United States it is approved for major depressive disorder and generalized anxiety disorder; in the UK, EU, Canada, Australia, and New Zealand it is also approved for panic disorder, social anxiety disorder, and obsessive-compulsive disorder. (1) (2)

Take escitalopram exactly as your prescriber directs. It carries a boxed warning about an increased risk of suicidal thinking in children, adolescents, and young adults, especially early in treatment or after a dose change, so close monitoring matters at those times. It also has a dose-related effect on heart rhythm (QT-interval prolongation), which is why some groups have a lower recommended maximum dose. Never stop or change your dose without your prescriber's guidance, since stopping suddenly can cause discontinuation symptoms.

Mechanism of action: how escitalopram works

Escitalopram is a selective serotonin reuptake inhibitor (SSRI); it is the single S-enantiomer of citalopram and increases intrasynaptic serotonin levels by blocking presynaptic reuptake. (1) (2)

What escitalopram is used for

Major depressive disorder

Used for the acute and maintenance treatment of major depressive disorder in adults, and in adolescents aged 12-17 in the United States. (1)

Generalized anxiety disorder

Used for the acute treatment of generalized anxiety disorder in adults, and in pediatric patients aged 7-17 in the United States. (1)

Panic disorder, social anxiety disorder, and obsessive-compulsive disorder (UK, EU, Canada, Australia, New Zealand)

In the UK, EU, Canada, Australia, and New Zealand, escitalopram is also approved for panic disorder with or without agoraphobia, social anxiety disorder (social phobia), and obsessive-compulsive disorder. This broader indication list is not part of the current US label. (2)

Before taking escitalopram

Do not take / not appropriate for

  • Do not take escitalopram if you are taking, or have taken within the last 14 days, a monoamine oxidase inhibitor (MAOI) prescribed for a psychiatric condition. Combining these can cause serotonin syndrome, a serious and potentially life-threatening reaction. (all countries) (1)
  • Do not start escitalopram if you are currently being treated with linezolid or intravenous methylene blue. (United States) (1)
  • Do not take escitalopram together with pimozide. (United States) (1)
  • Do not take escitalopram if you have a known long QT interval (including congenital long QT syndrome), or if you are taking another medicine known to prolong the QT interval. (United Kingdom, European Union) (2)
  • Do not take escitalopram if you have had a hypersensitivity reaction to escitalopram, citalopram, or any of its ingredients. (all countries) (1)

Tell your clinician about

  • Any personal or family history of bipolar disorder, mania, or hypomania.
  • Any heart rhythm problems, a known long QT interval, or a family history of QT prolongation.
  • Any history of low blood sodium (hyponatremia), especially if you are elderly or take diuretics.
  • Any bleeding disorders, or use of aspirin, NSAIDs, other antiplatelet medicines, or warfarin.
  • Any history of narrow-angle glaucoma.
  • All other medicines and supplements you take, especially other antidepressants, triptans, tramadol, St. John's Wort, or anything else that affects serotonin.
  • Pregnancy, plans for pregnancy, or breastfeeding.
(1) (2)

How to take escitalopram

  • Take escitalopram exactly as prescribed, at around the same time each day, with or without food.
  • It can take several weeks of regular use before the full antidepressant or anti-anxiety effect is felt.
  • Do not change your dose, and do not stop taking escitalopram, without your prescriber's guidance -- stopping suddenly can cause discontinuation symptoms, and your prescriber will usually recommend a gradual dose reduction if treatment is to end.
  • Report any new or worsening low mood, agitation, or thoughts of self-harm to your prescriber promptly, especially in the first few months of treatment or after a dose change.
(1) (2)

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4) (5) (6)

Missed dose

Take the missed dose as soon as you remember, unless it is nearly time for your next dose, in which case skip the missed dose and continue your regular schedule. Do not double your next dose to make up for a missed one. Contact your prescriber or pharmacist if you are unsure.

Overdose

Seek emergency medical help immediately if an overdose is suspected. Reported effects have included dizziness, tremor, agitation, and, in more severe cases, changes in heart rhythm or seizures. (1)

Side effects

Side effects and their urgency vary; report severe, persistent, or concerning symptoms.

Insomnia or somnolence (sleepiness).

What to notice: Insomnia or somnolence (sleepiness).

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Nausea and other digestive effects.

What to notice: Nausea and other digestive effects.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Increased sweating, fatigue.

What to notice: Increased sweating, fatigue.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Sexual side effects, including decreased libido, ejaculation problems, or difficulty reaching orgasm.

What to notice: Sexual side effects, including decreased libido, ejaculation problems, or difficulty reaching orgasm.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Headache and dizziness.

What to notice: Headache and dizziness.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (2)

Serious warnings

New or worsening suicidal thoughts or behavior, or unusual changes in mood or behavior — boxed_warning

Symptoms: Worsening depression or anxiety, agitation, unusual changes in behavior, or thoughts of self-harm -- most closely watched for in children, adolescents, and young adults up to age 24, especially in the first few months of treatment or after a dose change.

Action: Contact your prescriber promptly, or seek emergency help immediately for any thoughts of self-harm. Close monitoring by family, caregivers, or the prescriber is recommended, especially early in treatment. (1)

Signs of an abnormal heart rhythm (QT-interval prolongation) — high caution

Symptoms: Irregular heartbeat, palpitations, dizziness, or fainting.

Action: Seek emergency medical help immediately for fainting or a very irregular heartbeat. Tell your prescriber about any heart conditions or medicines that might add to this risk before starting. (2)

Serotonin syndrome — emergency

Symptoms: Agitation, hallucinations, fast heartbeat, high body temperature, muscle stiffness or twitching, loss of coordination, nausea, vomiting, or diarrhea, especially when combined with other serotonergic medicines.

Action: Seek emergency medical help immediately if these symptoms occur. (1)

Discontinuation symptoms after stopping or missing doses — high caution

Symptoms: Dizziness, sleep disturbances, irritability, agitation, tingling sensations, anxiety, nausea, or tremor.

Action: Your prescriber will usually recommend a gradual dose reduction rather than stopping abruptly; contact your prescriber if you experience these symptoms after a dose change. (1) (2)

Signs of mania or hypomania — high caution

Symptoms: Unusually elevated mood, excessive energy, racing thoughts, or decreased need for sleep.

Action: Contact your prescriber promptly; they will assess whether a personal or family history of bipolar disorder was previously missed. (1)

Eye pain or vision changes suggesting angle-closure glaucoma — emergency

Symptoms: Eye pain, vision changes, or swelling or redness in or around the eye.

Action: Seek emergency medical help immediately. (1)

Unusual bleeding or bruising — high caution

Symptoms: Unexplained bruising, nosebleeds, or bleeding gums, especially when combined with aspirin, NSAIDs, or warfarin.

Action: Tell your prescriber promptly, especially if you take other medicines that affect bleeding. (1)

Interactions

  • Monoamine oxidase inhibitors (MAOIs): must not be combined with escitalopram, and a 14-day gap is required on either side of switching, due to the risk of serotonin syndrome. (1)
  • Other serotonergic medicines (triptans, other antidepressants including SNRIs and tricyclics, fentanyl, tramadol, lithium, buspirone, St. John's Wort): increase the risk of serotonin syndrome. (1)
  • Aspirin, NSAIDs, other antiplatelet medicines, and warfarin: can increase the risk of bleeding. (1)
  • Other medicines that prolong the QT interval: should generally not be combined with escitalopram. (2)
  • CYP2D6-metabolised medicines: escitalopram can increase blood levels of some of these; your prescriber may need to adjust doses. (1)

Pregnancy, breastfeeding, kidney/liver function, age

Pregnancy

SSRI use later in pregnancy has been associated with a modestly increased risk of postpartum hemorrhage, persistent pulmonary hypertension of the newborn, and a neonatal adaptation syndrome (respiratory distress, feeding difficulties, tremor, irritability). Discuss the benefits and risks with your prescriber; a pregnancy exposure registry exists in the United States. (1) (2) (3) (4) (5) (6)

Breastfeeding

Escitalopram passes into breast milk. UK guidance advises against breastfeeding during treatment; discuss feeding options with your prescriber, who can weigh this against the benefits of treatment. (1) (2) (3) (4) (5) (6)

Children

Approved for major depressive disorder from age 12 and generalized anxiety disorder from age 7 in the United States; not approved for use in children under 7 in the sources reviewed. (1) (2) (3) (4) (5) (6)

Elderly

A lower starting dose (5 mg daily) and a lower maximum dose (10 mg daily) apply in the UK/EU due to QT-prolongation risk; short-term studies showed a reduced suicidality risk with antidepressant use in this age group compared with younger patients. (1) (2) (3) (4) (5) (6)

Hepatic_impairment

A lower starting dose (5 mg daily) and lower maximum dose (10 mg daily) apply for mild-to-moderate hepatic impairment; severe hepatic impairment needs careful, individualised titration by a prescriber. (1) (2) (3) (4) (5) (6)

Renal_impairment

Not specifically established in the sources reviewed for severe renal impairment; use with caution and prescriber oversight. (1) (2) (3) (4) (5) (6)

Monitoring

Before starting

  • Screening for personal/family history of bipolar disorder
  • Cardiac history and QT-prolongation risk factors
  • Baseline mood/suicidality assessment
  • Review of other serotonergic medicines

During treatment

  • Close monitoring for new or worsening suicidal thoughts or behavior, especially in the first few months and after dose changes.
  • Watching for signs of serotonin syndrome, mania, or abnormal bleeding.
  • Periodic reassessment of ongoing need and dose, particularly in elderly patients or those with hepatic impairment.
(1)

Storage

Store at 20-25°C (68-77°F); brief excursions to 15-30°C (59-86°F) are permitted during transport.

Study the drug class: SSRI antidepressants

Professional information

Clinician-facing context only, sourced from the current US FDA prescribing information and UK SmPC; verify against the current full label before prescribing.

United States

Indication: Major depressive disorder and generalized anxiety disorder

Dose summary: Adults: 10 mg once daily initial, max 20 mg once daily (no additional benefit seen at 20 mg vs 10 mg in MDD trials), increase interval at least 1 week. Adolescents 12-17 (MDD): 10 mg daily initial, max 20 mg daily, increase interval at least 3 weeks. Pediatric 7-17 (GAD): 10 mg daily initial, max 20 mg daily, increase interval at least 2 weeks. Elderly/hepatic impairment: 10 mg once daily recommended.

Renal context: Not specifically established in the source reviewed for severe renal impairment. (1)

United Kingdom / European Union

Indication: Major depressive episodes, panic disorder, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder

Dose summary: Adults: 10 mg daily standard, max 20 mg daily. Elderly (over 65): 5 mg daily initial, max 10 mg daily. Hepatic impairment (mild/moderate): 5 mg daily initial, max 10 mg daily. CYP2C19 poor metabolisers: 5 mg daily for first 2 weeks, max 10 mg daily. Contraindicated with known QT prolongation/congenital long QT syndrome or other QT-prolonging medicines.

Renal context: Not specifically detailed in the source reviewed. (2)

Mechanism of action

Hepatic guidance

Hepatic impairment reduces escitalopram clearance; a lower starting dose and lower maximum dose are recommended in the UK/EU sources reviewed, with individualised titration for severe impairment.

Overdose note

Reported escitalopram overdose effects include dizziness, tremor, agitation, and QT-interval changes; management is supportive, per local poison-control guidance, with cardiac monitoring where QT prolongation is a concern. (1) (2)

Frequently asked questions

Why does escitalopram have a boxed warning?

Because antidepressants, including escitalopram, were associated with an increased risk of suicidal thinking and behavior in short-term studies of children, adolescents, and young adults up to age 24. This is why close monitoring is recommended for anyone starting treatment at any age, especially in the first few months or after a dose change. (1)

Can I stop taking escitalopram once I feel better?

Do not stop or change your dose on your own. Your prescriber will decide, based on your individual situation, whether and how to reduce your dose -- stopping suddenly can cause discontinuation symptoms such as dizziness, irritability, or sleep disturbances. (1) (2)

Is escitalopram available in the US, UK, Europe, Canada, Australia, and New Zealand?

Yes, it is approved and available in all of these regions, marketed as Lexapro in the US/Australia/New Zealand and as Cipralex in the UK/EU/Canada. (1) (3) (2) (4) (5) (6)

What is the mechanism of action of escitalopram?

Escitalopram is a selective serotonin reuptake inhibitor (SSRI); it is the single S-enantiomer of citalopram and increases intrasynaptic serotonin levels by blocking presynaptic reuptake. (1) (2)

What is the generic name of Escitalopram?

The generic name is escitalopram. It is sold under brand names including Lexapro (United States, Australia, New Zealand), Cipralex (United Kingdom, European Union, Canada). (1) (2)

What class of drug is escitalopram?

Escitalopram is classed as: Selective serotonin reuptake inhibitor (SSRI) antidepressant. (1) (2)

References

  1. LEXAPRO (escitalopram) tablets/oral solution -- full prescribing informationU.S. Food and Drug Administration / DailyMed (NIH), full prescribing information, Allergan/AbbVie (Lexapro) · United States · accessed 2026-07-29 · source 1
  2. Escitalopram 20 mg tablets -- Summary of Product Characteristicselectronic medicines compendium (emc), United Kingdom · United Kingdom · accessed 2026-07-29 · source 2
  3. Escitalopram -- list of nationally authorised medicinal products / PSUSA single assessmentEuropean Medicines Agency (EMA) -- escitalopram is authorised via national procedures across EU member states, with Cipralex as the original reference product · European Union · accessed 2026-07-29 · source 3
  4. Cipralex (escitalopram oxalate) Product MonographHealth Canada product monograph · Canada · accessed 2026-07-29 · source 4
  5. Lexapro (escitalopram) -- ARTG registrationTherapeutic Goods Administration (TGA), Australia · Australia · accessed 2026-07-29 · source 5
  6. Lexapro New Zealand Data SheetMedsafe (New Zealand regulator) · New Zealand · accessed 2026-07-29 · source 6

Brand names by country

Single-ingredient escitalopram names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries

United States

  • Lexapro20 mg, 5 mg, 10 mg · allergan, inc.

United Kingdom

  • Cipralex (2)MHRA licensed emc smpc confirmed · 5 mg, 10 mg, 15 mg, 20 mg tablets · Lundbeck

Canada

  • CIPRALEX
  • CIPRALEX MELTZ
  • ACH-ESCITALOPRAM
  • ACT ESCITALOPRAM ODT

Australia

  • Lexapro (5)TGA ARTG registered confirmed · 10 mg, 20 mg tablets, oral solution · Lundbeck Australia Pty Ltd

New Zealand

  • Lexapro (6)Medsafe approved confirmed · 10 mg, 20 mg tablets · A. Menarini / Lundbeck
View brands in additional countries.

European Union

Cipralex (3)

This page provides general reference information about escitalopram and is not a substitute for advice from the prescriber managing your treatment. All dosing and treatment decisions should be made with your prescriber.

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