Understanding Lexapro Side Effects in the First Week
Starting Lexapro (escitalopram) can be a major step toward improving anxiety and depression. Like most medications, the first week often comes with adjustments as your body adapts. This guide explains how Lexapro works, the most common early side effects, and practical ways to manage them—so you can begin treatment confidently and comfortably.
What Is Lexapro and How Does It Work?
Lexapro is a selective serotonin reuptake inhibitor (SSRI), a type of antidepressant that increases serotonin levels in the brain. Serotonin is the neurotransmitter responsible for mood, anxiety regulation, and emotional stability.
By preventing serotonin from being reabsorbed too quickly, Lexapro helps restore balance in the brain’s mood-regulating system. This leads to:
Improved mood
Reduced anxiety symptoms
Better emotional resilience
Lexapro is often preferred over other SSRIs because it tends to cause fewer side effects and has fewer interactions with other medications.
Why Side Effects Happen in the First Week
When you begin Lexapro, your body experiences a rapid shift in serotonin levels. This adjustment period can temporarily affect:
Sleep
Digestion
Energy levels
Hormonal regulation
Stress responses
These symptoms are typically short-lived and improve as your body stabilizes.
Common Lexapro Side Effects in the First Week
It’s normal to experience one or more of these early side effects. Most are mild and fade as your system adjusts.
Fatigue & Drowsiness
You may feel unusually tired or sleepy. This occurs because the medication has a calming effect on the brain.
What helps: short naps, gentle movement, consistent sleep schedule.
Gastrointestinal Upset
Nausea, stomach discomfort, or diarrhea are common.
What helps: small meals, bland foods, ginger or peppermint tea, hydration.
Dizziness or Lightheadedness
As serotonin levels shift, some people feel unsteady when standing.
What helps: getting up slowly, staying hydrated, avoiding sudden posture changes.
Sleep Changes
Some people feel sedated; others experience insomnia or restless sleep.
What helps: bedtime routine, limiting screens, calming activities before bed.
Skin Sensitivity
Mild itching or rashes can appear as your body adjusts.
What helps: hypoallergenic skincare, cool compresses, avoiding harsh soaps.
Lexapro Side Effects in Women
Because serotonin interacts with reproductive hormones, women may notice:
Mild menstrual irregularities
Heightened sensitivity to hormonal changes
Temporary mood fluctuations around the cycle
Tracking your cycle and discussing changes with your provider can help determine whether adjustments are needed.
How to Manage First-Week Lexapro Side Effects
These practical strategies can make the adjustment period smoother:
Stay Hydrated
Water reduces headaches, nausea, and dizziness.
Eat Light and Regularly
Small, balanced meals support digestion during the transition.
Create a Relaxing Bedtime Routine
Warm baths, gentle stretching, or reading can improve sleep quality.
Move Slowly When Standing
This prevents dizziness and reduces the chance of falls.
Monitor Skin Changes
Use gentle products and consult your provider if itching or rashes worsen.
Keep Communication Open
If side effects interfere with your daily life, your provider may suggest:
Adjusting the dosage
Changing the timing (morning vs. evening)
Slowing the titration schedule
You should never change your dose without medical guidance.
Long-Term Benefits and What to Expect
Most early side effects fade after the first 1–2 weeks. As your body adapts, Lexapro may provide:
Significant reduction in anxiety
Improved mood stability
Clearer thinking and concentration
Better stress tolerance
Enhanced participation in therapy or lifestyle changes
Many patients find the long-term benefits far outweigh the initial adjustment.
When to Contact Your Provider
Seek medical guidance if you experience:
Severe or worsening side effects
Persistent vomiting or diarrhea
Extreme fatigue
Worsening depression or anxiety
Any signs of an allergic reaction (rash, swelling, difficulty breathing)
Early communication helps ensure safe, effective treatment.
Final Thoughts
Starting Lexapro is a meaningful step toward better mental health. While the first week can come with temporary discomfort, understanding why these symptoms happen—and how to manage them—can make the process smoother. With patience, support, and guidance from your provider, Lexapro can be a highly effective tool in reducing anxiety and improving your overall quality of life.
