Lexapro dosage, forms, and strengths

Lexapro is a brand-name prescription drug that treats major depressive disorder (MDD) in adults and adolescents and generalized anxiety disorder in adults. The active ingredient in Lexapro, escitalopram oxalate, is a selective serotonin reuptake inhibitor (SSRI), a class of drugs that includes commonly-prescribed antidepressants such as Prozac (fluoxetine), Paxil (paroxetine), Zoloft (sertraline), and Celexa, whose active ingredient (citalopram) is nearly identical to Lexapro. 

Serotonin is a chemical in the brain that activates nerve pathways in the brain that modulate mood, fear, anger, aggression, stress, and other behaviors. By increasing the amount of serotonin at nerve junctions, escitalopram improves the ability to manage mood and anxiety. Lexapro tablets are taken daily with or without food to first relieve major depression or anxiety and then prevent a recurrence.

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Lexapro dosage, forms, and strengths

Lexapro is currently available only as tablets in three different dosing strengths. At one time, Lexapro could also be purchased as an oral solution, but this product is no longer marketed in the United States. Generic escitalopram, however, can still be taken as tablets or liquid.

• Tablets: 5 mg, 10 mg, 20 mg

Lexapro dosage for adults

Lexapro treats MDD and generalized anxiety disorder in adults. Some healthcare providers, however, may prescribe Lexapro off-label as a treatment for other psychiatric disorders including obsessive-compulsive disorder (OCD), panic disorder (panic attacks), post-traumatic stress disorder, premenstrual dysphoric disorder, or eating disorders such as bulimia or anorexia. 

• Standard dosage for adults: 10 mg taken once per day by mouth

• Maximum dosage for adults: 20 mg taken once per day by mouth

• Maximum dosage for older adults: 10 mg taken once per day by mouth 

Lexapro dosage for children

The Food and Drug Administration (FDA) has approved Lexapro for the treatment of major depressive disorder in children 12 years of age and older. Lexapro is, however, sometimes prescribed off-label to treat children between the ages of 7-11 years for depression. Other pediatric off-label uses include treatment for social anxiety disorder in children 10–17 and, at a lower dose, to improve behavior regulation in children 6 and older with autism. 

Because they are at an increased risk of suicidal thinking or suicide attempts when taking Lexapro, adolescents and young adults should be closely monitored by their caregivers for worsening symptoms of depression and suicidality.

Lexapro dosage for major depressive disorder

Lexapro is approved to treat major depressive disorder, defined as two weeks or more of persistent depression, loss of interest in enjoyable activities, sleep problems, fatigue, feelings of worthlessness, thoughts of suicide, and other symptoms that significantly interfere with daily life and responsibilities.

• Adults and adolescents 12 years and older: 10 mg taken by mouth once per day

• Mild to moderate renal impairment: No adjustment

• Severe renal impairment: Use with caution

• Hepatically impaired patients: Maximum dose not to exceed 10 mg per day

Lexapro dosage for generalized anxiety disorder

Lexapro is approved to treat generalized anxiety disorder (GAD) in adults. GAD is a chronic condition characterized by at least six months of excessive, persistent, and often unexplainable worry, anxiety, and fear that significantly interferes with daily life.

• Adults 18 years and older: 10 mg taken by mouth once per day

• Mild to moderate renal impairment: No adjustment

• Severe renal impairment: Use with caution

• Hepatically impaired patients: Maximum dose not to exceed 10 mg per day

Lexapro dosage for pets

The FDA has not approved Lexapro or its active ingredient, escitalopram, for use in animals. However, a veterinarian may prescribe escitalopram to treat problem behaviors in dogs. Because of the lack of studies, escitalopram dosing for animals has not been defined, so individual veterinarians may use different dosages. As with humans, escitalopram will be administered to the dog once per day over a period of months as part of a larger behavior treatment plan.

How to take Lexapro

Lexapro tablets are taken once daily with or without food. It may take a month or more before symptoms improve, so continue taking the medicine even if it doesn’t seem to be working. 

• Take this medicine as directed. The dose may sometimes need to be changed.

• Read the medication guide that comes with the prescription. Ask the pharmacist for a copy if it’s missing.

• Try to take Lexapro at the same time each day. It does not matter if it’s in the morning or evening as long as the tablet is taken at the same time every day.

• Store Lexapro tablets in a tightly closed container at room temperature (68°F–77°F).

Lexapro dosage FAQs

How long does it take Lexapro to work?

It takes several weeks of daily dosing for Lexapro or other SSRIs to improve major depression or anxiety symptoms. Improvement should become noticeable in one or two weeks, and symptoms should steadily get better over the next six weeks. Some people, however, may need to take SSRIs for as long as six weeks before they notice any improvement in symptoms. Escitalopram, however, has a more rapid onset of action than other antidepressants.

Even after symptoms have improved, Lexapro maintenance treatment will need to continue for at least several months and often longer to prevent depression or anxiety from recurring.

How long does Lexapro stay in your system?

With a half-life of 27–32 hours, a single dose of Celexa falls to undetectable levels in the body in about six to seven days. However, the effects of escitalopram are more complex than that. The body converts escitalopram into a very similar substance that works just like escitalopram. Healthcare professionals call these substances “active metabolites,” and the active metabolite of escitalopram has the same therapeutic effects as the original drug. It has a half-life of 54 hours and takes about 10 days to be cleared from the body. 

What happens if I miss a dose of Lexapro?

Take a dose as soon as it’s remembered. If it is almost time for the next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.

For Lexapro to work, it is important to take the medicine faithfully every day for weeks and months. If doses are being skipped frequently, consider setting up an alarm, phone app, or alarm to serve as a reminder. A pharmacist or other healthcare provider can provide other tips for managing a dosing schedule.

How long can you take Lexapro?

SSRIs are long-term treatments for depression. In general, people need to take escitalopram for six to 12 weeks to achieve satisfactory remission of depression symptoms and another six months to a year to fully resolve an episode of major depression. People with chronic forms of depression may need to take Lexapro or another SSRI for two years or more to manage symptoms. Fortunately, Lexapro, like other SSRIs, has not been shown to cause serious problems when taken over the long term.

How do I stop taking Lexapro?

Do not stop taking Lexapro without talking to a doctor or other healthcare professional first. Discontinuing Lexapro suddenly could cause withdrawal symptoms such as:

• Anxiety

• Restlessness

• Irritability

• Trouble sleeping

• Headache

• Dizziness

• Sweating

• Nausea

• Weird skin sensations

• Confusion

• Tremors

To prevent withdrawal symptoms, a doctor or other healthcare provider will prescribe a steadily reducing dose before stopping Lexapro completely.

Not all people will be able to stick with Lexapro. People who have an allergic reaction to Lexapro, pregnant women in their third trimester, or people who experience hypomania, serotonin syndrome, worsening depression or anxiety, suicidal thoughts, glaucoma, hyponatremia (low blood sodium), significant side effects, or heart rhythm problems may need to stop taking Lexapro. Because escitalopram passes into breast milk, women who are breastfeeding also sometimes choose to stop taking Lexapro if the drug starts showing effects on the infant.

If Lexapro is stopped, alternative antidepressant medications include other SSRIs, tricyclic antidepressants, serotonin and norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MAO inhibitors), or atypical antidepressants. People with generalized anxiety disorder can turn to other SSRIs, SNRIs, tricyclic antidepressants, benzodiazepines, or buspirone in place of Lexapro.

What is the maximum dosage for Lexapro?

The maximum dosage for Lexapro is 20 mg per day. However, the elderly and people with liver problems should not take more than 10 mg per day.

Can you overdose on Lexapro?

Do not exceed the recommended daily dose of Lexapro. An overdose of Lexapro will require medical attention, especially if other drugs or alcohol are also involved. Symptoms of a Lexapro overdose include dizziness, low blood pressure, drowsiness, insomnia, nausea, vomiting, and low blood pressure. More serious side effects include changes to the heart’s rhythm, coma, and kidney failure. If there’s any suspicion of a Lexapro overdose, call a poison helpline and go to an emergency room. 

What interacts with Lexapro?

A number of drugs can interact with Lexapro. Some drugs can cause hazardous drug interactions with Lexapro, so it’s vitally important to inform all healthcare professionals providing care about taking Lexapro. Do not start or stop any medication—including over-the-counter medications or supplements—until talking to a doctor, pharmacist, or other healthcare professional. Avoid Lexapro with the following:

• MAOIs. Some include Marplan (isocarboxazid), phenelzine, tranylcypromine, and selegiline.

• Antipsychotic drugs pimozide and thioridazine as well as Cerdelga (eliglustat), a drug that treats an extremely rare inherited medical condition.

• Drugs that also raise serotonin levels. Examples include other SSRIs and SNRIs, sumatriptan, lithium, and tramadol. Popular home remedies such as St. John’s wort and tryptophan also raise serotonin levels.

• All SSRIs can affect heart rhythm, but there is a greater potential for this with Lexapro. Tell your healthcare provider about any personal or family history of heart disease or abnormal heart rhythms.

Because Lexapro increases the risk of bleeding, tell your doctor if you are at risk for bleeding or are taking an anticoagulant (such as warfarin). Be careful about drugs that can be purchased without a prescription, too. Over-the-counter NSAIDs (nonsteroidal anti-inflammatory drugs) such as aspirin, ibuprofen, or naproxen also thin the blood.

Related resources for Lexapro dosages:

• Celexa prescribing information,

• Early onset of selective serotonin reuptake inhibitor antidepressant action

• Early onset of SSRI antidepressant action

• Escitalopram compound summary

• Escitalopram (Lexapro)

• Escitalopram oxalate solution prescribing information,

• Generalized anxiety disorder

• Lexapro

• Lexapro prescribing information,

• Onset of action of escitalopram compared with other antidepressants: results of a pooled analysis

• Pharmacological intervention

• Pharmacological properties of the active metabolites of the antidepressants desipramine and citalopram

• Practical guideline for the treatment of patients with major depressive disorder

• Steps following attainment of remission: Discontinuation of antidepressant therapy