Lexapro Side Effects Guide: First Week Surprises, Long Term Changes & Women Specific Concerns

Why Side Effects Happen

When starting taking Lexapro, many patients wonder why side effects occur. To understand this, we need to look at how Lexapro works in the body. Lexapro, like other SSRIs (Selective Serotonin Reuptake Inhibitors), targets the brain’s serotonin system, a neurotransmitter that plays a crucial role in regulating mood, anxiety, and overall emotional well-being.

Serotonin is responsible for a wide range of functions in the brain, including mood regulation, sleep patterns, and even digestion. Lexapro works by inhibiting the serotonin transporter (SERT), which means it prevents serotonin from being reabsorbed by the neurons too quickly. By blocking this reuptake, Lexapro helps to increase serotonin levels in the brain, which can improve mood and reduce anxiety. However, the brain and body don’t always immediately adjust to this change in serotonin levels. When you start Lexapro, the brain begins to adapt to this altered serotonin activity, which can trigger temporary side effects. For some individuals, this may result in symptoms like nausea, drowsiness, or headaches, particularly during the first few days of treatment.

These side effects are typically temporary, as the body adjusts to the new serotonin levels. However, some side effects, such as sexual dysfunction or weight changes, may persist and become more noticeable over time. This is because Lexapro’s influence on serotonin extends to other downstream pathways in the brain that regulate various bodily functions, such as appetite, mood, and sexual desire.

For a deeper dive into the pharmacokinetics of Lexapro and its impact on serotonin, be sure to check out our Review on how SSRIs work in the brain.

Day 1-14 “Adjustment” Symptoms vs. Persistent Issues

Starting Lexapro is often a time of significant adjustment, and it’s common for new users to experience a variety of temporary symptoms in the first 1 to 2 weeks of treatment. These symptoms are part of the body’s process of adjusting to the medication and can often be referred to as “adjustment” symptoms. While these early effects can be uncomfortable, they are usually short-lived and tend to subside after a few days to a week.

During the first few days, nausea is one of the most common side effects. It can range from mild queasiness to more noticeable discomfort. Some people also experience fatigue, headaches, and dizziness as their body adjusts to the increase in serotonin levels. These side effects are typically temporary and should improve once your body becomes accustomed to the medication. Sleep disturbances, such as trouble falling asleep or vivid dreams, are also common, especially in the first couple of weeks. Many of these issues improve as the body adapts to the treatment. While most of these adjustment symptoms tend to resolve within the first two weeks, some side effects may persist and become more prominent with time. For instance, sexual dysfunction, including reduced libido or delayed orgasm, is a common long-term side effect of SSRIs like Lexapro. This can become a persistent issue for many individuals, even after the initial adjustment period. Weight changes are another side effect that may not be immediately noticeable but can become more apparent with continued use, especially as the medication alters your appetite or metabolism.

It’s important to distinguish between temporary adjustment symptoms and persistent issues that may require a dosage adjustment or a change in treatment. If you continue to experience side effects like sexual dysfunction or significant weight gain after the first few weeks, it’s a good idea to talk to your doctor. They may adjust your dosage or recommend alternative treatments to help manage these symptoms.

Weight, Libido, Menstrual Cycle Notes

One of the most frequently discussed concerns when it comes to Lexapro side effects is the impact on weight, libido, and the menstrual cycle, particularly in women. These side effects can be both frustrating and concerning, and it’s essential to understand how Lexapro may influence these areas of health.

Weight Gain

Many patients report weight gain as a side effect of Lexapro, although the extent of this effect can vary widely. While not everyone will experience it, some users may find that they gain weight after taking Lexapro for an extended period. The reason for weight changes is thought to be related to serotonin’s influence on appetite regulation. SSRIs like Lexapro can alter how the brain controls hunger and satiety, leading to increased cravings for food or a change in metabolism. It is also possible that mood improvements can lead to an increase in appetite, especially if someone previously had a reduced desire to eat due to depression or anxiety.

While Lexapro-induced weight gain is common in some users, it is not inevitable. Maintaining a balanced diet and regular exercise can help mitigate this effect. However, if weight gain becomes problematic, your doctor may consider adjusting your dosage or exploring alternative medications.

Libido Changes

Sexual dysfunction is another common Lexapro side effect, particularly in women. Many individuals find that Lexapro can cause a reduced libido, difficulty reaching orgasm, or general discomfort during sexual activity. These side effects are commonly seen with SSRIs due to their effects on serotonin levels, which play a role in sexual arousal and response. Some users may experience a diminished interest in sex, while others may have difficulty achieving orgasm, even if they still feel sexual desire. This can be a significant concern for many women, especially those in active relationships. If sexual side effects become a persistent issue, talk to your healthcare provider. They may suggest adjusting the dosage, switching to a different SSRI, or combining Lexapro with medications like sildenafil to alleviate the problem.

Menstrual Cycle Changes

Lastly, Lexapro can also affect the menstrual cycle in some women. Changes in hormonal balance brought on by Lexapro may lead to irregular periods, longer or shorter cycles, or more intense PMS symptoms. Some women report changes in the frequency or intensity of their menstrual cycles, while others notice more severe cramps or mood swings during their cycle.

Although these side effects are less commonly discussed, they are important to recognize, as hormonal changes can significantly impact quality of life. If you experience menstrual irregularities or other hormonal-related issues, it’s important to consult with your healthcare provider for further evaluation and to discuss potential solutions.

For more detailed information about the prevalence of these gender-specific side effects, check out Review.

Red Flag Symptoms That Need Urgent Care

While Lexapro is generally well-tolerated, there are certain red flag symptoms that require immediate medical attention. These are serious side effects that, if left unchecked, could lead to severe complications. It’s important to recognize these signs and seek help right away.

Suicidal Thoughts or Mood Swings

One of the most critical concerns when taking Lexapro especially in younger patients is the potential for suicidal thoughts or extreme mood swings. If you notice yourself feeling increasingly hopeless, having suicidal thoughts, or experiencing drastic shifts in mood, it’s essential to seek immediate medical attention. This is a known risk associated with SSRIs and requires prompt intervention.

Severe Allergic Reactions

Although rare, some individuals may experience severe allergic reactions to Lexapro. Symptoms can include difficulty breathing, swelling of the face, lips, tongue, or throat, and a severe rash. If you experience any of these symptoms, contact emergency services immediately.

Serotonin Syndrome

Serotonin syndrome is a rare but life-threatening condition that can occur when there is an excess of serotonin in the brain. Symptoms include high fever, muscle rigidity, tremors, confusion, and rapid heartbeat. If you experience any combination of these symptoms while taking Lexapro, especially if you are also taking other serotonergic medications like MAOIs or triptans, seek emergency care immediately. Serotonin syndrome can progress rapidly, so it’s critical to act fast.

Severe Dizziness or Fainting

If you experience severe dizziness, lightheadedness, or fainting, particularly when standing up, it could indicate a drop in blood pressure or other cardiovascular issues. These symptoms may not be common but should be taken seriously, as they can affect your safety. Let your doctor know if this happens so they can adjust your treatment plan.

It’s important to remember that while Lexapro side effects are often mild and temporary, these red flag symptoms require immediate attention. If you experience any of these serious symptoms, don’t hesitate to seek urgent care. Early intervention can prevent more severe outcomes and ensure your treatment plan is adjusted appropriately.

Internal Links to Related Articles

As you navigate your Lexapro treatment, it’s helpful to have access to other resources that can guide you through the process. Below are links to related articles that provide essential information on Lexapro dosage adjustments and withdrawal symptoms.

How Lowering the Dose Helps

If you’re struggling with side effects like nausea or sexual dysfunction, lowering the dose might be an effective solution. Many patients find that starting with a lower dose of Lexapro and gradually increasing it helps minimize side effects while still providing therapeutic benefits. For more details on how adjusting your Lexapro dosage can alleviate side effects, check out our article on Lexapro Dosage Adjustments.

Don’t Stop Abruptly: Withdrawal and Discontinuation Syndrome

Discontinuing Lexapro too quickly can lead to withdrawal symptoms like dizziness, irritability, and flu-like symptoms. It’s important to gradually taper off the medication under the guidance of your healthcare provider. For tips on how to safely reduce your Lexapro dose and avoid discontinuation syndrome, read our article on Lexapro Withdrawal.

These resources will provide you with the information you need to make informed decisions about your treatment and manage side effects effectively.

Conclusion

Starting Lexapro for anxiety or depression can come with an adjustment period, and understanding potential side effects is key to managing your treatment. While many side effects, such as nausea and fatigue, are temporary and subside within the first two weeks, some, like sexual dysfunction or weight gain, may persist and require further attention. For women, specific concerns such as libido changes and menstrual cycle disruptions should also be considered when evaluating Lexapro’s impact.

It’s essential to distinguish between temporary adjustment symptoms and more persistent issues that might necessitate a change in dosage or treatment plan. Red flag symptoms like suicidal thoughts, serotonin syndrome, or severe allergic reactions must be taken seriously and addressed immediately.

Be sure to communicate openly with your healthcare provider about any side effects you experience. Your doctor can guide you through adjusting the dosage, managing side effects, or exploring alternative treatments if needed. For more detailed information on Lexapro dosage and how to manage potential withdrawal symptoms, refer to our other articles linked above.

Remember, patience is key, and with proper guidance, Lexapro can be an effective solution for managing anxiety and depression with minimal disruptions to your day-to-day life.