Escitalopram: SSRI antidepressant dosing, side effects and alternatives
Escitalopram is an SSRI used for depression and anxiety. Read about typical doses, common side effects, and how it compares to other antidepressants.
What is escitalopram?
Escitalopram is a selective serotonin reuptake inhibitor, or SSRI. It's one of the most widely prescribed antidepressants in the US, used mainly for major depressive disorder and generalised anxiety disorder.
How it works
SSRIs like escitalopram work by preventing your brain from reabsorbing serotonin. More serotonin stays available in the space between nerve cells, which helps regulate mood and reduce anxiety.
Typical dosing
Most people start on 10 mg daily. Doctors often increase this to 20 mg after a week or two. Some patients benefit from doses up to 30 mg daily. It typically takes 2 to 4 weeks to feel the full effect.
Common side effects
Many people experience:
- Nausea or digestive upset (usually mild and temporary)
- Headache
- Sleep changes (either insomnia or drowsiness)
- Sexual side effects (reduced libido or difficulty with arousal)
- Weight changes
Side effects often settle within the first few weeks.
Who should avoid it
Escitalopram isn't suitable if you:
- Are allergic to escitalopram or citalopram
- Take certain other medications that increase serotonin risk
- Have uncontrolled narrow-angle glaucoma
- Are in the first trimester of pregnancy (discuss risks and benefits with your doctor)
Alternatives
Other SSRIs include sertraline, paroxetine and fluoxetine. Different classes of antidepressants like SNRIs or tricyclics may work better for some people. Your doctor can help find the right fit.