Is Lexapro Addictive? Understanding Dependence and Withdrawal

Lexapro (escitalopram) is a prescription antidepressant used to treat depression and anxiety. While Lexapro isn't considered addictive and has a low potential for misuse, it can cause withdrawal symptoms if stopped too quickly.¹

For many people, Lexapro can be an effective part of managing their mental health. Understanding how it works, its potential side effects, and the difference between addiction and physical dependence can help you make informed decisions about your treatment.

What Is Lexapro?

Lexapro is the brand name for escitalopram, a selective serotonin reuptake inhibitor (SSRI) that helps increase the availability of serotonin in the brain.² It's approved by the FDA to treat major depressive disorder (MDD) in adults and children 12 and older, and generalized anxiety disorder (GAD) in adults and children seven and older.¹ It comes as a tablet in five, 10, and 20 milligram strengths, usually taken once a day with or without food.¹

How Does Lexapro Work?

Like other SSRIs, Lexapro works by blocking the reuptake of serotonin, a chemical messenger in the brain that helps regulate mood, sleep, and appetite.^2,3 This allows more serotonin to remain available between nerve cells, where it helps transmit certain types of brain signals.²

Unlike some other antidepressants, Lexapro primarily targets serotonin and has little effect on the reuptake of other neurotransmitters, such as norepinephrine and dopamine.¹ In other words, Lexapro helps serotonin stay active in the brain longer, which can help improve mood and reduce symptoms of depression and anxiety over time.

What Are the Side Effects of Lexapro?

The most common side effects of Lexapro include:¹

• Nausea.
• Dry mouth.
• Trouble sleeping (insomnia).
• Drowsiness or fatigue.
• Increased sweating.
• Sexual side effects, including decreased sex drive, delayed ejaculation, and difficulty reaching orgasm.

Some people may also experience changes in appetite or weight while taking Lexapro, including weight gain. These changes can vary from person to person.¹

Although less common, Lexapro can cause serious side effects. One is serotonin syndrome, a potentially life-threatening condition caused by excessive serotonin activity in the nervous system.¹ The risk increases when Lexapro is combined with certain medications that affect serotonin. Symptoms of serotonin syndrome may include agitation, fast heartbeat, fever, and muscle stiffness.¹

Lexapro also carries a boxed warning, the FDA's strongest safety warning, about an increased risk of suicidal thoughts and behaviors in children, teens, and young adults.¹ Anyone taking Lexapro should be monitored for worsening depression, suicidal thoughts, or unusual changes in mood or behavior, especially during the first few months of treatment or after a dose change.¹

Is Lexapro Addictive?

Lexapro isn’t generally considered addictive, and its potential for misuse is low.¹ Unlike medications with a higher risk of addiction, Lexapro isn’t classified as a controlled substance. While premarketing clinical research didn't find drug-seeking behavior among people taking Lexapro, the FDA does note that these observations weren't systematic, meaning the studies weren't specifically designed to evaluate the medication's potential for misuse or addiction.¹

Addiction, clinically diagnosed as a substance use disorder (SUD), involves a pattern of problematic substance use. The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) outlines 11 criteria, with at least two required within a 12-month period for a diagnosis:⁴

• Using more of a substance, or using it for longer, than intended.
• Wanting to cut back or stop, but being unable to.
• Spending a lot of time getting, using, or recovering from a substance.
• Experiencing cravings or a strong urge to use.
• Failing to meet responsibilities at work, school, or home because of use.
• Continuing to use despite relationship problems it causes.
• Giving up activities that used to matter in favor of using.
• Using in physically hazardous situations.
• Continuing to use despite a physical or psychological problem it's causing or worsening.
• Needing more of the substance to get the same effect.
• Experiencing withdrawal symptoms when stopping.

Although Lexapro isn't considered addictive, it can still cause physical dependence.¹ Importantly, though, the DSM-5 specifies that tolerance and withdrawal—both potential manifestations of physiological dependence—don't count toward a substance use disorder diagnosis when they occur solely during appropriate medical treatment with prescribed medications.⁴ Furthermore, a review of antidepressants found that these medications aren't generally associated with addictive behaviors.⁵

Can Lexapro Be Misused?

While Lexapro generally isn’t considered addictive, it does have the potential for misuse, although this is low.¹ Like other prescription medications, Lexapro can be misused if taken differently than prescribed. Misuse of prescription medications includes taking more than prescribed, using someone else's prescription, or taking medication to get high.⁶ Misuse doesn't necessarily mean someone has developed an addiction.¹

Can Lexapro Cause Withdrawal?

Yes, stopping Lexapro suddenly or reducing your dose too quickly can cause withdrawal symptoms, also known as antidepressant discontinuation syndrome. Lexapro withdrawal symptoms can include:¹

• Headache.
• Unusual sensations, such as electric shock-like feelings sometimes called "brain zaps.
• Confusion.
• Low or irritable mood.
• Anxiety.
• Agitation.
• Sudden mood changes.
• Hypomania, a period of unusually elevated mood or energy.
• Trouble sleeping.
• Fatigue or low energy.

These symptoms often resolve on their own, but they can sometimes be severe or persist for weeks or longer.¹ To reduce the risk of withdrawal symptoms, the FDA recommends gradually lowering the dose of Lexapro rather than stopping suddenly. This process (known as tapering) should always be done under the guidance of a healthcare provider.

Your provider can help develop an individualized tapering schedule based on factors like your current dose, how long you've been taking Lexapro, and how you respond to dose reductions. If you're considering stopping Lexapro, talk with your healthcare provider about a tapering plan that's right for you.¹

Symptoms you might experience after stopping Lexapro, or even after missing just a few doses, can be difficult to distinguish from a return of depression or anxiety. Whether you're experiencing medication withdrawal or a recurrence of your original symptoms, those symptoms can be quite troublesome and even scary. The important thing to remember is that healthcare professionals recognize these challenges and can help you manage them, whether that means adjusting your medication, exploring other mental health treatments, or simply helping you understand what's happening and guiding you through the next steps.

Scot Thomas, MDMedical Editor

Is It Lexapro Withdrawal or a Return of Depression or Anxiety?

Withdrawal from antidepressants like Lexapro can sometimes look similar to symptoms of depression or anxiety.⁷ This can make it difficult to tell whether you're experiencing withdrawal or a return of your original condition. Both can cause changes in mood, anxiety, and trouble sleeping.⁷ However, certain characteristics may help healthcare providers distinguish between medication discontinuation symptoms and a recurrence of the underlying mental health condition.

According to research published in BJPsych Advances, signs that may suggest antidepressant withdrawal rather than a return of depression or anxiety include:⁷

• When symptoms begin: Withdrawal symptoms often appear within days of reducing or stopping an antidepressant, while a return of depression or anxiety typically develops more gradually.⁷
• Physical symptoms: Dizziness, nausea, and electric shock-like sensations (sometimes called "zaps") may point toward withdrawal, particularly when they occur alongside emotional symptoms.⁷
• How symptoms change: Withdrawal symptoms may follow a “wave-like” pattern of increasing, peaking, and gradually improving, although some people experience symptoms that last longer.⁷
• How symptoms respond to medication: Withdrawal symptoms may improve relatively quickly when the medication is reinstated under medical supervision, whereas a return of depression or anxiety typically takes longer to respond to treatment.⁷

These differences aren't always clear, though. Sometimes, withdrawal symptoms can be mistaken for a return of the original mental health condition. If you experience symptoms after reducing or stopping Lexapro, talk with your healthcare provider. They can help determine what may be causing your symptoms and discuss appropriate next steps.

Find Support

If you're taking Lexapro and have questions about side effects, withdrawal, or your treatment plan, talk with your healthcare provider. They can help you understand what to expect and whether any adjustments may be needed. Always consult your prescriber before changing your dose or stopping Lexapro.

If you're concerned about your relationship with Lexapro or another medication, learning more about prescription drug misuse can help you recognize potential warning signs and understand when to seek additional support. If you're considering treatment options, Recovery.com can help you find and compare programs that fit your needs.