Does Lexapro Cause Weight Gain?

By Andrew Yocum, MD
Medically reviewed checkmarkMedically reviewed
March 30, 2022

Body weight changes are a common concern people have when their doctor recommends starting an antidepressant such as Lexapro.

While a few of these medications may cause weight loss, most list weight gain as a possible side effect. 

Lexapro appears to cause different effects in different people.

As with any medication, it’s important to discuss the benefits and potential drawbacks with your doctor when choosing an antidepressant

In this article, I’ll talk about Lexapro in detail. I’ll discuss its uses, how it works, and its connection to the risk of weight gain.

I’ll also talk about other side effects, how to take Lexapro, and precautions before taking it.

Finally, I’ll share when to see a doctor about Lexapro.

Have questions about a Lexapro prescription? Chat with a doctor today.
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What Is Lexapro?

Lexapro is a brand name of the drug escitalopram.

It belongs to a class of medications called selective serotonin reuptake inhibitors (SSRIs).

Lexapro is a newer antidepressant and has fewer side effects than older antidepressants like nortriptyline. 

Lexapro uses

Lexapro is only available by prescription.

It is used to treat major depressive disorder and generalized anxiety disorder.

It’s also used off-label to treat obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), social anxiety disorder, panic disorder, premenstrual dysphoric disorder, and hot flashes in menopause. 

How Lexapro works

Lexapro is a selective serotonin reuptake inhibitor (SSRI).

SSRIs increase the level of serotonin available in the brain by preventing the reabsorption of serotonin by nerve cells in the brain. 

Serotonin is a neurotransmitter (brain chemical) that helps regulate mood, sleep, pain, and digestion, among other things.

Low serotonin levels have been associated with depression and anxiety.

SSRIs help reduce depressive symptoms such as decreased mood, insomnia, and fatigue by making serotonin more available in the brain. 

Lexapro and Weight Gain

Weight gain is a common side effect of many antidepressant medications.

But everyone responds to medications differently.

To make things more confusing, Lexapro may cause either weight gain or weight loss.

This may be because serotonin plays a role in appetite regulation, so Lexapro may increase or decrease appetite.

What the research says

Compared with older antidepressants like monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs), SSRIs are less likely to cause weight gain.

Looking specifically at Lexapro, researchers in one study compared people taking escitalopram and nortriptyline (Pamelor, a tricyclic antidepressant).

Study participants taking escitalopram gained, on average, less than a third of a pound in 12 weeks.

Those taking nortriptyline gained almost 10 times as much weight. 

Additionally, some people may be more likely than others to gain weight while taking Lexapro.

One study showed that people who smoke, don’t engage in physical activity, and eat a Western diet (high in processed meats, fast food, and snacks) have a greater chance of gaining weight while on any SSRI.

Common Side Effects of Lexapro

Aside from changes in appetite, common side effects of Lexapro include:

Depression and Weight Changes

Even without medication, depression often leads to weight changes.

It can cause some people to lose all desire for food or feel undeserving of food, leading to weight loss.

Other people may turn to food for comfort or feel less motivated to work out and make healthy meals.

These things can cause weight gain.

How to Take Lexapro

Lexapro comes in tablet or liquid form to be taken orally once daily, with or without food.

Take Lexapro at the same time every day, that way you’re less likely to forget a dose.

If you do forget, take the dose as soon as you remember.

But if it’s close to the time of the next dose, skip the missed dose altogether.

Never take a double dose. 

It may take four weeks or longer to see Lexapro’s effects, so don’t worry if you do not immediately see improvements. 

Don’t stop taking Lexapro when you feel better.

Doing so may lead to withdrawal symptoms like anxiety, changes in mood, abnormal excitement, irritability, and confusion.

If your doctor thinks you should stop Lexapro, they will gradually decrease your dose. 

Lexapro Precautions

Lexapro can cause serious adverse effects if you take it with other medicines or under certain conditions.

To be safe, let your doctor know if:

  • You’ve had an allergic reaction to escitalopram or any other medications in the past. 
  • You’re taking a monoamine oxidase inhibitor (MAOI) or stopped taking one less than two weeks ago.
  • You’re taking another SSRI.
  • You’re taking any other medicines or nutritional supplements.
  • You have epilepsy or are on electroconvulsive treatment. 
  • You have heart problems.
  • You have liver or kidney disease. 
  • You are pregnant, trying to become pregnant, or breastfeeding.

Some people experience worsened depression and suicidal thoughts after taking Lexapro.

Let your doctor know if your depression gets worse or you feel the urge to self-harm. 

Have questions about a Lexapro prescription? Chat with a doctor today.
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When to See a Doctor

If you take Lexapro, your doctor will monitor how you respond.

Contact them if you think you’re having an allergic reaction, which can be life-threatening and cause: 

  • Trouble breathing
  • Wheezing
  • Skin rash that comes with swollen, itchy, red, or peeling skin
  • Tightness in the throat
  • Trouble talking
  • Swelling of the mouth, lips, and tongue

Also contact your healthcare provider if you think you’ve taken too much Lexapro.

Lexapro overdose can cause vomiting, shaking, fast heart rate, and seizures. 

Lastly, if you experience suicidal thoughts or disturbing thoughts, seek immediate medical attention or call the National Suicide Prevention Lifeline at 800-273-8255.

It’s free, anonymous, and available 24 hours a day.

How K Health Can Help

Did you know you can get affordable primary care with the K Health app?

Download K to check your symptoms, explore conditions and treatments, and if needed text with a doctor in minutes. K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.

Frequently Asked Questions

Can Lexapro cause rapid weight gain?
Lexapro does not cause rapid weight gain. However, some individuals experience weight gain after long-term use of Lexapro. Know that other people lose weight on the medication.
Does Lexapro weight gain go away?
If you gain weight when taking Lexapro, you may be able to lose weight with regular exercise and healthy eating. Talk to your doctor or a registered dietitian for support and individual guidance.
Will I lose weight if I stop Lexapro?
You may lose weight when you come off of an antidepressant like Lexapro, but don’t stop taking your medication without your doctor’s advice.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Andrew Yocum, MD

Dr Andrew Yocum is a board certified emergency physician. He graduated Summa Cum Laude from Kent State University with a Bachelor of Science in Molecular Biology before attending Northeast Ohio Medical University where he would earn his Medical Doctorate (MD).