Can Lexapro Cause Insomnia?

By Andrew Yocum, MD
Medically reviewed checkmarkMedically reviewed
March 7, 2022

Lexapro is one of the most prescribed antidepressants in the United States.

People who take Lexapro often report improvements in the symptoms of depression and anxiety after 4-6 weeks, but it’s important to note the medication can have side effects that range from mild to severe. 

One of the most common side effects of Lexapro is insomnia, where patients find it difficult to fall or stay asleep. 

In this article, we’ll discuss the relationship between Lexapro and insomnia, whether Lexapro causes insomnia, and how to manage insomnia caused by Lexapro.

We’ll also look into when to see a doctor if you think Lexapro is causing your insomnia.

What is Lexapro?

Lexapro is a brand name for the medication escitalopram oxalate.

It is a medication belonging to the selective serotonin uptake inhibitors (SSRI) class of drugs. 

SSRIs prevent the reuptake of serotonin in the brain, thereby increasing the amount available.

Serotonin is a neurotransmitter responsible for mood, sleep, and other bodily functions.

A comparative review suggests that escitalopram is more effective and has a better tolerability profile than other SSRIs. 

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What does Lexapro treat?

Lexapro is prescribed for the treatment of major depressive disorder (MDD), also known as depression, in adults and children as young as 12 years old.

It is also prescribed for the treatment of generalized anxiety disorder (GAD) in adults.

It can also be prescribed off-label for the treatment of obsessive-compulsive disorder (OCD), panic disorders, eating disorders, premenstrual dysphoric disorder (PMDD), and post-traumatic stress disorder (PTSD).

Off-label means the U.S. Food and Drug Administration (FDA) has not approved it to treat those conditions but your healthcare provider can prescribe it if they believe it may help.  

Can Lexapro Cause Insomnia? 

More than 10% of patients reported insomnia while on Lexapro, according to the FDA, making it one of the most common side effects of the medication.

Many antidepressants, especially SSRIs, can cause insomnia due to their effect on the serotonergic system responsible for certain bodily functions, including sleep.

Insomnia presents as not being able to fall asleep even when you feel tired, or being unable to stay asleep, which affects your sleep quality. 

If you’re taking Lexapro and experiencing insomnia, there is a possibility it might be caused by your medical condition rather than the medication.

Studies show that sleep disorders like insomnia occur in about three-quarters of depressed patients.

It is also a symptom of generalized anxiety disorder (GAD). 

In some cases, Lexapro can help with insomnia symptoms.

A randomized controlled trial reported improved sleep quality and reduced insomnia symptoms among perimenopausal and postmenopausal people with hot flashes. 

Another study suggests that Lexapro can help alleviate sleep problems in the treatment of MDD and GAD.

How to Manage and Deal with Insomnia from Lexapro 

Insomnia can have a serious negative effect on your quality of life.

If you constantly feel tired or like you’re not well-rested, it can worsen the symptoms of depression and anxiety.

To manage Lexapro-induced insomnia, here are some techniques you can apply:

  • Take Lexapro in the morning: If you’ve been taking your medicine at night, try switching it to morning. The insomniac effect of Lexapro may wear off by nighttime, allowing you to have a good night’s rest. However, don’t make this change without approval from your physician or healthcare provider.
  • Avoid alcohol: Alcohol has a sedative effect, so people often turn to it as a remedy for insomnia. But in the long run, it can worsen the quality of your sleep. The FDA does not recommend consuming alcohol at the same time as Lexapro. Consuming the two together can increase some of the side effects of the medication, like nausea and dry mouth.
  • Avoid late-night caffeinated beverages: Caffeine is a stimulant that can prevent you from falling asleep. With a half-life ranging between 1.5-9.5 hours, it can stay in the body for an extended period and make it difficult to sleep. It may be smart to avoid coffee and other caffeinated drinks after noon.
  • Exercise: Exercise can help you fall asleep faster and generally improve the quality of your sleep. During the day, stay active—walk, jog, take a run, sign up for a gym—and make it a lifestyle. But try to avoid intense exercise at least 1 hour before you go to bed, as it may cause sleep problems.
  • Avoid technology close to bedtime: Devices like your smartphone and computer emit blue light, which can suppress your body’s production of a hormone that causes sleepiness called melatonin. Research shows that avoiding exposure to blue light for 2 hours before bedtime helps improve sleep quality.
  • Create the right condition for sleep: Making sure your room is quiet, dimly lit, and at the right temperature can help you sleep better.

A combination of these techniques can help improve your sleep pattern and quality.

If there are no changes, discuss other options with your doctor.

Will the insomnia go away? 

With continuous use of Lexapro, insomnia will likely diminish over time.

After starting the medication, it can take at least 1 or 2 weeks to see an improvement in your sleep pattern.

If insomnia persists for several weeks, talk to your doctor or healthcare provider. They may have other options for you.

Additional Side Effects 

Besides insomnia, some other common side effects from using Lexapro include:

  • Sleepiness
  • Nausea
  • Dizziness
  • Sexual problems like ejaculation disorder
  • Dry mouth
  • Changes in stool like Diarrhea or Constipation
  • Infection
  • Not feeling hungry
  • Feeling anxious
  • Weakness
  • Shaking
  • Sweating
  • Weight loss (in children)
  • Headache

Most of these side effects can be appropriately managed and will diminish over time.

However, sexual side effects are not known to decrease over time and it may be worth talking to your doctor about switching to another medication if you’re experiencing them.

Having troubles sleeping while taking Lexapro? Chat with a doctor today.
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When to See a Doctor

If insomnia caused by Lexapro lasts for several weeks and is severe, see your doctor or healthcare provider.

They may decide to adjust your dosage, switch you to a different antidepressant, or prescribe sleeping medication.

How K Health Can Help

Some of the side effects of Lexapro, like insomnia, can be worrisome, especially when they last for long. In such cases, it’s time to speak with a doctor. 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

How long does insomnia last with Lexapro?
Insomnia as a side effect of using Lexapro typically does not last long. You can expect to stop experiencing insomnia within the first two weeks of using the medication. If your insomnia persists after several weeks, talk to a doctor about other options.
Is it better to take Lexapro at night or in the morning?
You should take Lexapro according to your doctor's prescription. If you're experiencing insomnia with Lexapro, your doctor may decide that it's better to take it in the morning. Do not switch your dosage or medication timing without consulting your doctor or healthcare provider first.

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).