By day four on Lexapro, some are wondering why the depression prescription has made the sofa so inviting.
They are sleeping for longer, yawning through a meeting and feeling slightly removed from the day. Others have the opposite complaint: they are restless and unable to sleep.
Escitalopram can do either. Sleepiness and fatigue are common early side effects, but do not necessarily last.
Why can Lexapro cause fatigue?
Lexapro can disrupt sleep, concentration and daytime energy by altering serotonin signaling and the brain and body need time to adjust.
It can feel like being physically tired: heavy eyes, slow movement and a strong inclination to nap. Or it might resemble mental fatigue. The person can do the work but everything takes longer.
This often commences during the first week or after a dose increase and resolves over the following two to four weeks.
There is a complication, though. Depression can be a cause of fatigue, just as can the anxiety disrupting sleep for months. It is not always obvious what is a characteristic of the illness and what is a side effect of the tablet.
Reflect on the week before treatment and were mornings already difficult? Did you sleep all weekend? If the exhaustion clearly came after the first Lexapro dose, the medication becomes more likely to be the culprit.
Take it at the time which fits its effect
Lexapro can be taken in the morning or evening.
If it makes you sleepy a few hours after taking it, evening may be preferable. If it makes you alert or restless, morning is better.
Do not take the morning dose and then a full evening dose to change things around. Ask a pharmacist for advice about how to move things forward without having the two doses too close to each other.
Keep the new schedule for several days so that switching between morning and night every time you have a tired afternoon is not difficult to assess whether it has worked.
The tablet can be taken with or without food. A small meal is useful where nausea is an issue.
Check what else is making you sleepy
Lexapro may be only part of the afternoon slump.
Alcohol adds to drowsiness and disrupts sleep later in the night. A person can fall asleep quickly after drinking and then wake multiple times and feel exhausted the next day.
Nighttime antihistamines, anti-anxiety medicines, sleeping tablets and some painkillers can add to the sedation. An over-the-counter allergy pill can be relevant.
Sleep apnea is easy to miss. Loud snoring, choking during sleep, waking up with a dry mouth and feeling unrefreshed after eight hours are useful clues. Lexapro will not fix an airway that continues to close overnight.
Anemia and thyroid problems can contribute to fatigue. If tiredness was present before treatment or persists long after the early adjustment period, a review of sorts may be more helpful than constantly changing the dose timing.
Should you use more coffee?
A little more coffee may get somebody through the first few days. Turning it into a treatment plan usually creates another issue.
Too much coffee can worsen anxiety, cause a racing heart and make sleep more difficult. The next morning begins with more fatigue and a coffee. It is a fairly efficient way of keeping the problem with it.
Try spending some time outside in the day, eating regularly and moving around when the slump starts. These are not cures for depression or medication side effects, but they make the adjustment period less punishing.
If driving feels unsafe or you continue to fall asleep during work, call the prescriber. Severe drowsiness is not something managed by willpower.
When does Lexapro fatigue become concerning?
Allow some time for mild early tiredness if the medication is otherwise tolerable. Contact the prescriber if it remains strong after several weeks, continues to get worse or arises after every dose increase.
The solution may be a lower dose, different timing or another antidepressant. The comparison between Celexa and Lexapro shows how closely related SSRI’s can feel different.
Unusual fatigue can occasionally point to low sodium, a rare SSRI complication. Older adults and those on diuretics are at greater risk. Headache, weakness and unsteadiness can appear first. Confusion, seizures or loss of consciousness are an emergency.
Heavy sweating, fever, diarrhea, agitation, tremor and rigid muscles may suggest serotonin syndrome, particularly after adding another serotonin-raising medicine. That also is an urgent matter.
New suicidal thoughts, extreme restlessness or a sudden period of very high energy with hardly any sleep should be reported immediately.
Do not quit suddenly because you are tired
Stopping Lexapro abruptly may bring dizziness, nausea, vivid dreams, anxiety and electric-shock sensations. The original depression or anxiety may come back.
If the fatigue is unbearable, the prescriber can plan a dose reduction or switch. Other antidepressant medications may be less sedating for a particular person.
It is also helpful in assessing the whole result. Is Lexapro reducing panic attacks but causing manageable afternoon sleepiness? Or do you feel equally depressed and now unable to function?
Those are different conversations.
Lexapro fatigue is usually most noticeable at the beginning and often eases. Move the timing if appropriate, keep the alcohol and other sedating medicines in check and let the mild symptoms take it easy.
If you are still dragging yourself through the day after several weeks, it is time to adjust the plan not simply buy stronger coffee.
