When is the Best Time to Take Lexapro for Anxiety?

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Introduction

If you’ve been diagnosed with an anxiety disorder, your doctor may have prescribed you a medication called Lexapro to help manage your symptoms. Lexapro, also known by its generic name escitalopram, is a commonly used antidepressant that belongs to a class of drugs called selective serotonin reuptake inhibitors (SSRIs). While Lexapro can be very effective in treating anxiety, it’s important to take it at the right time to maximize its benefits and minimize potential side effects. In this article, we’ll explore when the best time is to take Lexapro for anxiety based on individual factors and provide tips for managing side effects and optimizing your treatment.

Understanding Lexapro and Anxiety

Anxiety disorders are the most common mental health condition in the United States, affecting over 40 million adults each year^[1]. Symptoms can include excessive worry, restlessness, irritability, difficulty concentrating, sleep disturbances, and physical symptoms like muscle tension and rapid heartbeat. While therapy and lifestyle changes can help manage anxiety, medication is often necessary for more severe cases.

Lexapro works by increasing levels of serotonin, a neurotransmitter that helps regulate mood, sleep, and appetite^[2]. By blocking the reabsorption of serotonin back into nerve cells, Lexapro allows more of this “feel-good” chemical to remain active in the brain, which can help alleviate anxiety symptoms. Lexapro is FDA-approved to treat generalized anxiety disorder (GAD) in adults and is also commonly prescribed off-label for other anxiety disorders like social anxiety disorder and panic disorder.

The Importance of Finding the Right Time

Taking Lexapro at the optimal time of day is crucial for several reasons:

1. Maximizing effectiveness: Finding a consistent time to take Lexapro each day can help maintain steady levels of the medication in your system, which may enhance its anxiety-reducing effects.
2. Minimizing side effects: Some people experience side effects like nausea, insomnia, or drowsiness when starting Lexapro. Taking it at a specific time, such as with a meal or before bed, may help lessen these effects.
3. Fitting it into your routine: Choosing a time that works well with your daily schedule makes it easier to remember to take your medication and stick with your treatment plan.

The Best Time to Take Lexapro for Anxiety

So when exactly is the best time to take Lexapro? The answer depends on several individual factors:

Based on Individual Side Effects

One of the main considerations in timing your Lexapro dose is how it affects you personally in terms of side effects. The most common side effects of Lexapro include^[3]:

• Nausea
• Diarrhea
• Dry mouth
• Sweating
• Fatigue or drowsiness
• Insomnia
• Decreased appetite
• Sexual side effects

If Lexapro tends to make you feel drowsy, taking it at night before bed may be preferable. On the other hand, if it causes insomnia or sleep disturbances, taking it in the morning may be a better option. Some people also find that taking Lexapro with food helps minimize gastrointestinal side effects like nausea.

It’s important to note that many of these side effects are temporary and tend to improve after the first few weeks of treatment as your body adjusts to the medication. However, if any side effects are severe or persist, be sure to let your doctor know.

Morning vs. Night

In general, Lexapro can be taken either in the morning or at night, depending on what works best for you. The medication has a half-life of about 27-32 hours, meaning it takes your body that long to clear half of the drug from your system^[4]. Because of this relatively long half-life, Lexapro levels remain fairly steady in your body regardless of what time of day you take it.

That said, there may be some advantages to taking Lexapro at a specific time:

• Morning: If Lexapro energizes you or causes insomnia, taking it in the morning may help you avoid sleep problems at night. Morning dosing may also be easier to remember for some people as part of a regular routine.
• Night: If Lexapro makes you drowsy or fatigued, taking it at bedtime may minimize daytime sleepiness and help you get a better night’s rest. Nighttime dosing may also be preferable if you experience nausea, as lying down after taking it could worsen this side effect.

Ultimately, the best time of day to take Lexapro is the time you’ll be most likely to remember it consistently. Pick a time that fits well into your daily schedule and that you can stick to long-term.

Adjusting Your Schedule

If you’ve been taking Lexapro at a certain time but want to switch to a different time, it’s generally safe to do so as long as you don’t skip or double up on doses. For example, if you normally take Lexapro at night but want to start taking it in the morning instead, simply skip your nighttime dose and take it the next morning as scheduled.

However, if you take Lexapro for other conditions besides anxiety, such as depression or premenstrual dysphoric disorder (PMDD), check with your doctor before changing your dosing schedule, as timing may be more important for these indications. Also, if you take a high dose of Lexapro (20 mg or more), it’s best to talk to your doctor before making any changes to avoid potential withdrawal effects.

Factors to Consider

When deciding the best time to take Lexapro, there are a few key factors to keep in mind:

Side Effects and Their Impact

As mentioned earlier, the specific side effects you experience with Lexapro should guide your timing of the medication. If you’re not sure how it will affect you, starting with nighttime dosing may be wise since any drowsiness or nausea will likely be less disruptive while you’re sleeping. You can always switch to morning dosing later if needed.

It’s also important to consider how potential side effects may impact your daily functioning and responsibilities. For instance, if you operate heavy machinery or drive for your job, you’ll want to time your Lexapro so that you’re at your most alert during those tasks. On the other hand, if you have trouble falling asleep at night, taking Lexapro in the morning may be better so it doesn’t interfere with your sleep.

Sleep Patterns

Sleep is a crucial factor to consider when timing your Lexapro dose, as the medication can cause either insomnia or drowsiness in some people. If you already struggle with sleep problems like difficulty falling asleep or waking up frequently at night, taking Lexapro in the morning may help prevent it from worsening these issues.

Conversely, if you have no pre-existing sleep problems and find that Lexapro makes you sleepy, taking it at bedtime could promote better sleep and help you wake up feeling more refreshed. Just be sure to take it at least a few hours before your target bedtime so that it has time to kick in.

Lifestyle and Daily Routine

Your daily habits and schedule should also play a role in determining the best time to take Lexapro. Consider the following questions:

• What time do you typically wake up and go to bed?
• Do you eat breakfast regularly? Could you take Lexapro with your morning meal?
• What does your work or school schedule look like?
• When would it be easiest for you to remember to take your medication consistently?

Answering these questions can help you find a time that seamlessly fits into your existing routine. For example, if you’re a morning person who always eats breakfast, taking Lexapro with your first meal of the day could become a natural habit. Or, if you wind down each night with a cup of herbal tea, taking your dose then could serve as a helpful reminder.

The key is to choose a time that you can stick to consistently, as maintaining steady levels of Lexapro in your system is important for its effectiveness. It’s also a good idea to keep your medication visible, such as on your nightstand or kitchen counter, and set a daily alarm to help you stay on track.

Lexapro and Anxiety Management

While finding the right time to take Lexapro is important, it’s just one piece of the puzzle when it comes to managing anxiety. Understanding how the medication works, addressing side effects, and incorporating other therapies and lifestyle changes can all help optimize your treatment.

How Lexapro Works

Lexapro belongs to a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs), which are considered first-line treatments for anxiety disorders. SSRIs work by blocking the reabsorption of serotonin, a neurotransmitter that plays a key role in regulating mood and anxiety.

Normally, serotonin is released by nerve cells to transmit messages and then reabsorbed back into the cells. SSRIs like Lexapro prevent this reuptake process, allowing more serotonin to remain active in the brain. Over time, this increased serotonin activity is thought to alleviate anxiety symptoms and improve mood.

It’s important to note that Lexapro is not an instant fix for anxiety. It can take several weeks of consistent use to start noticing improvements, and it may take up to 12 weeks to experience the full benefits. During this time, it’s crucial to keep taking your medication as prescribed, even if you don’t feel better right away.

Managing Side Effects

While Lexapro is generally well-tolerated, it can cause side effects in some people, especially when first starting the medication. Common side effects include:

• Nausea
• Diarrhea
• Dry mouth
• Sweating
• Fatigue or drowsiness
• Insomnia
• Decreased appetite
• Sexual side effects

Most of these side effects are mild and temporary, subsiding within the first few weeks of treatment as your body adjusts to the medication. However, if any side effects are severe or persist, be sure to let your doctor know.

There are also some strategies you can try to manage specific side effects:

• Nausea: Taking Lexapro with food or at bedtime may help minimize nausea. Eating smaller, more frequent meals and staying hydrated can also be helpful.
• Insomnia: If Lexapro causes sleep problems, taking it in the morning instead of at night may help. Practicing good sleep hygiene, such as sticking to a regular sleep schedule and avoiding caffeine and electronics before bed, can also promote better sleep.
• Drowsiness: If Lexapro makes you drowsy during the day, taking it at night may be preferable. Engaging in regular exercise and staying active can also help combat fatigue.
• Sexual side effects: Sexual problems like decreased libido or difficulty reaching orgasm are common with SSRIs. If these issues persist, talk to your doctor about potential solutions such as adjusting your dose or switching to a different medication.

Remember that everyone reacts differently to medication, so what works for one person may not work for another. It may take some trial and error to find the best approach for managing your specific side effects.

Therapy and Lifestyle Adjustments

Medication is just one aspect of treating anxiety; therapy and lifestyle changes can also be incredibly beneficial. In fact, research shows that combining medication with psychotherapy tends to be more effective than either treatment alone for anxiety disorders.

Some common therapy approaches for anxiety include:

• Cognitive-behavioral therapy (CBT): CBT helps you identify and change negative thought patterns and behaviors that contribute to anxiety. You’ll learn coping skills and relaxation techniques to better manage anxiety symptoms.
• Exposure therapy: This type of CBT involves gradually exposing yourself to feared situations or objects in a safe, controlled way. Over time, this can help reduce anxiety and avoidance behaviors.
• Acceptance and commitment therapy (ACT): ACT focuses on accepting anxious thoughts and feelings without trying to fight them, while committing to actions that align with your values and goals.

In addition to therapy, making healthy lifestyle choices can also help reduce anxiety symptoms. Some strategies to try:

• Exercise regularly: Physical activity can help alleviate stress, improve mood, and promote better sleep. Aim for at least 30 minutes of moderate exercise most days of the week.
• Practice relaxation techniques: Deep breathing, progressive muscle relaxation, and mindfulness meditation can all help calm anxiety and promote relaxation.
• Get enough sleep: Aim for 7-9 hours of quality sleep each night. Stick to a regular sleep schedule and create a relaxing bedtime routine.
• Eat a balanced diet: Focus on whole, nutrient-dense foods and limit caffeine, alcohol, and added sugars, which can worsen anxiety symptoms.
• Connect with others: Social support is crucial for managing anxiety. Reach out to friends and family, join a support group, or consider talking to a therapist.

Incorporating these lifestyle habits alongside your Lexapro treatment can help you better manage anxiety symptoms and improve your overall quality of life. Remember to be patient with yourself and celebrate small victories along the way.

Alternatives to Lexapro

While Lexapro is a popular and effective treatment for anxiety, it’s not the only option available. If you find that Lexapro isn’t working well for you or you can’t tolerate the side effects, there are several alternatives to consider.

Other Antidepressants

Other SSRIs: Besides Lexapro, other commonly prescribed SSRIs for anxiety include:

• Prozac (fluoxetine)
• Zoloft (sertraline)
• Paxil (paroxetine)
• Celexa (citalopram)

These medications work similarly to Lexapro but may have slightly different side effect profiles. For example, Prozac has a longer half-life than Lexapro, meaning it stays in your system longer and may be less likely to cause withdrawal symptoms if you miss a dose.

SNRIs: Serotonin-norepinephrine reuptake inhibitors (SNRIs) are another class of antidepressants that can be effective for anxiety. They work by increasing levels of both serotonin and norepinephrine, another neurotransmitter involved in mood regulation. Common SNRIs include:

• Cymbalta (duloxetine)
• Effexor (venlafaxine)
• Pristiq (desvenlafaxine)

SNRIs may be particularly helpful for people who also have chronic pain or fibromyalgia, as they can help alleviate both physical and emotional symptoms.

Other antidepressants: There are also some older classes of antidepressants that may be used to treat anxiety, such as tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs). However, these medications tend to cause more side effects than newer options like SSRIs and SNRIs.

Therapy Options

For some people, therapy alone may be sufficient to manage anxiety symptoms. In addition to the types of therapy mentioned earlier (CBT, exposure therapy, ACT), other approaches that can be helpful for anxiety include:

• Psychodynamic therapy: This type of therapy focuses on exploring unconscious thoughts and emotions that may be contributing to anxiety.
• Interpersonal therapy: Interpersonal therapy aims to improve communication skills and resolve relationship conflicts that may be exacerbating anxiety.
• Group therapy: Participating in group therapy with others who have similar struggles can provide a sense of community and support.
• Family therapy: If family dynamics are contributing to anxiety, involving family members in therapy can help improve communication and relationships.

It’s important to find a therapist who you feel comfortable with and who has experience treating anxiety disorders. Don’t hesitate to try out a few different therapists until you find the right fit.

Lifestyle Changes

As mentioned earlier, making healthy lifestyle choices can go a long way in managing anxiety symptoms. Some additional strategies to consider:

• Limit caffeine and alcohol: Both substances can worsen anxiety symptoms in some people. Try cutting back or avoiding them altogether to see if it makes a difference.
• Practice good sleep hygiene: Create a relaxing bedtime routine, avoid screens before bed, and keep your bedroom cool and dark to promote better sleep.
• Try relaxation techniques: Incorporate deep breathing, progressive muscle relaxation, or mindfulness meditation into your daily routine to help calm anxiety.
• Engage in hobbies: Doing activities you enjoy, such as reading, painting, or gardening, can help reduce stress and promote a sense of accomplishment.
• Volunteer: Giving back to your community can boost self-esteem and provide a sense of purpose, which can help alleviate anxiety symptoms.

Remember that everyone’s anxiety is unique, so what works for one person may not work for another. Be open to trying different approaches and don’t get discouraged if something doesn’t work right away. With time and patience, you can find the combination of treatments that works best for you.

Important Considerations

While Lexapro can be a safe and effective treatment for anxiety, there are some important considerations to keep in mind before starting or while taking the medication.

Drug Interactions

Lexapro can interact with certain medications, supplements, and substances, potentially increasing the risk of side effects or reducing the effectiveness of treatment. Some common drug interactions to be aware of include:

• Other antidepressants: Taking Lexapro with other antidepressants, particularly MAOIs, can cause a dangerous buildup of serotonin in the body known as serotonin syndrome.
• Triptan migraine medications: Combining Lexapro with triptan medications like sumatriptan can also increase the risk of serotonin syndrome.
• NSAIDs: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen may increase the risk of bleeding when taken with Lexapro.
• Blood thinners: Lexapro may enhance the effects of blood thinners like warfarin, increasing the risk of bleeding.
• St. John’s wort: This herbal supplement can increase serotonin levels and should be avoided while taking Lexapro.

Be sure to tell your doctor about all medications, supplements, and substances you’re taking before starting Lexapro to avoid potential interactions. Don’t start or stop any medications without first consulting your healthcare provider.

Cautions and Concerns

There are also some specific populations and situations where extra caution is warranted with Lexapro:

• Pregnancy and breastfeeding: Lexapro may increase the risk of certain birth defects when taken during pregnancy, particularly in the first trimester. It can also pass into breast milk and cause side effects in nursing infants. If you’re pregnant, planning to become pregnant, or breastfeeding, talk to your doctor about the potential risks and benefits of taking Lexapro.
• Children and adolescents: Lexapro is FDA-approved for the treatment of major depressive disorder in adolescents aged 12-17, but it is not approved for the treatment of anxiety disorders in this age group. Antidepressants may increase the risk of suicidal thoughts and behaviors in children and young adults, so close monitoring is essential.
• Older adults: Older adults may be more sensitive to the side effects of Lexapro, such as dizziness and falls. Lower doses may be necessary, and close monitoring is important to ensure safety.
• History of bipolar disorder: Lexapro and other antidepressants can sometimes trigger manic episodes in people with bipolar disorder. If you have a history of bipolar disorder or manic symptoms, be sure to discuss this with your doctor before starting Lexapro.
• Discontinuing treatment: Stopping Lexapro abruptly can cause withdrawal symptoms like dizziness, headache, and nausea. If you decide to stop taking Lexapro, your doctor will likely recommend tapering off the medication slowly to minimize these effects.

It’s important to have an open and honest conversation with your doctor about your medical history, current symptoms, and any concerns you have before starting Lexapro or any new medication.

Consulting with Your Doctor

Working closely with your healthcare provider is key to finding the best treatment approach for your anxiety. Be sure to:

• Discuss your symptoms: Give your doctor a detailed description of your anxiety symptoms, including when they started, how often they occur, and how they impact your daily life.
• Be honest about your medical history: Tell your doctor about any past or current medical conditions, as well as any medications, supplements, or substances you’re taking.
• Ask questions: Don’t hesitate to ask your doctor about the potential benefits and risks of Lexapro, how long it may take to work, and what side effects to expect.
• Follow up regularly: Schedule regular check-ins with your doctor to monitor your progress and adjust your treatment plan as needed. Let them know if you experience any concerning side effects or if your anxiety symptoms aren’t improving.

Remember that finding the right treatment for anxiety can take time and may involve some trial and error. Be patient with the process and don’t hesitate to advocate for yourself and your mental health needs.

Conclusion

Lexapro can be an effective treatment option for many people with anxiety disorders, but finding the right time to take it is important for maximizing its benefits and minimizing side effects. The best time to take Lexapro ultimately depends on individual factors like sleep patterns, side effects, and daily routines.

Finding the Optimal Time

For some people, taking Lexapro in the morning may be best if it causes insomnia or jitteriness. Others may find that taking it at night helps them sleep better and reduces daytime drowsiness. Experimenting with different times and paying attention to how your body responds can help you find the optimal timing for your needs.

Seeking Professional Guidance

While this article provides general information about when to take Lexapro for anxiety, it’s crucial to work closely with your doctor or mental health provider to develop a personalized treatment plan. They can help you weigh the potential benefits and risks of Lexapro, monitor your progress, and make adjustments as needed.

If you’re considering stopping Lexapro or changing the timing of your doses, be sure to talk to your doctor first. Stopping the medication suddenly can cause withdrawal symptoms, so it’s important to taper off slowly under medical supervision.

Taking Control of Your Anxiety

Living with anxiety can be challenging, but effective treatments are available. Whether you decide to take Lexapro, try therapy, make lifestyle changes, or a combination of approaches, know that you don’t have to struggle with anxiety symptoms alone.

By working with your healthcare team, communicating openly about your experiences, and being patient with the process, you can find the strategies that work best for managing your anxiety and improving your quality of life. Remember that recovery is possible, and every small step you take towards better mental health is worth celebrating.

Takeaways

• Lexapro is a commonly prescribed SSRI antidepressant that can be effective for treating anxiety disorders.
• The best time to take Lexapro depends on individual factors like side effects, sleep patterns, and daily routines.
• Some people may benefit from taking Lexapro in the morning if it causes insomnia, while others may prefer taking it at night to reduce daytime drowsiness.
• Lexapro can interact with certain medications and substances, so it’s important to tell your doctor about everything you’re taking before starting treatment.
• Extra caution may be necessary when taking Lexapro during pregnancy, in children and adolescents, and in older adults.
• Working closely with your doctor, being honest about your symptoms and experiences, and following up regularly are key to finding the best treatment approach for your anxiety.
• Recovery from anxiety is possible with the right combination of medication, therapy, lifestyle changes, and support.

References

1. Anxiety and Depression Association of America. (2021). Facts & Statistics. https://adaa.org/understanding-anxiety/facts-statistics
2. National Alliance on Mental Illness. (2020). Escitalopram (Lexapro). https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Escitalopram-(Lexapro)
3. U.S. Food and Drug Administration. (2017). Lexapro (escitalopram oxalate) tablets/oral solution. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021323s047lbl.pdf
4. Rao, N. (2007). The clinical pharmacokinetics of escitalopram. Clinical Pharmacokinetics, 46(4), 281-290. https://doi.org/10.2165/00003088-200746040-00002