Does Lexapro cause weight gain?

In this article:

• Does Lexapro cause weight gain?
• Causes
• Dosages and weight gain
• Weight effects after discontinuation
• Managing Lexapro weight gain
• Cost
• Expert takeaway
• FAQs

In this article

• Does Lexapro cause weight gain?
• Causes
• Dosages and weight gain
• Weight effects after discontinuation
• Managing Lexapro weight gain
• Cost
• Expert takeaway
• FAQs

Lexapro (escitalopram) is a widely used selective serotonin reuptake inhibitor (SSRI) antidepressant in the U.S. Some people gain weight while taking it, but the average amount of weight gain is usually small. Many people do not gain any weight at all.

Here’s what we know about weight gain with Lexapro, including why it may happen and when you should talk to your healthcare provider about switching medications.

Does Lexapro cause weight gain?

Lexapro may cause modest weight gain in some people. Factors such as your starting weight, metabolism, genetics, other medications, and changes in depression or anxiety symptoms may affect whether you gain weight.

“Individuals’ reactions vary significantly from each other; therefore, I am not going to assume that every individual who initiates Lexapro will gain weight,” says Allen Masry, MD, a psychiatrist board-certified in adult and addiction psychiatry and medical director of All in Solutions located in Florida, New Jersey, and California.

The clinical trials used for FDA approval did not find a clinically important difference in weight between people taking Lexapro and those taking a placebo. According to the prescribing information, decreased appetite occurred in 3% of people taking Lexapro and 1% of those taking a placebo.

How much weight might you gain on Lexapro?

On average, people taking Lexapro gained about 1.4 pounds in the first six months, according to a study published in Annals of Internal Medicine.

The study followed 183,118 adults across eight U.S. health systems who were starting one of eight commonly prescribed antidepressants. After six months, people taking escitalopram (the generic version of Lexapro) had gained an average of 1.4 pounds, compared with 0.5 pounds among those taking Zoloft (sertraline).

The study did not include a comparison group of people who weren’t taking an antidepressant, so the researchers note that the difference between medications is more reliable than the total amount gained. Some of that weight change likely reflects factors unrelated to the medication, such as changes in smoking status or diet.

Escitalopram was among the medications associated with more weight gain, along with Paxil (paroxetine) and Cymbalta (duloxetine). Compared with sertraline, people taking escitalopram, paroxetine, or duloxetine had a 10% to 15% higher chance of gaining at least 5% of their starting weight.

After two years, people taking escitalopram gained about 3.6 pounds on average, compared with about 3.2 pounds in the sertraline group.

The two-year figures are also far less reliable than the six-month ones because only about 4% to 5% of participants were still taking the antidepressant they started with by then. That made it much harder for researchers to attribute the later weight changes to any specific medication.

Why does Lexapro cause weight gain?

Lexapro can change the way your brain signals hunger and fullness. It can also restore appetite if depression or anxiety had previously affected your eating patterns. Because these changes can occur at the same time, it’s difficult to know whether weight gain comes directly from Lexapro or from an improvement in mental health symptoms.

“Once depressive or anxiety disorders improve, many individuals report normalization of their appetite,” says Lauren Grawert, MD, a double board-certified addiction psychiatrist and clinical advisor at Retreat of Boston. “It is thus challenging to differentiate a direct pharmacological effect from improvements in one’s psychiatric symptoms.”

Lexapro raises serotonin levels in your brain. Serotonin is a neurotransmitter that helps with mood, but it also affects how hungry or full you feel.

One review suggests that long-term antidepressant use may reduce the activity of 5-HT2C receptors. These receptors normally help signal when the body is full. Escitalopram does not strongly affect the receptors that cause greater appetite changes with some other antidepressants. This may be why Lexapro usually causes only a small amount of weight gain.

An increase in appetite is not always a side effect of the medication. If depression or anxiety previously reduced your appetite, returning to regular eating habits may mean your symptoms are improving.

Does a lower dose of Lexapro cause less weight gain?

Researchers have not directly compared weight changes between people taking a daily dose of 10 mg and 20 mg of Lexapro. The FDA does not list weight gain as dose-dependent. It is unknown if taking a lower dose, like 10 mg instead of 20 mg, will reduce the risk of weight gain.

“While there are certainly some prescription medication side effects that appear to correlate directly with dosage, there is no evidence supporting a linear association between dosing of Lexapro (escitalopram) and resultant weight gain,” Dr. Grawert explains.

She notes that a number of factors may affect your weight more than the Lexapro dose itself, including:

• Sedentary lifestyle
• Starting weight
• Sleep patterns
• Genetics
• Other medications
• Treatment duration

Adults usually take between 10 and 20 mg of Lexapro daily. If you are worried about weight management or think your dose should change, talk with your healthcare provider. Do not adjust your dose on your own.

Does the weight gain go away after stopping Lexapro?

Some people lose weight after stopping Lexapro, but it doesn’t always happen right away, says Dr. Grawert.

“For those who do experience some reversal of weight gain after cessation of the medication, the magnitude of the weight loss is usually proportional to how quickly normal eating habits or appetite were restored,” she adds.

Do not stop taking Lexapro because of weight concerns without talking with your healthcare provider. Stopping an SSRI suddenly can cause withdrawal symptoms, including:

• Dizziness
• Drowsiness
• Nausea
• Irritability
• Headaches
• Trouble sleeping

The FDA recommends lowering your dose slowly instead of stopping abruptly. Your healthcare provider can help you make a plan to taper off safely.

How can you manage or prevent weight gain on Lexapro?

Healthy habits may help you manage weight fluctuations while taking Lexapro. Dr. Masry recommends:

• Getting regular physical activity
• Eating balanced meals and avoiding processed foods
• Getting adequate sleep
• Paying attention to hunger and fullness cues

Most experts recommend building healthy habits you can stick with, rather than following a strict or restrictive diet. It may be worth speaking with a registered dietitian if you need help creating an eating plan that supports your health and weight-management goals.

Untreated depression and anxiety can change your appetite and activity levels. Some weight gain after starting Lexapro may therefore reflect a return to your previous eating patterns rather than an effect of the medication.

“If you begin to notice steady increases in weight, then the prescribing physician can evaluate your diet, activity level, other prescribed medications, and metabolic issues contributing to weight loss or gain rather than immediately attributing Lexapro as the sole contributor,” Dr. Masry says.

When should you talk to your healthcare provider about switching medications?

Talk with your healthcare provider if the weight gain continues, causes emotional distress, or makes you consider stopping Lexapro, Dr. Masry advises.

A few antidepressants may be less likely than others to cause weight gain. In the Annals of Internal Medicine study, Wellbutrin (bupropion) was the only medication associated with slight weight loss after six months. People taking bupropion were also about 15% less likely than those taking sertraline to gain at least 5% of their starting body weight.

Prozac (fluoxetine) had a similar effect on weight as sertraline. Celexa (citalopram) and Effexor (venlafaxine) fell between medications associated with lower and higher amounts of weight gain.

Whether you stay on Lexapro or try something else depends on your mental health, your concerns about weight, and your overall well-being. Some people do best by staying on Lexapro. Others may need to try a different medicine. Do not stop taking Lexapro or switch antidepressants without guidance from your healthcare provider.

How much does Lexapro cost?

Brand-name Lexapro costs about $596 for 30, 10 mg tablets. With a free SingleCare coupon, you can get generic Lexapro (escitalopram) for as little as $4 for 30, 10 mg tablets.

SingleCare coupons are free and work at more than 35,000 pharmacies, including CVS, Walgreens, Walmart, Kroger, Albertsons, Safeway, Rite Aid, and Meijer. Anyone with a valid prescription can use a coupon. Present your prescription discount card at the pharmacy counter to receive the discounted price.

Expert takeaway

“Some patients gain weight when they are less depressed because they eat normally,” notes Leslie Greenberg MD, Associate Professor of Family and Community Medicine at University of Nevada Reno School of Medicine. Watch your diet and increase your exercise to help avoid gaining weight when taking an antidepressant, she advises..

Frequently asked questions

Will 10 mg of Lexapro cause weight gain?

It’s possible, but not everyone gains weight on 10 mg of Lexapro. Taking a lower dose does not always lower the risk. Other factors may contribute to weight gain more than the dose of Lexapro you’re taking.

Is Lexapro one of the worst antidepressants for weight gain?

Not necessarily. In an Annals of Internal Medicine study comparing eight commonly prescribed antidepressants, Lexapro (escitalopram) was associated with more weight gain than some of the other medications studied. It was in the higher-weight-gain group with Paxil (paroxetine) and Cymbalta (duloxetine). However, over six months, people taking escitalopram gained only about one pound more on average than those taking sertraline.

How long does it take for Lexapro to cause weight gain?

If you gain weight on Lexapro, it usually happens slowly over several months to years.