Lexapro and exercise: Can you work out while on antidepressants?

If you’re among the 13.2% of Americans currently taking an antidepressant medication, such as Lexapro (escitalopram), to treat depression, you’ve probably heard how exercise can also improve mood and decrease anxiety.

But how do you get started on an exercise plan when it’s hard just to get out of bed some mornings? And is exercise safe when taking a prescription antidepressant? Read on to find out everything you need to know about Lexapro and exercise.

Evaluating Lexapro’s side effects 

Both prescription and over-the-counter medications can have side effects. Although, one study found that while 60% of patients experienced at least one side effect while taking an antidepressant, Lexapro proved to be more effective and better tolerated than the other selective serotonin reuptake inhibitors (SSRIs).

Side effects of Lexapro can include: 

• Headache
• Upset stomach
• Nausea 
• Insomnia
• Fatigue 

“Most of the side effects are relatively minor and typically subside after the first week of starting a new medication,” says Antonia Baum, MD, a sports psychiatrist in private practice in Bethesda, Maryland. “Some of the more common side effects such as nausea or diarrhea can often be alleviated by taking Lexapro with food.”

In some cases, Dr. Baum says Lexapro can result in dry mouth and increased sweating.

“It’s important to stay well hydrated, especially when exercising,” she says. “Overall, the risks of dry mouth and excessive sweating are minimal and shouldn’t preclude exercising or taking Lexapro.”

When taking Lexapro, Dr. Baum says it’s important to not take monoamine oxidase inhibitors (MAOIs), an older form of antidepressants.

Certain supplements such as St. John’s Wort and SAMe should also not be taken with Lexapro.

Losing weight on Lexapro 

If part of your motivation for exercising is to lose weight, this antidepressant shouldn’t interfere. “Although individual results can vary, Lexapro isn’t known to cause severe weight gain,” says Rahul Khurana, MD, a board-certified psychiatrist with a private practice in Seattle, Washington. “I do think that on average, Lexapro is gentler and has less overall side effects than other SSRIs and serotonin-norepinephrine reuptake inhibitors (SNRIs), so it can be a good choice for someone worried about weight gain.”

Dr. Baum has also seen patients who initially lose weight after starting Lexapro. “While weight gain can occur with all SSRIs, it’s not a given,” Dr. Baum says. “Every patient is different.”

She explains that since antidepressants interfere with serotonin, the neurotransmitter that regulates anxiety while also controlling appetite, many patients experience changes in appetite and weight fluctuations after starting Lexapro. “These changes can lead to carb cravings in some patients and loss or appetite and weight loss in others,” Dr. Baum says.

By following a healthy eating plan, maintaining portion control, and increasing physical exercise, many people can successfully manage any weight gain associated with antidepressant use. If weight gain persists, Dr. Baum recommends talking to your healthcare provider about the possibility of switching medications or having your dosage lowered to counteract weight gain.

Exercising while taking Lexapro

Healthcare providers encourage patients with depression to exercise, since physical activity has been shown to ease the symptoms of depression. A study conducted in 2019 found that adding 35 minutes a day of physical activity can significantly reduce the odds of depression. If you haven’t exercised in a while or are having problems getting motivated, start with 10-minute increments.

“On average, no antidepressant should ever interfere with someone’s ability to exercise unless they are experiencing more severe than usual side effects like dizziness or fatigue,” Dr. Khurana says. 

Before starting any new exercise regimen, Dr. Khurana recommends checking in with your healthcare provider if you have a pre-existing health condition, such as heart disease, diabetes, or high blood pressure. Also keep in mind that exercise and Lexapro are only two components in effectively managing your depression.

“Almost every patient being treated for any psychiatric illness should have a holistic treatment plan including nutrition, exercise, and psychotherapy (talk therapy),” he says.