Key points
- Escitalopram is approved for major depressive disorder from age 12 and for generalized anxiety disorder from age 7.
- It is one form of the citalopram molecule, and the label says the two should not be taken together.
- PTSD is an off-label use, and the VA reports not enough evidence to recommend it for or against.
- The boxed warning covers suicidal thoughts and behaviors in young people, and it is not approved for children under 7.
- Stopping suddenly can cause withdrawal symptoms, so talk with your prescriber before any change.
What escitalopram is
Escitalopram is an antidepressant in the group called selective serotonin reuptake inhibitors, or SSRIs. Lexapro is its brand name, and generic escitalopram is also sold. MedlinePlus says it comes as a tablet and a liquid.
The label calls it the S-enantiomer of citalopram. Citalopram contains two mirror-image forms of one molecule, and escitalopram is the form the label describes as the active one. Citalopram has its own page and its own label. Nothing here means one is a better fit than the other for any one person.
What escitalopram is approved for, and off-label uses
The Lexapro label lists two approved uses:
- Major depressive disorder, in adults and in people aged 12 and older.
- Generalized anxiety disorder, in adults and in people aged 7 and older.
What falls outside the label
Off-label means a use not on the FDA label. Panic disorder, social anxiety disorder, OCD and PTSD are not on the Lexapro label. MedlinePlus says escitalopram may be prescribed for other uses, and to ask your doctor or pharmacist for more information. If you are unsure whether a use is approved, your prescriber or pharmacist can tell you what the label covers.
For PTSD, the VA's National Center for PTSD says only sertraline and paroxetine are FDA-approved and that other medication uses are off-label. It reports insufficient evidence in the 2023 VA/DoD guideline to recommend escitalopram for or against.
Lexapro is not approved for children under 7, according to its boxed warning.
How escitalopram is thought to work
The label says its antidepressant action is presumed to be linked to raising serotonin activity by blocking nerve cells from taking serotonin back up. Serotonin is a natural chemical messenger in the brain. Animal studies described in the label suggest it is highly selective, with minimal effects on norepinephrine and dopamine, two other messengers.
What taking escitalopram can be like
MedlinePlus says it may take several weeks to feel the full benefit, and that people should keep taking it even when they feel well. The label asks for close watching on mood and behavior, especially early on and at dose changes.
The label adds caution about driving or using machinery until you know how it affects you, because medicines of this kind can affect judgment and motor skills. Its Medication Guide also says a child's height and weight should be monitored during treatment.
Do not stop escitalopram suddenly. The label says stopping, particularly abruptly, can cause low or irritable mood, agitation, dizziness, electric-shock sensations, anxiety, confusion, headache, tiredness, trouble sleeping and other effects. These usually pass on their own, but serious symptoms have been reported. Talk with your prescriber first.
Side effects and warnings for escitalopram
Boxed warning: antidepressants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients in short-term studies. Anyone taking escitalopram should be watched closely for worsening or new suicidal thoughts, including new agitation, irritability or trouble sleeping. If you are in crisis, call or text 988, or call 911. Locascio Wellness does not provide emergency services. Our crisis resources list more options.
The label names these common side effects: trouble sleeping, sweating, nausea, tiredness, sleepiness, decreased sex drive, delayed ejaculation, and delayed orgasm or difficulty having an orgasm.
Dangers and combinations named on the label:
- MAOIs: contraindicated with escitalopram, or within 14 days of either one ending, because of serotonin syndrome. This includes linezolid and intravenous methylene blue.
- Pimozide: contraindicated.
- Citalopram: the two should not be taken together, and a known allergy to either one, or to the inactive ingredients, is a contraindication.
- Serotonin syndrome: a potentially life-threatening reaction, with raised risk alongside other serotonin-affecting medicines.
- Bleeding risk with NSAIDs, aspirin or warfarin, mania or hypomania, seizures, low sodium and angle-closure glaucoma.
Can escitalopram be managed online in Pennsylvania and New York
The Lexapro label lists no controlled-substance schedule for escitalopram. A licensed psychiatrist on our team, a Doctor of Osteopathic Medicine, treats anxiety and depression by secure video for people physically located in Pennsylvania or New York during each visit. See online psychiatry in Pennsylvania or in New York.
Whether it is an option for you is a decision for you and your prescriber. Ask us whether our psychiatrist can help, using our contact form. We can also answer questions about fees, insurance and the ages he sees. Our therapists do not prescribe, and they see clients in Pennsylvania, West Virginia, Arizona, Colorado and Florida, not New York. People in New York can get psychiatry here but not therapy here.
Common questions
Is escitalopram the same as citalopram?
They are closely related but are separate medicines with separate labels. The label says escitalopram is the active form of the citalopram molecule and that the two should not be taken together. Their approved uses differ too: escitalopram lists depression and generalized anxiety, while the Celexa label lists adult depression only.
Is escitalopram approved for teens?
Partly. The Lexapro label covers depression from age 12 and generalized anxiety from age 7, and it is not approved under 7. The boxed warning about suicidal thoughts applies to young people, so close watching matters. Please ask us about the ages our psychiatrist sees, as this page only describes the label.
What should I tell my prescriber before taking escitalopram?
Share every medicine and supplement you take, especially MAOIs, pimozide, citalopram and blood thinners. Mention any personal or family history of bipolar disorder, plus seizures or glaucoma. If you are pregnant, may become pregnant or are breastfeeding, tell your prescriber.
Sources
Published by Locascio Wellness. Published November 5, 2026. Clinically reviewed by Kenneth M. Levy, DO, Psychiatrist (Pennsylvania license OS007464L). This page is general information, not medical advice or a diagnosis.