What’s the Best Time to Take Lexapro for Anxiety?

This content is for informational purposes and not a substitute for medical advice. Always consult with your healthcare provider about medication timing and dosage.

Quick Answer: The best time to take Lexapro varies from person to person (based on bioindividual needs and lifestyle). Most people take it in the morning to avoid sleep problems, but if it makes you drowsy, evening may work better. The key is consistency—take it at the same time daily. Your doctor can help you find the timing that minimizes side effects while treating your anxiety effectively.

Understanding Lexapro and Its Role in Anxiety Treatment

If you’ve been prescribed Lexapro (escitalopram) for anxiety, you’re not alone. This antidepressant medication is one of the most commonly prescribed treatments for anxiety disorders. Understanding how Lexapro works can help you make informed decisions about when to take it.

How Lexapro works to increase serotonin

Lexapro (escitalopram) is a selective serotonin reuptake inhibitor (SSRI), a class of antidepressants commonly prescribed for anxiety and depressive disorders. It functions by inhibiting the reabsorption (reuptake) of serotonin in the brain, thereby increasing the availability of this neurotransmitter in the synaptic cleft [1].

Serotonin plays a key role in regulating mood, anxiety, and emotional stability. By enhancing serotonergic activity, Lexapro helps improve mood and reduce symptoms of anxiety and depression. However, therapeutic effects are not immediate; it typically takes 4 to 8 weeks for patients to experience the full clinical benefits, as neurochemical and receptor-level adaptations occur gradually over time [2].

FDA-approved uses and who it’s prescribed for

The Food and Drug Administration (FDA) has approved Lexapro for two main conditions: major depressive disorder (MDD) in adults and adolescents aged 12-17, and generalized anxiety disorder (GAD) in adults [3].

However, doctors often prescribe Lexapro “off-label” for other anxiety-related conditions. This off-label use is common and safe when monitored by your healthcare provider. Many people successfully use Lexapro for panic disorder, social anxiety disorder, and post-traumatic stress disorder, even though these aren’t FDA-approved uses [4].

If you’re taking Lexapro for a condition other than MDD or GAD, don’t worry. Your doctor has prescribed it based on clinical evidence and their professional judgment about what’s best for your specific situation.

Morning vs. Evening Dosing: What to Consider

The timing of Lexapro (escitalopram) administration can influence how well it’s tolerated and how side effects are experienced. With a half-life of approximately 27 to 33 hours, Lexapro maintains relatively stable blood levels over 24 hours, allowing flexibility in dosing time. Both morning and evening dosing are acceptable; the best choice often depends on individual response and side effect profile.

Taking Lexapro in the morning: Pros and cons
Morning dosing is commonly recommended, particularly when the medication causes restlessness or interferes with sleep. Taking it with breakfast or shortly after waking can help maintain consistency.

Potential benefits of morning dosing include:

• Improved sleep quality in individuals who experience insomnia or increased alertness as a side effect
  
  
• Easier adherence when paired with a morning routine
  
  
• May align with circadian patterns of cortisol, which peaks in the morning and supports alertness

Potential drawbacks:

• Increased risk of daytime gastrointestinal (GI) side effects, such as nausea
  
  
• Fatigue or drowsiness in the afternoon in some individuals
  
  
• May impair morning function if sedation is experienced

Taking Lexapro at night: Pros and cons
 For some patients, evening dosing may be better tolerated, especially if Lexapro causes sedation or if early side effects are disruptive during the day.

Potential benefits of evening dosing include:

• May reduce awareness of early side effects such as nausea or dizziness by sleeping through them
  
  
• Can be helpful if Lexapro has a sedating effect
  
  
• May minimize impact on daytime energy levels

Potential drawbacks:

• Sleep disturbances, including insomnia or increased alertness, in some individuals
  
  
• Reports of vivid dreams or nightmares
  
  
• Residual morning drowsiness in sensitive individuals

Ultimately, the choice of dosing time should be guided by how the individual tolerates the medication and any impact on sleep or daily functioning. Adjustments can be made in consultation with a qualified healthcare provider; while also being attuned to how one feels.

Comparison Table: Morning vs. Evening Dosing

Factor	Morning Dosing	Evening Dosing
Best for	Individuals who experience activation or insomnia as a side effect	Individuals who experience sedation or fatigue with Lexapro
Sleep impact	May support better sleep if activating effects are present	May cause sleep disturbances, including insomnia or vivid dreams in some patients
Nausea management	Nausea, if present, may occur during daytime activities	Individuals may sleep through initial gastrointestinal side effects
Routine	Often easier to incorporate into morning routines	Can be integrated into consistent bedtime routines
Side effects	Side effects are experienced during waking hours, allowing for easier monitoring	Some side effects may be less noticeable if they occur during sleep

This table serves as a general guide; individual response can vary. The optimal dosing time should be tailored to each patient’s tolerability, lifestyle, and symptom profile in collaboration with a qualified healthcare provider.

How Side Effects Influence Timing Choices

Individual response to Lexapro (escitalopram) side effects often plays a key role in determining the most appropriate time of day to take the medication. Understanding how these effects manifest can help guide timing decisions for optimal tolerability and adherence.

Nausea, drowsiness, and insomnia

These are among the most commonly reported early side effects. Clinical studies estimate that nausea affects approximately 18% of individuals when initiating Lexapro [6]. Taking the medication with food can reduce gastrointestinal discomfort, regardless of dosing time. For some, evening dosing allows them to sleep through the initial nausea. If sedation or fatigue occurs, evening administration may be preferable to align with the body’s natural rest cycle. Conversely, if Lexapro produces activating effects such as insomnia or restlessness, morning dosing is generally better tolerated.

Importantly, these side effects typically subside within the first one to two weeks as the body adjusts to the medication.

Sexual dysfunction and other timing-sensitive issues

Sexual dysfunction is a recognized adverse effect of SSRIs, including Lexapro [7]. While dosing time does not directly influence its occurrence, maintaining consistent timing may assist with planning around potential impacts on intimacy.

Other side effects that may be influenced by timing include:

• Headaches: May be better managed with morning dosing and adequate hydration
  
  
• Sweating: Often more pronounced at night; morning dosing may reduce nocturnal symptoms
  
  
• Appetite changes: Dosing time can be adjusted based on how Lexapro affects meal patterns and hunger cues
  
  

As with all medication decisions, dosing time should be individualized in consultation with a healthcare provider based on patient-specific tolerability, symptom patterns, and daily routine.

Personalizing Your Routine: What Matters Most

Finding the right time to take Lexapro isn’t just about side effects—it’s about fitting the medication into your life in a sustainable way.

Aligning with your schedule and other medications

Consider your daily routine when choosing your dosing time. If you travel frequently across time zones, morning dosing based on local time can help maintain consistency. If you work night shifts, you might need a different approach than someone with a 9-to-5 schedule.

Also think about other medications you take. Some medications interact with Lexapro, and spacing them out might be necessary. Always discuss your complete medication list with your healthcare provider or pharmacist.

Tips for remembering your dose daily

Consistency is crucial for Lexapro to work effectively. Here are practical strategies to never miss a dose:

• Set a daily phone alarm at your chosen time
• Keep Lexapro next to something you use daily (toothbrush, coffee maker)
• Use a pill organizer marked with days of the week
• Try a medication reminder app with tracking features
• Link it to an existing habit like eating breakfast or brushing teeth

How to Safely Switch Your Dosing Time

Sometimes you need to change when you take Lexapro. Maybe your schedule changed, or you want to manage side effects better. Here’s how to do it safely.

Skipping a dose and what to avoid

Because Lexapro has a long half-life, you have flexibility when switching times. Never double dose. This is the most important rule.

To switch from morning to evening (or vice versa):

1. Take your regular dose at the current time today
2. Tomorrow, take it at your new preferred time
3. Continue at the new time going forward

For example, if you take Lexapro at 8 AM and want to switch to 8 PM, take it at 8 AM today, then wait until 8 PM tomorrow for your next dose. This creates a longer gap, but it’s safe due to Lexapro’s long-lasting effects.

When to involve your provider

Always inform your healthcare provider when making timing changes, especially if you:

• Experience new or worsening side effects
• Miss multiple doses during the switch
• Feel your anxiety or depression symptoms returning
• Take other medications that might interact

Your provider might have specific recommendations based on your individual situation and can monitor your progress during the transition.

What to Do If You Miss a Dose or Experience Issues

Life happens, and sometimes you’ll forget a dose. Knowing what to do keeps you safe and maintains your treatment progress.

Missed doses, double dosing, and when to call your doctor

If you miss a dose:

• Same day: Take it as soon as you remember
• Next day: Skip the missed dose and take your regular dose at the usual time
• Multiple days: Contact your healthcare provider for guidance

The golden rule: never take a double dose to make up for a missed one. This can increase side effects without providing extra benefits.

Call your doctor if you:

• Miss doses for more than 2-3 days in a row
• Experience withdrawal-like symptoms (dizziness, “brain zaps,” mood changes)
• Feel your anxiety returning or worsening

When side effects become a concern

While many side effects improve with time, some require medical attention. Contact your healthcare provider if you experience:

• Thoughts of self-harm or suicide (seek immediate help)
• Severe mood changes or increased anxiety
• Allergic reactions (rash, swelling, difficulty breathing)
• Unusual bleeding or bruising
• Severe headaches or vision changes

Remember, your healthcare team wants to help you succeed with treatment. Don’t hesitate to reach out with concerns. Also, do not underestimate your relationship and knowledge of your body. If something feels off, trust it and contact your physician.

Final Takeaways on Finding Your Best Time

Finding the best time to take Lexapro for anxiety is bioindividual. What works for one person might not work for another, and that’s perfectly normal. The research shows that morning versus evening dosing doesn’t affect how well Lexapro works. It’s all about managing side effects and fitting the medication into your life [8].

Start with morning dosing unless your doctor suggests otherwise. Give yourself at least two weeks to adjust before making changes. Pay attention to how you feel at different times of day, and don’t hesitate to work with your healthcare provider to find your sweet spot.

Remember, taking Lexapro consistently at the same time each day matters more than the specific time you choose. With patience and good communication with your healthcare team, you’ll find the routine that helps you feel your best while managing your anxiety effectively.

Factors, such as consistent sleep, a nutrient dense diet, exposure to sunlight and nature, meaningful connections and therapy, as well as appropriate movement are all valuable to implement for regulating anxiety [9].

Frequently Asked Questions

Can I take Lexapro with food? Yes, you can take Lexapro with or without food. Taking it with food may help reduce nausea, which is one of the common side effects of Lexapro. Many people find that taking it with breakfast or dinner helps establish a routine and minimizes stomach upset.

How long does it take for Lexapro to start working for anxiety? While you might notice some changes within 1-2 weeks, Lexapro typically takes 4-8 weeks to reach its full effect for anxiety. Don’t get discouraged if you don’t feel better right away. Your body needs time to adjust as serotonin levels gradually increase. Keep taking it as prescribed and stay in touch with your healthcare provider about your progress.

What should I do if Lexapro makes me too sleepy or too awake? If Lexapro makes you drowsy, try taking it in the evening before bed. If it makes you feel alert or causes insomnia, switch to morning dosing. These effects often improve as your body adjusts to the medication. If sleep problems persist after 2-3 weeks, talk to your healthcare provider about additional strategies or potential dose adjustments.

Not sure if you have anxiety or whether Lexapro could help?

Talk to a licensed provider at PsychPlus to get personalized guidance on medication timing, side effect management, and building a treatment plan that fits your life.

References

[1] Kirino E. Escitalopram for the management of major depressive disorder: a review of its efficacy, safety, and patient acceptability. Patient Prefer Adherence. 2012;6:853-861. https://pubmed.ncbi.nlm.nih.gov/23271894/

[2] Garnock-Jones KP, McCormack PL. Escitalopram: a review of its use in the management of major depressive disorder in adults. CNS Drugs. 2010;24(9):769-796. https://pubmed.ncbi.nlm.nih.gov/20806989/

[3] U.S. Food and Drug Administration. Lexapro (escitalopram oxalate) prescribing information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/021323s055,021365s039lbl.pdf

[4] Baldwin DS, Anderson IM, Nutt DJ, et al. Evidence-based pharmacological treatment of anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder: a revision of the 2005 guidelines from the British Association for Psychopharmacology. J Psychopharmacol. 2014;28(5):403-439. https://pubmed.ncbi.nlm.nih.gov/24713617/

[5] Rao N. The clinical pharmacokinetics of escitalopram. Clin Pharmacokinet. 2007;46(4):281-290. https://pubmed.ncbi.nlm.nih.gov/17375980/

[6] U.S. Food and Drug Administration. (2017). Lexapro (escitalopram oxalate) [Prescribing information]. https://www.fda.gov/media/135185/download

[7] Schweitzer I, Maguire K, Ng C. Sexual side-effects of contemporary antidepressants: review. Aust N Z J Psychiatry. 2009;43(9):795-808. https://pubmed.ncbi.nlm.nih.gov/19670052/

[8] National Institute of Mental Health. Mental health medications. https://www.nimh.nih.gov/health/topics/mental-health-medications

[9] Amiri S, Mahmood N, Javaid SF, Khan MA. The Effect of Lifestyle Interventions on Anxiety, Depression and Stress: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Healthcare (Basel). 2024 Nov 13;12(22):2263. doi: 10.3390/healthcare12222263. PMID: 39595461; PMCID: PMC11594078. https://pubmed.ncbi.nlm.nih.gov/39595461/