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Lexapro (escitalopram) Disease Interactions

There are 9 disease interactions with Lexapro (escitalopram):


Ssri Antidepressants (Includes Lexapro) ↔ Depression

Severe Potential Hazard, Moderate plausibility

Applies to: Depression, Psychosis

Adult and pediatric patients with depression and other psychiatric disorders may experience worsening of their symptoms and may have the emergence of suicidal thoughts and behavior. Patients should be monitored appropriately and observed closely for worsening of their symptoms, suicidality or changes in their behavior, especially during the first few months of treatment, and at times of dose changes. Families and caregivers should be advised of the need for close observation and communication with the treating physician. Discontinuing the medication should be considered if symptoms are persistently worse, or abrupt in onset. It may be prudent to refrain from dispensing large quantities of medication to these patients.


Citalopram (Includes Lexapro) ↔ Renal Dysfunction

Moderate Potential Hazard, Low plausibility

Applies to: Renal Dysfunction

Citalopram (racemic) and escitalopram (the more pharmacologically active S-enantiomer) are extensively metabolized and only small amounts are excreted unchanged in the urine. No dosage adjustments are necessary in patients with mild to moderate renal impairment, as the oral clearance of citalopram has been shown to decrease only modestly (17%) in these patients compared to those with normal renal function. There is no information on the pharmacokinetics of citalopram or escitalopram in patients with severe renal impairment (CrCl < 20 mL/min). Therapy with these agents should be administered cautiously in such patients.


  1. "Product Information. Celexa (citalopram)." Forest Pharmaceuticals, St. Louis, MO.
  2. "Product Information. Lexapro (escitalopram)." Forest Pharmaceuticals, St. Louis, MO.

Ssri (Includes Lexapro) ↔ Hyponatremia

Moderate Potential Hazard, Moderate plausibility

Applies to: Hyponatremia

Treatment with SSRI antidepressants can cause hyponatremia. Caution should be used when treating patients with hyponatremia or at greater risk of hyponatremia such as the elderly, patients taking diuretics or who are volume depleted.


Ssris (Includes Lexapro) ↔ Liver Disease

Moderate Potential Hazard, High plausibility

Applies to: Liver Disease

Selective serotonin reuptake inhibitors (SSRIs) are primarily metabolized by the liver. The plasma concentrations of SSRIs and their metabolites may be increased and the half-lives prolonged in patients with impaired hepatic function. Dosage adjustments may be necessary in accordance with the individual product package labeling.


  1. Guthrie SK "Sertraline: a new specific serotonin reuptake blocker." DICP 25 (1991): 952-61
  2. "Product Information. Celexa (citalopram)." Forest Pharmaceuticals, St. Louis, MO.
  3. Finley PR "Selective serotonin reuptake inhibitors: pharmacologic profiles and potential therapeutic distinctions." Ann Pharmacother 28 (1994): 1359-69
View all 17 references

Ssris (Includes Lexapro) ↔ Mania

Moderate Potential Hazard, Moderate plausibility

Applies to: Bipolar Disorder, Mania, Depression

Selective serotonin reuptake inhibitors (SSRIs), like other antidepressants, may occasionally cause or activate mania or hypomania. The reported incidence ranged from 0.1% to 2% in premarketing testing of several SSRIs. Patients with bipolar disorder are generally more likely to experience mania from antidepressants. Therapy with SSRIs should be administered cautiously in patients with a history of mania or bipolar disorder. Prior to initiating treatment it is recommended to adequately screen patients for bipolar disorder, including a family history of suicide, bipolar disorder, and depression.


  1. Peet M "Induction of mania with selective serotonin re-uptake inhibitors and tricyclic antidepressants." Br J Psychiatry 164 (1994): 549-50
  2. "Product Information. Zoloft (sertraline)." Roerig Division, New York, NY.
  3. Guthrie SK "Sertraline: a new specific serotonin reuptake blocker." DICP 25 (1991): 952-61
View all 27 references

Ssris (Includes Lexapro) ↔ Platelet Function

Moderate Potential Hazard, High plausibility

Applies to: Bleeding, Coagulation Defect, Thrombocytopathy, Thrombocytopenia, Vitamin K Deficiency

The use of selective serotonin reuptake inhibitors (SSRIs) has been associated with altered platelet function. Petechiae, purpura, ecchymosis, increased bleeding times, epistaxis and gastrointestinal hemorrhage have been reported. Therapy with SSRIs should be administered cautiously in patients with severe active bleeding or a hemorrhagic diathesis.


  1. Hergovich N, Aigner M, Eichler HG, Entlicher J, Drucker C, Jilma B "Paroxetine decreases platelet serotonin storage and platelet function in human beings." Clin Pharmacol Ther 68 (2000): 435-42
  2. "Product Information. Zoloft (sertraline)." Roerig Division, New York, NY.
  3. Skop BP, Brown TM "Potential vascular and bleeding complications of treatment with selective serotonin reuptake inhibitors." Psychosomatics 37 (1996): 12-6
View all 18 references

Ssris (Includes Lexapro) ↔ Seizure Disorders

Moderate Potential Hazard, Moderate plausibility

Applies to: Seizures

Selective serotonin reuptake inhibitors (SSRIs) may trigger seizures in approximately 0.2% of patients, and some of them are not recommended in patients with unstable epilepsy. Therapy with SSRIs should be administered cautiously in patients with seizure disorders.


  1. Marshall RD, Printz D, Cardenas D, Abbate L, Liebowitz MR "Adverse events in PTSD patients taking fluoxetine." Am J Psychiatry 152 (1995): 1238-9
  2. Hargrave R, Martinez D, Bernstein AJ "Fluoxetine-induced seizures." Psychosomatics 33 (1992): 236-9
  3. Messiha FS "Fluoxetine - adverse effects and drug-drug interactions." J Toxicol Clin Toxicol 31 (1993): 603-30
View all 21 references

Ssris (Includes Lexapro) ↔ Siadh

Moderate Potential Hazard, Moderate plausibility

Applies to: Dehydration, Hyponatremia, SIADH

The use of selective serotonin reuptake inhibitors (SSRIs) has rarely been associated with hyponatremia, sometimes secondary to development of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). These events have generally been reversible following discontinuation of SSRI therapy and/or medical intervention. SSRI-related hyponatremia may be more common in elderly female patients and those who are volume-depleted or receiving concomitant diuretic therapy. Caution may be warranted when SSRI therapy is administered in these patients and patients with preexisting hyponatremia or SIADH. Serum electrolytes, especially sodium as well as BUN and plasma creatinine, should be monitored regularly.


  1. Schattner A, Skurnik Y "Fluoxetine-induced SIADH." J Am Geriatr Soc 44 (1996): 1413
  2. Kessler J, Samuels SC "Sertraline and hyponatremia." N Engl J Med 335 (1996): 524
  3. Baliga RR, McHardy KC "Syndrome of inappropriate antidiuretic hormone secretion due to fluvoxamine therapy [published erratum appears in Br J Clin Pract 1993 May-Jun;47(3):119]." Br J Clin Pract 47 (1993): 62-3
View all 30 references

Ssris (Includes Lexapro) ↔ Weight Loss

Minor Potential Hazard, Moderate plausibility

Applies to: Anorexia/Feeding Problems, Malnourished, Weight Loss/Failure to Thrive

The use of selective serotonin reuptake inhibitors (SSRIs) may occasionally cause significant weight loss, which may be undesirable in patients suffering from anorexia, malnutrition or excessive weight loss. Anorexia may occur in approximately 5% to 10% of patients. Weight change should be monitored during therapy if an SSRI is used in these patients.


  1. "Product Information. Celexa (citalopram)." Forest Pharmaceuticals, St. Louis, MO.
  2. Fernstrom MH, Massoudi M, Kupfer DJ "Fluvoxamine and weight loss." Biol Psychiatry 24 (1988): 948-9
  3. Wagner W, Plekkenpol B, Gray TE, Vlaskamp H, Essers H "Review of fluvoxamine safety database." Drugs 43 Suppl 2 (1992): 48-53;disc. 53-4
View all 11 references

Lexapro (escitalopram) drug Interactions

There are 1091 drug interactions with Lexapro (escitalopram)

Lexapro (escitalopram) alcohol/food Interactions

There is 1 alcohol/food interaction with Lexapro (escitalopram)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

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