By Dr. Shahrnaz Mashkoor, DNP, PMHNP-BC
If you’re always worried, have racing thoughts, or a tight chest that never seems to relax, you’ve probably tried everything: deep breathing, cutting back on caffeine, and mindfulness therapy. But the anxiety is still there. Sometimes, those strategies aren’t enough.
Lexapro (escitalopram) is the answer. Lexapro is one of the most frequent SSRIs used for anxiety. It has helped millions of individuals feel better when nothing else worked. At the Wellness Institute of Southern Nevada, we’ve helped a lot of patients decide to start Lexapro. We’ve talked about what to expect in the first week and how to deal with possible side effects.
We’ll explain how it works, what the 5 mg dose can do, and if it’s the best decision for you. If you’re thinking about taking medicine, you have a right to straightforward, honest answers, and that’s what you’ll find here.
What Is Lexapro & How Does It Work?
Escitalopram, often known as Lexapro, is a selective serotonin reuptake inhibitor (SSRI). It helps regulate mood and calm excessive worry by keeping more of this “feel-good” neurotransmitter in synaptic gaps by preventing serotonin’s reabsorption in the brain. It is FDA-approved for both major depressive disorder and generalized anxiety disorder (GAD) in adults and kids 12 and older.
Unlike older anti‑anxiety meds, which can make you sleepy or addicted. Lexapro, on the other hand, slowly changes the chemistry of your brain over weeks, giving you long-term relief without the crash or cravings.
Lexapro and Anxiety: Why It Helps
At the Wellness Institute of Southern Nevada, we witness the impacts of anxiety that isn’t addressed, like trouble sleeping, tense muscles, upset stomach, and even burnout. For a lot of people, SSRIs like Lexapro are an important part of anxiety treatment by:
- Reducing “racing thoughts” that fuel panic and procrastination
- Lowering baseline tension makes therapy techniques like CBT more effective
- Improving sleep quality, which in turn enhances emotional resilience
- Dampening the fight‑or‑flight response, so your body can relax
More than 60% of people in clinical studies who took escitalopram saw a big drop in their GAD symptoms by week 8, compared to 35% of people who took a placebo.
Lexapro Dosing: From 5 mg to 20 mg
Lexapro dosing typically starts low and gradually increases:
- 5 mg daily (low‑dose starter)
- 10 mg daily (standard dose after 1–2 weeks)
- 20 mg daily (maximum recommended)
Your provider will change this based on how bad your symptoms are, how well you can handle side effects, and how well you respond. Take Lexapro at the same time every day.
Is 5 mg of Lexapro a Low Dose—and Is It Enough?
Is 5 mg of Lexapro a low dose? Yes, 5 mg is half of the usual starting amount. But “low” doesn’t indicate “not working.” For people who are sensitive to medicines or have minor anxiety, 5 mg can help them feel better while causing fewer adverse effects. In some research, up to 40% of those taking 5 mg say their anxiety goes down a lot within two weeks.
But if your symptoms don’t go away after that time, your doctor may suggest increasing the dose to 10 mg. The goal is to discover the lowest dose that works for you and keeps you comfortable.
What to Expect: Lexapro Side Effects First Week and Beyond
Knowing what could happen will help you feel more ready and less worried about starting therapy. Your body is getting used to having more serotonin available during those first few days, and this change can sometimes cause temporary side effects. We see these most often:
- Nausea (affecting about 15-20% of patients initially)
- Mild headaches
- Some drowsiness or, conversely, difficulty sleeping
- Slight dizziness
- Changes in appetite
The good news is that these early adverse effects usually get better in the first one to two weeks as your body gets used to them. Eating while taking Lexapro can assist with nausea, and drinking enough water can help with headaches.
We always tell our patients that having some side effects at first is normal and only shows that your brain is getting used to a new, healthier balance.
Common Benefits & Timeline
Patience pays off. Lexapro and anxiety reduction follow a typical pattern:
- Week 1–2: Mild mood lift, decreased restlessness
- Week 3–4: Noticeable drop in worry frequency, improved sleep quality
- Week 6–8: Full anxiolytic effect—fewer panic symptoms, greater emotional stability
SSRIs don’t work right away. Talk to your doctor about changing to 20 mg or trying other ways to boost your mood (such as therapy or making changes to your lifestyle) if you still don’t feel anything by week 6 at a steady dose.
Comparing Lexapro to Other Options
Why choose Lexapro over Zoloft, Prozac, or Wellbutrin? Quick comparisons:
- Versus Zoloft (sertraline): Similar efficacy for GAD, but Lexapro is often better tolerated—less GI upset.
- Versus Prozac (fluoxetine): Prozac has a longer half-life, which makes it easier to miss doses without going through withdrawal. However, it can also be more stimulating, which is not good if your anxiety gets worse at night.
- Versus Wellbutrin (bupropion): Wellbutrin increases energy and focuses on dopamine, but it can make anxiety worse for some people. Lexapro works directly on serotonin to soothe nerves.
The best choice depends on your own health history, whatever other illnesses you have, and how sensitive you are to side effects.
Beyond Medication: A Holistic Approach to Anxiety Treatment
Lexapro can be quite beneficial, but after years of expertise, we’ve learned that the best way to treat anxiety is to use medication together with other supporting methods. This is where the holistic approach we practice at the Wellness Institute shines.
Lifestyle factors play a huge role in anxiety management. We look at:
- Sleep patterns – Poor sleep can significantly worsen anxiety symptoms
- Nutrition – Certain deficiencies (like B vitamins and magnesium) can contribute to anxiety
- Exercise habits – Regular movement is one of the most powerful natural anxiety reducers
- Stress management techniques – including mindfulness, meditation, and breathing exercises
We also do genetic testing when it’s needed. Some people break down drugs like Lexapro quickly, while others do so more slowly. Knowing what genes you have can help us skip the annoying trial-and-error process and have you feeling better faster.
Lexapro treatment can also be greatly enhanced by herbal and plant-based supplements. We often suggest pharmaceutical-grade vitamins that combine well with medication to get the best results and maybe even lower the dose needed.
Important Considerations and Safety
Before starting Lexapro, there are several important factors we need to discuss:
Drug interactions are crucial to consider. Lexapro can interact with certain medications, and combining it with alcohol isn’t recommended as it can interfere with the medication’s effectiveness and potentially worsen anxiety symptoms.
Personalized treatment planning is essential. Lexapro may or may not be the correct choice for you based on your age, underlying health problems, past experiences with medications, and personal preferences.
It’s very important to talk to your doctor about any other medications or supplements you are taking. Some over-the-counter vitamins that seem safe might sometimes interfere with prescription drugs.
When to Seek Professional Help
If you’re reading this and see yourself in the signs we’ve talked about, it might be time to get professional help. You don’t have to deal with anxiety on your own, and it doesn’t have to run your life.
At the Wellness Institute of Southern Nevada, we take a comprehensive approach to anxiety treatment. We work together to understand the root causes of your anxiety and create a personalized treatment plan that addresses your mind, body, and spirit.
If you have generalized anxiety disorder, panic attacks, social anxiety, or any other kind of anxiety, you should know that there is treatment that works. A lot of my patients say they wish they had contacted us sooner.
Your Journey to Better Mental Health with Dr. Shahrnaz Mashkoor
Lexapro (escitalopram) has helped millions of people calm their minds and feel like they are in charge again. This medicine can be a very helpful element of your healing path if you take the right amount and get the right advice.
At the Wellness Institute of Southern Nevada, we understand that medicine is only one part of the puzzle. That’s why we make individualized strategies that include Lexapro (if it’s right for you), therapy, changes to your lifestyle, and continuing help.If you’re ready to take the first step, we’re here to walk with you. Schedule your free 15-minute consultation today and let’s explore whether Lexapro could be the reset your mind needs.