Escitalopram Dosage – Simple Guide for Safe Use

Escitalopram is a common SSRI used for depression and anxiety. Getting the dose right can make a big difference in how quickly you feel better and how few side effects you get. Below is a straightforward look at the usual doses, how doctors change them, and what you need to watch out for.

Standard Adult Dosing

Most adults start with 10 mg once a day. The tablet can be taken with or without food, and it’s best to take it at the same time each day. Some people feel a mild boost after a week, but the full effect often takes 4‑6 weeks.

If the initial 10 mg isn’t enough, doctors usually increase to 20 mg after at least one week. This is the maximum daily dose for most adults. Going higher rarely adds benefit and can raise the chance of nausea, insomnia, or sexual side effects.

When switching from another SSRI, doctors may keep you on a low dose of escitalopram and taper the previous drug gradually. This helps avoid serotonin syndrome, a rare but serious reaction.

Special Situations & Adjustments

Older adults often start lower, typically 5 mg daily. Their bodies process the drug more slowly, so a gentle start reduces dizziness and falls. If tolerated, the dose can be raised to 10 mg after a couple of weeks.

People with liver problems may also begin at 5 mg because escitalopram is cleared by the liver. Kidney issues don’t usually require a change, but doctors still monitor for side effects.

Pregnant or breastfeeding moms should talk with their doctor. Escitalopram crosses the placenta, and the risk‑benefit balance needs careful review.

If you’re taking other meds that affect serotonin (like tramadol or St. John’s wort) or drugs that slow escitalopram metabolism (such as certain antifungals), your doctor may keep the dose low or choose a different antidepressant.

Never skip a dose to “reset” the medication. If you miss one, take it as soon as you remember—unless it’s almost time for the next dose. In that case, skip the missed one and continue with your regular schedule.

Watch for side effects in the first few weeks: mild nausea, headache, or a dry mouth are common and often fade. If you notice severe sweating, fast heartbeat, agitation, or thoughts of self‑harm, call your doctor right away.

When you feel the medication is working, keep taking it even if you feel better. Stopping abruptly can cause withdrawal symptoms like brain‑zaps, dizziness, or mood swings. A doctor can taper you off slowly if you decide to stop.

In short, start low, stay consistent, and let your doctor adjust the dose based on how you feel. This approach gives you the best chance of steady improvement with the fewest hassles.