Can I Stay on Lexapro Forever? A Guide to Long-Term Use

October 5, 2025 •

4 min read

During 2015–2018, 13.2% of American adults reported using antidepressants in the past 30 days [1.7.6]. If you take this medication, you might wonder, 'Can I stay on Lexapro forever?' This article explores the complexities of long-term Lexapro use.

Quick Summary

An examination of the factors involved in long-term Lexapro (escitalopram) use, covering the benefits for chronic conditions, potential risks and side effects, and the importance of physician-guided decisions for your health.

Key Points

Long-Term Use is Possible: For many, staying on Lexapro indefinitely is a safe and effective strategy for managing chronic depression or preventing relapse [1.2.2, 1.3.7].
Decision is Individualized: The choice to continue Lexapro long-term depends on your specific condition, symptom history, and a collaborative discussion with your doctor [1.2.2].
Monitor for Side Effects: Be aware of potential long-term side effects like weight gain, sexual dysfunction, and emotional blunting, and discuss them with your provider [1.3.1, 1.7.2].
Never Stop Abruptly: Discontinuing Lexapro requires a gradual tapering schedule supervised by a healthcare provider to avoid withdrawal symptoms, known as Antidepressant Discontinuation Syndrome [1.2.4, 1.6.6].
Relapse Prevention is Key: The main benefit of long-term use is to prevent the return of debilitating depressive or anxiety symptoms, especially for those with recurrent episodes [1.2.2, 1.2.7].
Periodic Re-evaluation is Crucial: The FDA recommends that the long-term usefulness of Lexapro should be periodically re-evaluated for each individual patient [1.3.4, 1.5.6].
Holistic Approach is Best: Combining medication with psychotherapy (like CBT), exercise, and other lifestyle changes often yields the best long-term outcomes [1.2.4, 1.2.5].

What is Lexapro (Escitalopram)?

Lexapro, with the generic name escitalopram, is a widely prescribed medication belonging to a class of drugs called selective serotonin reuptake inhibitors (SSRIs) [1.2.2]. It is approved by the FDA for the acute and maintenance treatment of Major Depressive Disorder (MDD) in adults and adolescents, as well as for Generalized Anxiety Disorder (GAD) in adults [1.5.3]. SSRIs work by increasing the levels of serotonin, a neurotransmitter in the brain that helps regulate mood [1.2.5]. By blocking the reabsorption (reuptake) of serotonin into neurons, Lexapro helps improve mood, sleep, and energy levels, making it an effective tool for managing symptoms of depression and anxiety [1.2.1, 1.4.6]. Typically, it can take four to six weeks to feel the full benefit of the medication [1.2.5].

The Duration Debate: Short-Term vs. Long-Term Treatment

The decision on how long to stay on Lexapro is not one-size-fits-all and should be made in close consultation with a healthcare provider [1.2.2]. For a first depressive episode, American Psychiatric Association guidelines suggest staying on the medication for at least four to five months after symptoms resolve to prevent relapse [1.2.7]. For those with recurrent or severe depression (three or more episodes), longer-term maintenance treatment lasting several years may be recommended to maintain stability [1.2.2, 1.2.7]. The FDA's prescribing information advises that doctors should periodically re-evaluate the long-term usefulness of the drug for each individual patient [1.3.4, 1.5.6].

Potential Benefits of Staying on Lexapro Long-Term

For many individuals, long-term Lexapro use is considered safe and provides crucial benefits, particularly for those with chronic or recurring conditions [1.2.2, 1.3.7].

Relapse Prevention: The primary advantage of maintenance therapy is preventing the return of depressive or anxiety symptoms [1.2.2]. For individuals with a history of multiple episodes, continued treatment significantly reduces the risk of relapse.
Managing Chronic Conditions: For those whose depression or anxiety is persistent, long-term medication can provide the ongoing stability needed to function and maintain a good quality of life [1.2.2, 1.4.6].
Improved Daily Functioning: By keeping symptoms at bay, Lexapro can help individuals maintain relationships, work performance, and overall engagement with life [1.4.6].

Risks and Side Effects of Long-Term Lexapro Use

While generally considered safe for long-term use, staying on Lexapro for months or years is not without potential drawbacks [1.2.3]. The brain adapts to the constant presence of the drug, a process called neuroadaptation, which can lead to various effects [1.2.1].

Common long-term side effects include:

Weight Gain: Many patients on long-term antidepressant treatment report weight gain as their appetite returns or for other reasons [1.3.1, 1.3.7].
Sexual Dysfunction: A significant percentage of people using SSRIs report sexual side effects, such as decreased libido, difficulty reaching orgasm, or erectile dysfunction. For some, these issues can persist even after stopping the medication [1.3.1, 1.3.7].
Emotional Blunting: Some long-term users report feeling emotionally numb or apathetic, with a reduced capacity to experience both positive and negative emotions [1.3.1, 1.7.2].
Tolerance (Tachyphylaxis): Sometimes referred to as "poop-out," this is when a medication that was once effective becomes less so over time [1.8.4]. Studies suggest this can happen in 10% to 30% of patients, potentially requiring a dose adjustment or a change in medication [1.2.1, 1.8.2].
Increased Health Risks: Some large-scale studies have suggested associations between long-term antidepressant use and a higher risk of issues like coronary heart disease [1.4.2, 1.7.5]. Other studies have noted potential links to low bone mineral density [1.3.3].

Comparison Table: Short-Term vs. Long-Term Lexapro Use


Feature	Short-Term Use (e.g., < 1 year)	Long-Term Use (e.g., > 2 years)
Primary Goal	Achieve remission from an acute episode of depression or anxiety [1.2.7].	Prevent relapse of chronic or recurrent depression/anxiety [1.2.2].
Key Benefit	Symptom relief and restoration of normal functioning [1.4.6].	Sustained mood stability and improved quality of life [1.2.2].
Primary Risks	Initial side effects (nausea, headache), risk of increased suicidality in young adults [1.3.3].	Weight gain, sexual dysfunction, emotional blunting, tolerance, potential long-term health risks [1.3.1, 1.7.2].
Discontinuation	Tapering is required, withdrawal symptoms are possible [1.6.6].	Tapering is essential; risk of more severe and prolonged withdrawal symptoms increases with duration of use [1.2.1, 1.7.1].

Making the Decision with Your Doctor

The choice to continue, taper, or stop Lexapro is a significant medical decision that requires professional guidance [1.2.2]. Factors to discuss with your healthcare provider include the severity and frequency of your past symptoms, your response to the medication, any side effects you are experiencing, and your overall health [1.2.2, 1.2.7].

Stopping Lexapro: The Discontinuation Process

It is dangerous to stop taking Lexapro suddenly [1.2.4]. Abrupt cessation can lead to Antidepressant Discontinuation Syndrome, which can cause a range of withdrawal symptoms [1.6.6]. The longer someone has been on the medication, the higher the risk of severe withdrawal [1.7.1].

Common withdrawal symptoms include [1.6.2, 1.6.3]:

Dizziness and "brain zaps" (electric shock sensations)
Nausea and flu-like symptoms
Anxiety, irritability, and crying spells
Insomnia and vivid nightmares

To minimize these effects, a doctor will create a tapering schedule, gradually reducing the dose over a period of weeks or months [1.6.5, 1.6.6].

Alternatives to Lifelong Medication

Medication is often most effective when combined with other strategies. For many, these can serve as alternatives or supplements to long-term drug therapy [1.2.5, 1.2.4].

Psychotherapy: Cognitive Behavioral Therapy (CBT) has shown great efficacy in treating depression and anxiety [1.2.4].
Lifestyle Changes: Regular exercise, a balanced diet, and sufficient sleep are powerful tools for mental wellness [1.2.5].
Mindfulness and Stress Reduction: Practices like yoga and meditation can help manage symptoms and improve resilience [1.2.4].

Conclusion

So, can you stay on Lexapro forever? For some people, particularly those with severe, chronic, or recurrent depression, long-term or even lifelong use may be a safe and necessary strategy for maintaining mental health [1.2.2]. The primary benefit is the prevention of relapse. However, this must be weighed against potential long-term side effects like weight gain, sexual dysfunction, and the risk of the medication losing effectiveness [1.3.1, 1.8.4]. The decision is deeply personal and must be continuously evaluated in partnership with a healthcare provider, who can help determine if the benefits continue to outweigh the risks and can guide a safe tapering process if you decide to stop [1.3.4].

For more information on mental health treatments, you can visit the National Institute of Mental Health (NIMH).

Frequently Asked Questions

Yes, it is possible to experience what is known as tachyphylaxis, or "antidepressant poop-out," where a medication that once worked well is no longer as effective [1.8.4]. This may occur in 10-30% of patients and is often managed by adjusting the dose or switching medications [1.2.1].

Studies and patient reports indicate that common long-term adverse effects include sexual difficulties (like decreased libido), weight gain, and feeling emotionally numb [1.7.2].

For many people, taking an SSRI like Lexapro for many years is considered safe and is done under a doctor's supervision [1.3.7]. The key is regular monitoring to ensure the benefits continue to outweigh any potential risks [1.2.2].

Yes, a gradual taper is always recommended to minimize withdrawal symptoms, regardless of how long you've taken the medication. The risk and potential severity of withdrawal symptoms are higher with longer duration of use, making a supervised taper essential [1.2.1, 1.6.6].

Long-term use of SSRIs like Lexapro causes brain adaptations, such as the down-regulation of serotonin receptors, which can persist after stopping the drug [1.2.1]. However, current evidence does not suggest this is equivalent to brain damage; rather, it is the brain's way of adapting to the medication's effects [1.2.1, 1.2.4].

No, not everyone gains weight. While it is a reported side effect, escitalopram can also cause a decreased appetite and weight loss initially [1.3.7]. Weight changes vary significantly from person to person.

It is generally recommended to use caution, as alcohol can make you feel sleepy and may worsen symptoms of depression in the long run [1.2.5, 1.4.6]. It's best to discuss your alcohol use with your doctor.