Lexapro, the brand name for the drug escitalopram, is a widely prescribed selective serotonin reuptake inhibitor (SSRI) used to treat major depressive disorder and generalized anxiety disorder [1.2.3]. While effective for many, it's essential to be aware of its potential side effects. A common question that arises is, can Lexapro cause urinary tract infection? While a direct causal link is complex, the medication can influence urinary function in ways that may increase the risk of infection [1.2.9].
Understanding Lexapro and its Mechanism
Lexapro works by increasing the levels of serotonin, a neurotransmitter in the brain that plays a significant role in mood regulation [1.4.3]. By blocking the reuptake of serotonin into neurons, more of it is available in the synaptic space, which can help alleviate symptoms of depression and anxiety [1.4.3]. However, serotonin receptors are not just in the brain; they are also present in other parts of the body, including the urinary tract [1.2.9]. This is where the potential for urinary side effects originates.
The Link Between Lexapro, Urinary Retention, and UTIs
While UTI has been reported as a side effect of Lexapro, particularly in children and adolescents, a more frequently discussed mechanism is its potential to cause urinary retention or hesitancy [1.2.1, 1.2.2, 1.3.1]. Urinary retention is the inability to completely empty the bladder [1.4.4].
Here’s how they are connected:
- Serotonin's Role in Bladder Control: Serotonin is involved in the complex nervous system control of the bladder [1.2.9]. SSRIs like Lexapro can interfere with serotonin signaling, potentially leading to increased tone in the urethral sphincter, which can make it difficult to urinate and fully empty the bladder [1.4.3, 1.4.4].
- Urinary Retention as a Risk Factor: When urine remains in the bladder for extended periods (urinary stasis), it creates an environment where bacteria can multiply [1.4.4]. A urinary tract infection is typically caused by bacteria entering the urinary tract [1.6.2]. Therefore, by potentially causing urinary retention, Lexapro can indirectly increase the risk of developing a UTI [1.2.9].
Other urinary side effects reported with Lexapro and other SSRIs include urinary incontinence (involuntary leakage), frequent urination, and painful urination [1.3.1, 1.5.2, 1.3.3]. These symptoms are often reversible after adjusting the medication dosage or discontinuing the drug under a doctor's supervision [1.3.1].
What is a Urinary Tract Infection (UTI)?
A UTI is an infection in any part of the urinary system, which includes the kidneys, ureters, bladder, and urethra [1.6.2]. Most infections involve the lower urinary tract—the bladder and the urethra [1.6.3]. Common symptoms include:
- A strong, persistent urge to urinate [1.6.4]
- A burning sensation when urinating [1.6.4]
- Passing frequent, small amounts of urine [1.6.4]
- Cloudy, dark, or strong-smelling urine [1.6.4]
- Pelvic pain or pressure [1.6.4]
UTIs are typically caused by bacteria, most commonly E. coli from the gastrointestinal tract, entering the urethra and multiplying in the bladder [1.6.2].
Comparison: Lexapro Urinary Effects vs. Classic UTI Symptoms
It's important to distinguish between the direct side effects of the medication and the symptoms of a full-blown infection. A healthcare provider is the only one who can make an accurate diagnosis.
| Feature | Potential Lexapro Urinary Side Effect | Typical UTI Symptom |
|---|---|---|
| Primary Sensation | Difficulty starting urination (hesitancy), inability to fully empty the bladder (retention), or increased frequency/incontinence [1.3.1, 1.5.2]. | Pain or burning sensation during urination (dysuria) [1.6.2, 1.6.4]. |
| Urgency & Frequency | Can cause frequent urination, but may be accompanied by difficulty voiding [1.5.1]. | Strong, persistent urge to urinate, often passing only small amounts [1.6.4]. |
| Urine Appearance | Generally no change, unless dehydration from other side effects (like dry mouth) occurs. | Urine may be cloudy, reddish/pink (from blood), or have a strong odor [1.6.4]. |
| Systemic Symptoms | Generally absent, unless related to other side effects of the medication. | May include fever, chills, and lower back or abdominal pain, indicating the infection could be spreading [1.6.2]. |
What to Do If You Experience Urinary Symptoms
If you are taking Lexapro and develop any urinary symptoms—whether it's difficulty urinating, increased frequency, pain, or signs of an infection—it is crucial to contact your healthcare provider. Do not stop taking Lexapro abruptly, as this can lead to discontinuation symptoms [1.2.3].
Your doctor can perform tests, such as a urinalysis, to determine if you have a UTI.
- If a UTI is diagnosed, it will be treated with antibiotics [1.6.9].
- If the symptoms are determined to be a side effect of Lexapro, your doctor may suggest several options: waiting to see if the side effect subsides, adjusting your dose, or switching to a different antidepressant that may have a lower risk of urinary side effects [1.3.1]. For example, some studies suggest certain SSRIs may have different effects on the bladder [1.4.4].
Conclusion
The relationship between Lexapro and urinary tract infections is indirect but significant. Lexapro and other SSRIs can cause urinary side effects like urinary retention, hesitancy, and frequency [1.3.2, 1.5.1]. This retention can, in turn, create conditions favorable for bacterial growth, increasing the risk of a UTI [1.2.9]. While UTI itself is listed as a possible side effect, it's often the underlying urinary changes that are the primary concern [1.2.3]. Anyone experiencing urinary changes while on Lexapro should seek medical advice promptly for proper diagnosis and management.
For more information on antidepressant side effects, one authoritative resource is the National Institute of Mental Health (NIMH): https://www.nimh.nih.gov/health/topics/mental-health-medications.
