Does Lexapro Cause Constipation? Understanding the Link and How to Find Relief

October 9, 2025 •

4 min read

While less common than other digestive issues like diarrhea, constipation is a reported side effect of Lexapro (escitalopram). In clinical studies, a small percentage of patients experienced constipation, with some research indicating it is more frequent at higher doses. It is important to understand why this occurs and what can be done to effectively manage it without compromising your mental health treatment.

Quick Summary

Lexapro (escitalopram), an SSRI, can cause constipation by affecting serotonin receptors in the digestive system. Incidence rates are typically low, with symptoms often resolving as the body adjusts. Management includes dietary fiber, hydration, exercise, and sometimes over-the-counter laxatives. A healthcare provider can offer personalized guidance on coping with this side effect.

Key Points

Constipation is a Possible Side Effect: Lexapro (escitalopram) can cause constipation by affecting serotonin receptors in the gastrointestinal tract, but it is not a universally experienced symptom.
Incidence is Relatively Low: Clinical data indicates that the percentage of people experiencing constipation with Lexapro is low, typically around 3-6%, and often resolves as the body adjusts to the medication.
Higher Doses May Increase Risk: The incidence of constipation may be slightly higher for patients on a 20 mg/day dose compared to a 10 mg/day dose.
Lifestyle Changes Are the First Line of Defense: Increasing dietary fiber intake, drinking plenty of water, and getting regular exercise are effective strategies for managing medication-induced constipation.
OTC Remedies Can Help: Over-the-counter fiber supplements (Metamucil), osmotic laxatives (MiraLAX), or stool softeners (Colace) may be recommended if lifestyle changes aren't enough.
Consult a Doctor for Persistent or Severe Symptoms: If constipation is severe, persistent, or accompanied by other worrying symptoms like unusual bleeding, contact a healthcare professional immediately.

The Connection Between Lexapro and Constipation

Lexapro (escitalopram) is a selective serotonin reuptake inhibitor (SSRI) used to treat major depressive disorder and generalized anxiety disorder. Its primary function is to increase serotonin levels in the brain, but this action also has an impact on the gastrointestinal (GI) system. Serotonin is a key chemical messenger in both the brain and the gut, with approximately 90% of the body's serotonin located in the GI tract.

The gut contains a vast network of neurons known as the enteric nervous system, and it is rich with serotonin receptors. When Lexapro elevates serotonin levels, it can disrupt the normal functioning of these GI tract receptors, altering intestinal motility and fluid balance. This disruption can manifest as either diarrhea or constipation, although nausea is a more commonly reported GI side effect.

Frequency of Constipation with Lexapro

Constipation from Lexapro is considered a mild and relatively infrequent side effect compared to other issues like nausea. Clinical trial data shows that the percentage of patients reporting constipation is low, although it may increase with higher doses.

For 10 mg/day Lexapro: Approximately 3% of patients in clinical trials for Major Depressive Disorder (MDD) reported constipation, compared to 1% on placebo.
For 20 mg/day Lexapro: The incidence rises slightly to 6% in MDD trials.

For most people, any GI side effects, including constipation, are most noticeable during the first week or two of treatment as the body adjusts to the new medication. These symptoms often improve or resolve completely over time.

Comparison of Constipation Risk Among Antidepressants

Not all antidepressants have the same risk profile for causing constipation. Some older classes of drugs, such as tricyclic antidepressants, have more potent anticholinergic effects, which slow intestinal movements and secretions, making constipation a much more prominent side effect. SSRIs like Lexapro tend to have a lower risk.

Constipation Risk: Lexapro vs. Other Antidepressants


Antidepressant Class	Example	Mechanism	Constipation Risk Level
Tricyclic Antidepressants	Amitriptyline, Nortriptyline	Strong anticholinergic activity that slows gut motility	High
Older SSRIs	Paroxetine	May modulate gut motility, higher incidence in some studies	Moderate
Lexapro (SSRI)	Escitalopram	Serotonergic effects can disrupt gut function	Low (around 3-6%)
Sertraline (SSRI)	Zoloft	Some studies suggest higher incidence of diarrhea, lower of constipation	Low
SNRIs	Venlafaxine	Serotonergic and noradrenergic effects	Variable
Atypical Antidepressants	Bupropion	Different mechanism, generally less impact on GI motility	Low (not directly serotonin-related)

How to Manage Constipation Caused by Lexapro

If you experience constipation while on Lexapro, several strategies can help manage the symptoms. Always consult with your healthcare provider before making any changes to your medication or trying a new remedy.

Lifestyle Adjustments

Increase Fiber Intake: Add high-fiber foods to your diet, such as fruits, vegetables, whole grains, nuts, and legumes. Fiber adds bulk to your stool, helping it move through the colon more easily. Increase fiber slowly to avoid bloating and gas.
Stay Hydrated: Drink plenty of water and other caffeine-free fluids throughout the day. This helps keep stools soft and easier to pass. Dehydration is a major contributing factor to constipation.
Get Regular Exercise: Physical activity promotes normal bowel function by stimulating the muscles in your intestines. Even a short, daily walk can make a difference.

Over-the-Counter (OTC) Remedies

If lifestyle changes are not enough, consider OTC options. Again, discuss these with your doctor or pharmacist first.

Fiber Supplements: Products containing psyllium (Metamucil) or methylcellulose (Citrucel) can help bulk up stool.
Osmotic Laxatives: Medications like polyethylene glycol (MiraLAX) work by drawing water into the intestines to soften stool.
Stool Softeners: Docusate sodium (Colace) increases the water content in stool, making it softer and easier to pass.

When to Contact Your Doctor

While most cases of medication-induced constipation are mild and manageable, some situations require medical attention. Contact your doctor if you experience any of the following:

Your constipation is persistent, severe, or causes significant discomfort.
You notice blood in your stool or unusually dark, tarry stools, which can indicate more serious issues like gastrointestinal bleeding.
You experience symptoms of fecal impaction, such as watery stool leakage or abdominal pain.
Standard lifestyle adjustments or OTC treatments are not providing relief.

Your doctor can rule out other medical causes for the constipation, adjust your Lexapro dosage, or explore alternative antidepressant options with a different side effect profile.

Conclusion

For most individuals, Lexapro does not cause severe or long-lasting constipation, and any initial gastrointestinal side effects often diminish over time. Understanding the physiological link between serotonin and gut motility clarifies why this can occur. By implementing simple dietary and lifestyle modifications, such as increasing fiber, staying hydrated, and exercising regularly, most people can effectively manage this side effect. For more persistent or severe symptoms, safe and appropriate over-the-counter remedies are available. Most importantly, maintain open communication with your healthcare provider to ensure your treatment plan for both your mental health and physical well-being is optimized.

Disclaimer

This article is for informational purposes only and does not constitute medical advice. Please consult with your healthcare provider before starting, stopping, or changing any medication or treatment plan.

Authority

For authoritative guidelines on managing antidepressant side effects, consult sources like the Mayo Clinic's guide on antidepressants.

Frequently Asked Questions

Constipation is a possible side effect of Lexapro, but it is not one of the most common ones. Gastrointestinal side effects like nausea or diarrhea are reported more frequently. Clinical trials show that only a small percentage of patients experience constipation.

Lexapro increases serotonin levels in the body. Since a large portion of the body's serotonin is in the gut, this increase can interfere with the normal movement of the intestines, potentially slowing down the digestive process and leading to constipation.

You can first try lifestyle changes like increasing your dietary fiber, drinking more water, and getting regular exercise. If this doesn't help, talk to your doctor about over-the-counter options like a fiber supplement or osmotic laxative.

For many people, mild gastrointestinal side effects like constipation are most pronounced during the first couple of weeks as the body adjusts to the medication. These symptoms often improve or resolve over time, but if they persist, talk to your healthcare provider.

You should contact your doctor if your constipation is severe, persistent, or is not relieved by lifestyle and OTC remedies. Also, seek immediate medical attention if you notice blood in your stool or experience severe abdominal pain.

Lexapro is generally considered to have a lower risk of causing constipation compared to some other antidepressants, particularly older tricyclic antidepressants. While other SSRIs can also affect gut motility, Lexapro's incidence of constipation in clinical trials is relatively low compared to other GI side effects.

Some over-the-counter laxatives can be used to manage constipation while on Lexapro, but you should always consult your healthcare provider or pharmacist first. They can recommend the best type of laxative for your situation and ensure it won't interact with your medication.