Understanding Why Lexapro Causes Stomach Upset
Lexapro (escitalopram) is a selective serotonin reuptake inhibitor (SSRI) that increases serotonin levels in the brain to regulate mood. While serotonin is known for its role in mental health, a significant portion of the body's serotonin receptors are actually located in the gastrointestinal (GI) tract. The initial surge of serotonin in the gut is a primary reason for digestive side effects like nausea, diarrhea, and general stomach discomfort.
For most people, these GI side effects are most prominent during the first week or two of treatment and typically subside as the body adapts to the new medication levels. Higher doses can sometimes lead to more pronounced gastrointestinal issues. However, this adaptation period can be challenging, and there are many effective, doctor-approved strategies to help manage the symptoms.
Immediate Strategies for Relief
If you're experiencing an upset stomach shortly after starting Lexapro, several immediate steps can provide relief:
- Take with food: One of the simplest and most effective strategies is to take your daily dose with a meal or a light snack. This helps buffer the stomach and can prevent nausea by preventing the medication from irritating the stomach lining. It's especially useful for those who experience symptoms shortly after taking their pill.
- Eat smaller, more frequent meals: Instead of three large meals, consider eating several smaller, bland meals throughout the day. This keeps your stomach from becoming completely empty, which can exacerbate nausea.
- Try bland foods: When feeling nauseous, stick to simple, low-fat foods. The BRAT diet (bananas, rice, applesauce, toast) is a classic remedy for stomach upset. Avoiding rich, spicy, and fatty foods is also recommended.
- Sip fluids: Staying hydrated is crucial. Sipping on cool water, flat ginger ale, or ginger tea can help settle your stomach. Sucking on sugarless hard candy can also alleviate mild nausea.
- Consider antacids: For indigestion or heartburn, over-the-counter antacids like Tums or Pepcid might be helpful, but always check with your pharmacist or doctor before starting any new medication to ensure there are no interactions.
Timing Your Dose to Reduce Discomfort
When you take your Lexapro can significantly impact how you experience side effects.
Morning vs. Evening Dosing
Your doctor may have prescribed a specific time, but if you're experiencing side effects like nausea, they may be open to adjusting the schedule.
| Dosing Time | Best For | Considerations |
|---|---|---|
| Morning | Individuals who experience drowsiness or fatigue from Lexapro. | Can help manage daytime anxiety and energy levels, but may cause morning nausea if taken on an empty stomach. |
| Evening / Bedtime | Individuals experiencing significant nausea or daytime sleepiness. | Allows you to sleep through the initial, worst symptoms. Ensure it doesn't cause insomnia; if so, switch back to morning. |
Dietary Adjustments and Lifestyle Hacks
Small changes to your diet and daily habits can provide lasting relief.
Eating for a Calm Stomach
- Foods to eat: Focus on digestible options like crackers, broth, clear soups, and fresh fruits and vegetables. These are less likely to cause irritation. High-fiber foods can help with constipation if that is an issue.
- Foods to avoid: Steer clear of things that can aggravate your stomach. This includes fatty, greasy, and spicy foods, as well as alcohol and excessive caffeine.
Lifestyle Adjustments
- Hydration: Drink plenty of water throughout the day, not just when you feel nauseous. Dehydration can worsen side effects.
- Exercise: Regular, moderate physical activity can aid in digestion and help with overall well-being, but avoid intense exercise immediately after taking your dose.
Over-the-Counter and Prescription Options
When lifestyle changes aren't enough, some medications can help. Always discuss these options with your doctor before use.
- Antacids and Bismuth Subsalicylate: For mild indigestion or nausea, an antacid like Tums or Pepcid or a bismuth subsalicylate product like Pepto-Bismol can provide temporary relief.
- Anti-nausea medication: For severe nausea, your doctor may consider prescribing an anti-nausea medication like ondansetron (Zofran), though it's important to understand potential drug interactions.
- Dosage or formulation change: If side effects persist, your doctor might recommend a lower dosage or a slow-release formulation of escitalopram, which can help your body adjust more gradually.
When to Contact a Healthcare Professional
While an upset stomach is a normal side effect, some symptoms warrant immediate medical attention.
- Persistent or severe pain: If you experience severe abdominal pain that doesn't subside or worsens, contact your doctor.
- Signs of serotonin syndrome: This rare but serious condition requires immediate medical help. Symptoms include high fever, agitation, confusion, muscle twitching, rapid heartbeat, and severe nausea/vomiting.
- Bleeding: If you notice unusual bleeding or bruising, or see blood in your stool (which may appear black and tarry), seek urgent medical care. SSRIs can increase the risk of bleeding.
- Persistent symptoms: If your stomach issues don't improve after a couple of weeks, or if they are significantly impacting your quality of life, it's time for a follow-up consultation with your doctor.
Conclusion
Experiencing an upset stomach on Lexapro is a common initial side effect that is often manageable and temporary. By implementing simple strategies such as taking your medication with food, adjusting your dosing schedule, and making dietary changes, you can significantly reduce discomfort. However, it is vital to communicate openly with your healthcare provider about any persistent or severe symptoms. Never alter your dosage or stop taking Lexapro abruptly without medical supervision, as this can cause serious issues. Consistent communication and adherence to your doctor's plan are key to a successful treatment journey. Psych Central offers comprehensive resources on managing antidepressant side effects.
