Increasing Your Lexapro (Escitalopram) Dose: What to Expect and How It Works
Author:
Blossom Editorial
Feb 20, 2026
If your doctor recommends increasing your Lexapro (escitalopram) dose for depression or anxiety, it’s natural to wonder what changes to expect and how long it will take to notice improvements. Understanding the process of dose adjustment helps you know what's normal, what side effects might occur, and when you may start to feel real benefits from the higher dose.
Your doctor might suggest increasing your Lexapro dose when the current dose is effective but not enough to provide symptom relief. Most people tolerate dose increases well and notice additional improvement within a few weeks.
Key Takeaways
Lexapro dose can be increased once a week for adults, depending on how well they’re responding to it. Dose increments usually progress from 10mg to 20mg once daily, with the maximum recommended dose not exceeding 20mg per day.
Some people notice improvements from a dose increase within 1-3 weeks, though full effects may take 4-6 weeks.
Temporary side effects like nausea, headache, or increased anxiety may occur after a dose increase but often improve as your body adjusts to the new level.
Why Your Provider Might Increase Your Lexapro Dose
Your doctor might recommend increasing your Lexapro dose for several reasons. Here are a few of them:
Incomplete Symptom Relief
One of the common reasons for a dose increase is partial improvement in symptoms. For example, you might feel a bit better than before starting medication, but still experience symptoms that interfere with daily life.
For many people10mg of Lexapro is effective, but others may need a higher dose of up to 20mg. Your doctor evaluates how well your symptoms are responding to the medication todetermine if a higher dose would help.
Adequate Time at Current Dose
Before increasing the dose, your doctor usually ensures you’re taking the current dose for long enough to evaluate its efficacy. For adults, this may mean waiting for about 4-6 weeks. If there hasn’t been enough improvement for several weeks, your doctor might consider increasing the dose gradually to 15mg or 20mg.
However, if you've been on the initial dose for a short time, your doctor might recommend waiting a bit longer at the current dose before increasing it.
Good Tolerance of Current Dose
Increasing your lexapro dose can depend on whether you can tolerate your current dose well. If the side effects are mild and manageable, your doctor might recommend increasing the dose. But if the side effects are already difficult to manage at a lower dose, increasing it may not be recommended.
Standard Lexapro Dosing Increases
Lexapro comes in severalstrengths, and doctors follow established guidelines when increasing doses.
Typical Dose Progression for Adults
According to FDA prescribing information, the standard approach for adults with depression or anxiety starts at 10mg once daily, taken in the morning or evening. After at least 1 week at 10mg, your doctor may increase to 20mg once daily if needed. The maximum recommended dose is 20mg daily.
Some older adults and people sensitive to lexapro may start at 5mg daily. In these cases, the progression might go from 5mg to 10mg, then potentially to 20mg if needed.
Dose adjustments are typically spaced at least one week apart. This timing allows your body to adjust and helps your doctor see how you respond before making further changes.
Note: Medication details of Lexapro, including dosage and usage, are provided for general understanding and are not a prescription recommendation. Always consult a licensed healthcare provider before starting, changing, or discontinuing any medication.
Dosing for Children and Teens
For adolescents aged 12-17 with depression and children aged 7 and older with anxiety, the dose adjustments are typically approached more cautiously. They typically start at 10mg once daily. If a dose increase is needed, doctors generally wait at least 3 weeks before increasing to 20mg once daily.
The longer waiting period for young people allows extra time to monitor effects and side effects carefully, as younger patients may respond differently than adults
Why 20mg is the Maximum
Doses above 20mg generally don’t provide extra benefit for most people and can increase the risk of side effects. In fact, the research showed that 20mg wasn't significantly more effective than 10mg overall anddifferent people may simply respond better to different doses within this range.
Higher doses above 20mg are also linked with an increased risk of side effects without offering more symptom relief. For this reason, 20 mg daily is considered the maximum recommended dose.
What to Expect After a Dose Increase
When your doctor increases your Lexapro dose, your body may need time to adapt. These changes happen gradually over the following days and weeks.
During the first 3-5 days, you might notice some temporary side effects as your body adjusts to a higher dose. These may include: Mild nausea or upset stomach
Slight headache
Feeling more nervous or anxious temporarily
Changes in sleep (either more drowsy or more restless)
Dizziness
Increased sweating.
These effects are often similar to what you might have experienced when first starting Lexapro. For many people, they’re mild and begin to improve within a week.
Week 1-2
By the end of the first week, initial side effects typically start fading. You might begin noticing subtle improvements in your symptoms, though it's often too early for major changes. Your body is adjusting to maintaining the new, higher level of medication in your system.
During this time, continuing to take your medication exactly as prescribed can allow the adjustment process to continue smoothly.
Weeks 2-4
Many people start experiencing more noticeable improvements in their depression or anxiety symptoms during weeks 2-4 after a dose increase. You might feel changes like:
More stable mood
Reduced intensity or frequency of anxiety
Higher energy levels to do daily tasks
Improved sleep quality
Increased motivation or interest in activities
These improvements often happen gradually. It’s natural that you might not notice dramatic day-to-day improvements, but changes can become more apparent when compared to how you felt a few weeks ago.
After 4-6 Weeks
By 4-6 weeks at your new dose, many people have a clearer picture of how well the dose increment is working for them. This is often when your doctor evaluates whether the dose adjustment worked well or if further changes are needed.
If you've reached 20mg (the maximum dose) and still aren't seeing enough improvement after 6-8 weeks, your doctor might consider:
Adding another medication
Switching to a different antidepressant
Incorporating psychotherapy
Managing Side Effects During Dose Increases
While many people tolerate Lexapro dose increases well, knowing how to manage potential side effects helps you feel more comfortable during the adjustment period. Here are some tips to manage side effects during Lexapro dose increases:
Nausea and Upset Stomach
If you experience nausea after increasing your dose, taking Lexapro with food may help reduce stomach discomfort. Some people find it helpful to:
Eat smaller, more frequent meals rather than large meals.
Avoid spicy, greasy, or heavy foods during the first week.
Drink ginger tea or use ginger candies
For many people, nausea begins to improve within a week as their body adjusts to a higher dose.
Sleep Changes
Some people may experience drowsiness while others have trouble sleeping after a dose adjustment. Depending on how it affects you, your doctor might recommend adjusting the time of day you take it.
Maintain a regular sleep schedule, going to bed and waking up at consistent times andd avoiding caffeine in the afternoon and evening may also support your sleep quality.
If sleep disruption continues beyond a couple of weeks or significantly affects your daily functioning, consider discussing it with your doctor.
Temporary Increased Anxiety
Some people notice their anxiety temporarily increases for a few days after a dose increase before it improves. This is usually short-lived and doesn't mean the medication isn't working.
During this period, practicing deep breathing or relaxation techniques can help manage the temporary spike. Andcontinuing taking your medication as prescribed allows the body to adjust to a higher dose.
If anxiety feels intense or doesn’t begin to improve within several days, considercontacting your doctor.
When Side Effects Need Medical Attention
Most side effects after adose increase are mild and temporary. However, some symptoms may require immediate medical attention.
Contact your doctor or seek emergency medical care if you:
Experience severe anxiety or panic attacks that are worse than before
Thoughts of harming yourself
Extreme restlessness where you can't sit still
Chest pain or irregular heartbeat
Seizures
Signs of serotonin syndrome (severe confusion, high fever, muscle rigidity). These symptoms aren't normal adjustment side effects and might need professional evaluation.
Factors That Affect Your Lexapro Dose
Several factors influence what dose of Lexapro might work best for you. Because response varies from person to person, treatment decisions are also made based on your individual health concerns.
Age
Older adults (65 and older) typically need lower doses. The recommended dose for elderly patients is 10mg once daily, with increases to 20mg only if carefully evaluated. This is because older people's bodies may process medications more slowly, leading to higher medication levels that can cause more side effects.
Liver Function
Your liver breaks down Lexapro. If you have liver problems, your doctor may recommend lower doses or adjust more cautiously, depending on your overall health.
Other Medications
Some medications can interact with Lexapro, affecting how quickly your body processes it. For example, medications that inhibit certain liver enzymes can increase Lexapro levels in your blood. Your doctor considers all your medications when determining the right Lexapro dose.
Individual Differences in Response
People respond to antidepressants differently. Some individuals experience meaningful improvement at 10 mg, while others may benefit from 20 mg.
These differences are part of normal body responses and are one of the reasons why dose adjustments vary from case to case.
Communicating with Your Doctor About Dose Changes
Good communication with your doctorhelps ensure dose adjustments happen safely and effectively.
Keep a simple journal tracking how you've been feeling on your current dose. Note your mood each day (on a simple 1-10 scale), energy levels, sleep quality, anxiety levels, and any side effects. This information helps your doctor understand your response to the current dose.
Be prepared to discuss:
How long have youbeen on the current dose
What improvements have you noticed (if any)
What symptoms still bother you
W Your concerns about dose increases
Need support with your Lexapro dose?
Blossom Health offers virtual psychiatric care with board-certified providers who can evaluate your symptoms, adjust your medication safely, and monitor side effects effectively. With comprehensive care and evidence-based dose management, our psychiatrists help ensure your treatment is both safe and effective.
Questions to Ask
When your doctor suggests increasing your dose, it’s helpful to ask clarifying questions. You can ask about:
What specific improvements should I expect from the increase?
How long will it take to notice benefits?
What side effects are normal, and which are concerning?
When should I follow up with my doctor?
What should I do if side effects are too bothersome?
What time of day should I take Lexapro?
Understanding the plan helps you stay committed to treatment even if the adjustment period is uncomfortable.
Medical Disclaimer
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. If you are experiencing a mental health crisis, contact the 988 Suicide and Crisis Lifeline by calling or texting 988.
Sources
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Drugs.com. Lexapro Dosage Guide. (2025, November 7). https://www.drugs.com/dosage/lexapro.html
Mayo Clinic. (2026, February 01). Escitalopram (Oral Route). https://www.mayoclinic.org/drugs-supplements/escitalopram-oral-route/description/drg-20063707
National Institute of Mental Health. (2023, December). Mental Health Medications. https://www.nimh.nih.gov/health/topics/mental-health-medications
Landy K, Rosani A, Estevez R. (2023, November 10). Escitalopram. StatPearls. NCBI Bookshelf. 2023. https://www.ncbi.nlm.nih.gov/books/NBK557734/
Polychroniou PE, et al. (2018). Temporal profiles and dose-responsiveness of side effects with escitalopram and duloxetine in treatment-naïve depressed adults. PMC. 2018. https://pmc.ncbi.nlm.nih.gov/articles/PMC6071033/
Hers. (2025, 27 January). What To Expect When Increasing Lexapro Dosage. https://www.forhers.com/blog/what-to-expect-when-increasing-lexapro-dosage
American Psychiatric Association. (2025). Practice Guidelines for the Treatment of Patients with Major Depressive Disorder. https://www.apa.org/depression-guideline
