Missing a dose of Lexapro can happen to anyone. Life gets busy. You may forget your medication at home. You might fall asleep early or run out of refills. While one missed dose is usually not dangerous, it can cause uncomfortable symptoms for some people.
This guide explains what happens if you miss a dose of Lexapro, why symptoms occur, how long they last, and what you should do next. It also covers when to call your doctor and how to prevent missed doses in the future.
What Is Lexapro
Lexapro is the brand name for escitalopram. It belongs to a group of medications called selective serotonin reuptake inhibitors, also known as SSRIs.
Doctors prescribe Lexapro to treat:
- Major depressive disorder
- Generalized anxiety disorder
- Panic disorder
- Social anxiety disorder
- Obsessive compulsive disorder in some cases
Lexapro works by increasing serotonin levels in the brain. Serotonin is a chemical messenger that helps regulate mood, sleep, appetite, and emotional balance.
Because Lexapro changes serotonin levels gradually, it needs to be taken consistently to maintain stable levels in your body.
What Happens If You Miss One Dose of Lexapro
If you miss one dose, most people do not experience severe symptoms. However, some people are more sensitive to changes in medication levels.
Lexapro has a half life of about 27 to 32 hours. That means it takes over a day for half the medication to leave your body. Because of this, one missed dose may not immediately cause problems. But in some individuals, even small drops in serotonin can trigger symptoms.
You might notice:
- Mild headache
- Irritability
- Anxiety
- Slight dizziness
- Mood changes
These symptoms are usually mild and temporary.
Why Missing a Dose Causes Symptoms
When you take Lexapro daily, your brain adjusts to a steady level of serotonin. If you suddenly skip a dose, serotonin levels begin to drop. Your brain does not have time to adjust smoothly.
This sudden change can lead to what is known as antidepressant discontinuation symptoms. These are not the same as addiction or withdrawal in the traditional sense. Lexapro is not addictive. However, your brain becomes accustomed to its presence.
Even missing one or two doses can cause temporary imbalance in sensitive individuals.
Common Side Effects of Missing a Dose of Lexapro
Below are the most frequently reported symptoms after missing a dose of Lexapro.
Dizziness
Dizziness is one of the most common symptoms. Some people describe it as feeling lightheaded or off balance. Others say they feel a brief spinning sensation when turning their head.
Brain Zaps
Some people experience what are commonly called brain zaps. These feel like brief electrical sensations in the head. They can last a second or two and may occur repeatedly throughout the day.
Brain zaps are not dangerous but can be unsettling.
Increased Anxiety
Since Lexapro is often prescribed for anxiety, missing a dose can cause anxiety symptoms to return temporarily. You might feel restless, tense, or worried without a clear reason.
Mood Changes
You may notice irritability, sadness, or mood swings. These changes are usually temporary and improve once you resume your regular schedule.
Fatigue
Some people feel unusually tired after missing a dose. Others may experience difficulty sleeping.
Nausea
Mild stomach upset or nausea can occur as serotonin levels shift.
Headache
Headaches may develop due to chemical changes in the brain.
Emotional Symptoms to Watch For
In addition to physical symptoms, missing a dose can cause emotional changes.
These may include:
- Feeling tearful
- Low motivation
- Reduced concentration
- Feeling overwhelmed
- Increased sensitivity
For people being treated for depression, even a brief drop in serotonin can trigger low mood symptoms.
How Long Do Symptoms Last
For most people, symptoms from missing a single dose last less than 24 hours. Once you resume your regular dose, serotonin levels begin to stabilize again.
If you miss more than one dose, symptoms may last longer and feel more intense.
Typically:
- One missed dose causes mild symptoms that resolve within a day
- Two to three missed doses may cause moderate symptoms lasting several days
- Stopping suddenly after long term use can cause symptoms lasting one to two weeks or longer
Everyone responds differently. Some people notice no symptoms at all.
Is Missing One Dose of Lexapro Dangerous
In most cases, missing one dose is not dangerous. It may be uncomfortable, but it is unlikely to cause serious harm.
However, certain situations require caution:
- If you have severe depression
- If you have a history of suicidal thoughts
- If you have panic disorder and are prone to severe attacks
- If you are taking a high dose
In these cases, missing doses repeatedly can increase the risk of symptom relapse.
If you experience severe mood changes or suicidal thoughts, contact your healthcare provider immediately.
What To Do If You Miss a Dose of Lexapro
The general rule for Lexapro is simple.
- If you remember the missed dose within the same day, take it as soon as you remember.
- If it is almost time for your next dose, skip the missed dose and continue your regular schedule.
- Do not take two doses at once unless your doctor tells you to.
- Doubling up can increase the risk of side effects such as nausea, sweating, rapid heartbeat, or restlessness.
What Happens If You Miss Several Doses of Lexapro
Missing multiple doses increases the likelihood of discontinuation symptoms.
You may experience:
- Strong dizziness
- Brain zaps
- Flu like symptoms
- Sweating
- Sleep disturbances
- Emotional instability
If you miss more than two or three doses, contact your doctor for guidance. You may need to restart slowly depending on how long you have been off the medication.
Differences Between Missing a Dose and Stopping Completely
Missing one dose is not the same as stopping Lexapro abruptly.
Stopping suddenly after long term use can cause more intense symptoms such as:
- Severe mood swings
- Agitation
- Confusion
- Nausea and vomiting
- Electric shock sensations
- Return of depression or anxiety
Doctors usually recommend tapering gradually to avoid these effects.
Who Is More Likely To Notice Symptoms
Some people are more sensitive to missed doses.
You may be at higher risk if:
- You have been on Lexapro for many months or years
- You are on a higher dose
- You metabolize medications quickly
- You are sensitive to medication changes
- You have a history of withdrawal symptoms from other antidepressants
If you often notice symptoms after missing a single pill, you may need to be extra careful with timing.
Can Missing a Dose of Lexapro Cause Relapse
Missing one dose rarely causes full relapse. However, repeated missed doses can reduce treatment effectiveness.
If you frequently skip doses, serotonin levels may fluctuate enough to:
- Reduce symptom control
- Increase anxiety
- Trigger depressive episodes
- Cause irritability
Consistency is key for antidepressant treatment success.
When To Call Your Doctor
Contact your healthcare provider if:
- You missed several days in a row
- You feel severe dizziness or confusion
- You experience suicidal thoughts
- You have uncontrollable anxiety
- Symptoms last more than a few days
Your doctor may adjust your dose or provide guidance on restarting safely.
How To Prevent Missing Doses
Building a routine helps prevent problems.
Here are practical strategies:
Take It At The Same Time Daily
Link your medication to a daily habit such as brushing your teeth or eating breakfast.
Use A Pill Organizer
Weekly pill boxes make it easy to see if you missed a dose.
Set Phone Reminders
Use alarms or medication reminder apps.
Keep A Backup Supply
If you travel often, keep a small emergency supply in your bag.
Enable Automatic Refills
Running out of medication is a common reason for missed doses.
Special Considerations For Different Doses
Lexapro is often prescribed in doses such as 5 mg, 10 mg, or 20 mg.
Higher doses may produce more noticeable symptoms if missed because the drop in serotonin is larger.
People on 5 mg may notice little to no change after one missed dose. People on 20 mg may feel symptoms more quickly.
Can You Take Lexapro At A Different Time If You Miss A Dose
Yes, but try to return to your usual schedule the next day.
For example:
If you normally take it at 8 am but forget and remember at 2 pm, you can take it at 2 pm. The next day, you may take it slightly earlier to return to your normal time.
Avoid large time shifts unless advised by your doctor.
Are Withdrawal Symptoms Permanent
No. Discontinuation symptoms from missed doses are temporary.
Once regular dosing resumes, serotonin stabilizes and symptoms improve.
Persistent symptoms are more likely related to underlying depression or anxiety rather than the missed dose itself.
Frequently Asked Questions
1. Can missing a dose of Lexapro cause panic attacks?
Yes, in some individuals who take Lexapro for anxiety or panic disorder, missing a dose may temporarily increase anxiety levels and potentially trigger a panic attack. This is more likely if you are sensitive to medication changes or miss more than one dose.
2. Does missing a dose of Lexapro affect blood pressure or heart rate?
Lexapro does not directly treat blood pressure, but missing a dose may increase anxiety in some people. Increased anxiety can temporarily raise heart rate or blood pressure, especially in those prone to stress-related symptoms.
3. Can missing a dose make me feel emotionally numb?
Some people report emotional changes such as feeling detached, irritable, or unusually sensitive after missing a dose. Emotional numbness is less common but may occur briefly due to serotonin fluctuations.
4. Will missing a dose affect my other medications?
It depends on what other medications you take. Missing Lexapro itself does not usually interfere with other drugs, but mood or anxiety changes could indirectly affect how you feel overall. If you take multiple psychiatric medications, consistency is especially important.
5. Can alcohol make symptoms worse if I miss a dose?
Yes. Drinking alcohol after missing a dose may increase dizziness, mood instability, or fatigue. Alcohol can also worsen anxiety or depressive symptoms, which may already be heightened.
6. Does missing a dose affect how long Lexapro stays in my system?
Missing a single dose does not significantly change how long Lexapro remains in your body. Because of its relatively long half life, some medication remains in your system even if you skip one day.
7. Can missing a dose cause vivid dreams or nightmares?
Some individuals report unusual dreams, vivid dreams, or sleep disturbances when serotonin levels fluctuate. This can occasionally happen after a missed dose, though it is usually temporary.
8. Is it normal to feel fine after missing a dose?
Yes. Many people feel completely normal after skipping one dose. Not everyone experiences discontinuation symptoms. Sensitivity varies from person to person.
9. Can missing a dose affect sexual side effects?
A single missed dose is unlikely to significantly change sexual side effects. However, some people may notice brief changes in libido or sensitivity due to short term serotonin shifts.
10. If I frequently forget doses, should I switch medications?
If remembering daily medication is difficult, talk to your doctor. They may suggest strategies to improve consistency or consider other treatment options. Frequently missed doses can reduce treatment effectiveness, so addressing the issue is important.
Conclusion
Missing a dose of Lexapro is common and usually not dangerous. Most people experience mild or no symptoms after skipping one pill. However, some individuals are more sensitive and may notice dizziness, mood changes, anxiety, or brain zaps.
The best approach is consistency. Take Lexapro at the same time every day, use reminders, and plan ahead for travel or refills. If you miss a dose, take it when you remember unless it is almost time for your next scheduled dose.
If you miss several doses or experience severe symptoms, contact your healthcare provider for guidance. Never stop Lexapro suddenly without medical supervision.
Staying consistent helps maintain stable serotonin levels and keeps your treatment working effectively.
Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your doctor or qualified healthcare provider with any questions about your medication or health condition. Never start, stop, or change your medication without medical guidance.
