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LeahMSWuofm, Clinical Social Worker
Category: Mental Health
Satisfied Customers: 670
Experience:  10 years post-MSW experience
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I was just prescribed Escitalopram beginning 5mg for 4 days

Customer Question

I was just prescribed Escitalopram beginning 5mg for 4 days and 10mg after. After the first day, I experienced headaches and shaking upon waking. Day 2 was the same, but worse. The side effects suggest calling my doctor, should I worry or continue taking until I get a response from my doc?
JA: How is your mood? Are you experiencing regular sleep disturbances (e.g. trouble falling asleep, waking up early)?
Customer: Mood is slightly improved after taking it during the day. I sleep well with vivid dreams until I wake up after 4-6 hours.
JA: Anything else in your medical history you think the Psychologist should know?
Customer: I've informed them of everything I could remember. I also told them of my frequent headaches which is why this was prescribed as headaches are nit common of the medication.
Submitted: 2 months ago.
Category: Mental Health
Expert:  LeahMSWuofm replied 2 months ago.

Hi, thanks for writing. I am sorry you aren't feeling your best. The side effects you are having (headache, shakiness) are common in the first 3-4 weeks of starting a medication like escitalopram and often appear pretty quickly. So are peaked anxiety, depression, nausea, and generally feeling off. Typically it is advised to ride out these activation side effects as they will dissipate as your body adjusts and just about the time the side effects break, the medication will begin to help reduce anxiety and depression symptoms. Riding it out is not indicated if you feel the side effects are more than uncomfortable and are actually intolerable.

In this case, if you have a goal of reducing the anxiety and depression with the help of a med, then you may want to 1) consider halving your dose for a while longer with hopes you can tolerate the side effects, then doubling the dose after a couple of weeks. or

2) Ride out the current dose with hopes your side effects break soon. Or

3) Consider trying an alternative SSRI. They vary significantly in the way people react to them so quite possibly, trying a different med in the same class may have no/less side effects.

I hope this helps. I am here to chat more if you'd like!