Lexapro stands as the second most prescribed antidepressant in the United States, with close to nine million individuals relying on it.

However, an increasing number of patients are raising concerns about Lexapro’s severe side effects and potential for addiction.

Sheila Wojciechowski, a 42-year-old mental health counselor based in New York, has been taking Lexapro—generic name escitalopram—and other antidepressants for 20 years. She reports that the side effects have at times felt overwhelming, nearly jeopardizing her marriage.

Wojciechowski continues to grapple with her dependence on the medication.

Her journey with antidepressants began at age 21, following burnout from her job as a special needs teacher and the aftermath of a difficult breakup, which left her deeply depressed.

During a routine medical appointment, she shared her stress about work and personal life. Rather than suggesting therapy or discussing her issues in detail, the doctor promptly prescribed Lexapro.

While she was apprehensive about taking the medication at first, she relented. But after taking the 10 milligram (mg) pills for a week she felt no different.

This is quite usual as it can often take up to eight weeks to experience the medication’s full benefits, as changes in brain chemistry take time.  

However, after telling her doctor that the medication wasn’t working one week in, he instructed her to double the dose from 10mg to 20mg a day. The standard dosing for Lexapro is 10mg daily, and 20mg is the highest standard dose in most treatment guidelines. 

And after upping her dosage, Wojciechowski was pleased to find her depression lifted and she felt more like herself again. 

Sheila Wojciechowski, a mental health counselor from New York, was put on Lexapro at 21 after burnout from work as special needs teacher and a traumatic breakup

Lexapro is a selective serotonin reuptake inhibitor (SSRI) that works by increasing serotonin levels in the brain, leading to improved mood, reduced anxiety, and better sleep and focus. 

SSRIS like Lexapro and Zoloft are the most commonly prescribed type of antidepressant, accounting for up to 70 percent of all antidepressant prescriptions.

In 2024, approximately 11.4 percent of US adults were taking prescription medication for depression, including SSRIs.

Wojciechowski told former FDA medical officer Dr Josef Witt-Doerring in a YouTube interview: ‘I did start feeling better. So I did have the experience that it was helping. 

‘I became this really good patient and advocate for meds and trying to preach to everyone like don’t suffer, just take this. It’s great. It’s amazing. It’s wonderful.’

However, over several years when she was in her late 20s, she noticed memory loss and that her behavior had become reckless.

She said: ‘I lost chunks of time which I don’t remember.

‘I started to engage in some reckless behavior and it was different than the typical experimenting that we do when we’re young. 

‘I really couldn’t access my compass, like I had no sense of right and I was really, really reckless and spontaneous and just doing things that that weren’t me. 

‘I was lucky I didn’t get into more trouble than I did but you know I was close at times.’

In rare cases, some individuals report cognitive side effects associated with Lexapro, especially at higher doses or when combined with other medications. 

As the fertility rate in the US gradually diminishes, more and more Americans are being prescribed SSRIs, the most common type of antidepressant. The purple line on the graph above shows the increasing use of antidepressants, while the pink line shows declining fertility rates 

The latest data from nonprofit March of Dimes shows that fertility in the US is gradually declining

Concerned about her cognitive health, Wojciechowski tried to get off the medication, but her doctor advised her to halve her dosage for two weeks before stopping it completely.

Stopping antidepressants suddenly can be dangerous because it may cause withdrawal symptoms such as insomnia, headaches, nausea, and mood swings and a rapid return of depression or anxiety. 

The brain needs time to adjust after stopping antidepressants because the medication alters serotonin levels, and the brain adapts to that change over time. 

When the drug is stopped suddenly, serotonin levels can drop rapidly, leading to withdrawal symptoms and a quick return of anxiety or depression. This happens because the brain’s receptors haven’t had enough time to re-regulate on their own.

Wojciechowski said the tapering method did not work as the cognitive symptoms continued and she ‘felt weird’ again. 

She said: ‘My mind just would race and race and race. I stopped being able to eat. I stopped being able to sleep. My digestion was a wreck. I was in full-blown panic mode 24/7.’

Because of this, she decided to go back on Lexapro, but this cycle would repeat.

She went through this stop-start cycle around five times and she managed 18 months without antidepressants at one point.

But that was the longest she was off the medication in a 20-year stretch.

To help wean her off Lexapro, Wojciechowski was prescribed Wellbutrin, another antidepressant, by one health practitioner when she was in her mid-20s.  

Doctors sometimes prescribe Wellbutrin to help transition off Lexapro.

Wellbutrin is not an SSRI; it works differently by increasing dopamine and norepinephrine levels instead of serotonin, targeting different brain pathways, which can help ease withdrawal symptoms when transitioning off Lexapro. 

However, Wojciechowski continued to spiral and she suffered from extreme panic attacks and akathisia, a movement disorder characterized by an inner restlessness and a compelling, often unbearable, need to move.

Akathisia is typically a side effect of medications that block dopamine, such as antipsychotics, but can also occur after benzodiazepine withdrawal. At the time, Wojciechowski was also taking benzodiazepine to try and ease her anxiety.

Lexapro helps lift depression by increasing serotonin levels, leading to improved mood, reduced anxiety, and better sleep and focus

Plagued by a range of health problems and with her marriage in shreds because of the cocktail of drugs, Wojciechowski said she became suicidal. 

She told Dr Witt-Doerring: ‘I hit my ceiling and I’m pretty strong. Like, I’m from New York. I’ve been through a lot of s***.

‘[But] this was this wasn’t livable so I agreed to go into the hospital and that was in the summer of 2019.’

In the hospital, Wojciechowski was diagnosed with psychosis and she was given a mix of Ativan (lorazepam) and antipsychotics.

Ativan can help manage anxiety and agitation, while antipsychotics address psychosis.

She stopped this medication after three months, however, and started taking ‘a very high dose’ of Zoloft, another antidepressant, as an alternative to Lexapro, which she appeared to tolerate better.

While she was still on antidepressants in 2020, taking Zoloft at the time, Wojciechowski said she felt better about life and she was able to concentrate on getting her life back on track. 

But when the Covid-19 pandemic hit, she got a mild flu that exacerbated cognitive problems the Zoloft was causing and it was her memory which suffered the most. 

She said: ‘My brain stopped functioning. I stopped being able to sleep. I would get crazy mood swings out of nowhere. 

‘I would start screaming and crying for no reason. I couldn’t be around my family. I was just triggered by everything. I lost all sense of [and] sensations of hunger that’s still not 100 percent resolved.’

A friend suggested Wojciechowski change her diet to help her and recommended the keto diet, which is a high-fat, low-carbohydrate, moderate-protein dietary pattern. 

Wojciechowski found the diet helped alleviate some of her symptoms and she felt ’60 percent better,’ but she was still too scared to stop the antidepressants. 

Now, she remains on Zoloft and claims the medication stole the best years of her life and prevented her from having a child as she was in no state to start a family with her husband. 

She concludes: ‘I will not die on these medications, but I’m not tapering anytime soon because I have to work. I have to contribute to my family. I have a mother who is sick and I want to be there with her and to spend time with her for as long as as she has left.’