Yes, it's common for Lexapro (escitalopram) or other antidepressants to become less effective after a few years, a phenomenon known as antidepressant tolerance or "poop-out" (tachyphylaxis), where the body adapts, requiring dose changes, adding other treatments (like therapy), or switching medications, so it's crucial to talk to a doctor if this happens.
For some people, an antidepressant may simply stop working over time. This is called antidepressant tolerance. Healthcare professionals don't fully understand what causes antidepressant tolerance, also called tachyphylaxis, to happen. They also aren't sure why it happens for some people and not others.
Many patients can develop a tolerance to antidepressants over time. If you have been on oral antidepressants for some time, you may begin to realize that you are no longer feeling the same benefits from your medication that you experienced in the earlier stages of treatment.
Tolerance: When Lexapro Stops Working as Well
One consequence of neuroadaptation is the potential development of tolerance, where the medication becomes less effective over time.
Potential Long-Term Effects of Lexapro Use
This could be due to changes in metabolism, appetite, or altered mood affecting eating habits. In more extreme cases, weight gain and physical health decline can exacerbate negative feelings and worsen depression, creating a cycle of emotional distress.
Yes—many people take Lexapro for years. Some even stay on it for most of their lives. Medical research shows that SSRIs are safe for long-term use when monitored by a healthcare provider. There is no official time limit that says you must stop the medication after a certain number of years.
Some of the more common supplements that might be an effective alternative to Lexapro for anxiety or depression may include:
You may be tempted to stop taking antidepressants as soon as your symptoms ease, but depression can return if you quit too soon. Clinicians generally recommend staying on the medication for six to nine months before considering going off antidepressants.
Your body can build a tolerance to antidepressants. Antidepressant tachyphylaxis — a decreasing response to a drug — tends to occur only with selective serotonin reuptake inhibitors (SSRIs). Experts estimate that up to 25% of people treated for depression may experience tachyphylaxis.
Your mood or symptoms do not improve
Antidepressants are often prescribed for moderate and severe depression, of which symptoms can be significant and regular. If you don't notice and considerable reduction in these symptoms after 8 weeks of medication, it might be a sign the medication isn't working for you.
Jim Carrey talks about being on Prozac for a long time and he had to get off at a certain point as he didn't want to be on it indefinitely. “There are peaks, there are valleys,” he said. “But they're all kind of carved and smoothed out, and it feels like a low level of despair you live in.
For people with chronic or severe depression, medication may be needed on a long-term basis. In these cases, antidepressants are often taken indefinitely. That is, in part, because depression is not an illness that can be cured.
In addition to reducing interest in sex, SSRI medications can make it difficult to become aroused, sustain arousal, and reach orgasm. Some people taking SSRIs aren't able to have an orgasm at all. These symptoms tend to become more common with age.
Lexapro might initially make your anxiety worse because your body needs time to adjust to the medication's effects on your brain's serotonin levels. It's like your system needs some time to get used to it.
Adding Wellbutrin could provide symptom relief without the increased side effects of higher SSRI doses. The combination targets different neurotransmitter systems that higher Lexapro doses cannot reach. Different approaches may work better for different symptom clusters.
Some people notice cognitive improvements within days or weeks of discontinuing Lexapro, while others experience prolonged symptoms that can last months or, in some cases, years.
No one knows for sure why these medications lose their effectiveness the longer you take them, but one theory is that the receptors in the brain become less sensitive to the medication. Other common SSRIs prescribed for depression that can “poop out” on you include: Celexa (citalopram) Lexapro (escitalopram)
It's common for a medication that once worked wonders to become ineffective, especially if you've been taking it for a long time. Symptoms return for up to 33% of people using antidepressants — it's called breakthrough depression.
In time, the brain returns to a normal state after stopping antidepressants. If depressive symptoms do arise and gradually worsen, it's best to consult a psychiatrist or doctor if they don't improve within a few weeks or if they become severe.
If this is your first episode of depression, your doctor may prescribe Lexapro for a set period, for example, 6 months to a year. Some people with persistent depression may need to take it for many years. There are no known problems when Lexapro is taken long-term.
Antidepressant discontinuation syndrome (ADS) can happen if you stop taking your antidepressant medication, especially suddenly. It causes a variety of symptoms like nausea, insomnia, fatigue and achiness. Because of this, it's crucial to go off an antidepressant under the guidance of your healthcare provider.
Escitalopram (Lexapro) interacts with monoamine oxidase inhibitors (MAOIs), other antidepressants, and St. John's wort. It also interacts with blood thinners, nonsteroidal anti-inflammatory drugs (NSAIDs), and alcohol.
If you think your antidepressant has stopped working, it's important to talk to your doctor. They can help you figure out the cause and suggest the best course of action. This may include adjusting your dosage, switching to a different medication, or adding another treatment, such as therapy.
There's good news for people with severe treatment-resistant depression: Esketamine is a groundbreaking therapy that can provide relief from major depression within hours.
Vitamin B-12 and other B vitamins play a role in making brain chemicals that affect mood and other brain functions. Low levels of B-12 and other B vitamins and folate may be linked to depression.