Accidentally Took Two Lexapro Pills
In our latest question and answer, the pharmacist discusses what can happen, and what to do if you accidentally take an extra dose of Lexapro.
I recently transitioned from Celexa (40 mg once a day) to Lexapro (20 mg once a day) for about a month. I accidentally took two 20 mg of Lexapro this morning. I feel foggy, out of it, but nothing severe. I also take Klonopin (1mg) for anxiety. Hasn't been my first time doing this but first time doing this with a new medication. Will I be okay?
Apr 10, 2021- Contact Poison Control at 1-800-222-1222 if you're concerned about taking extra Lexapro, as they can evaluate your situation.
- Lexapro has a relatively wide safety range, and taking an extra 20 mg dose to reach 40 mg total is unlikely to cause serious harm, though you may experience mild side effects like nausea, dizziness, or low blood pressure.
- Take your next scheduled dose as planned rather than skipping it, but confirm this approach with your doctor or pharmacist since everyone's situation is different.
Accidentally taking an extra dose of any medication can certainly happen, and it is important to be aware of the steps that you should take if you find yourself in this precarious situation.
First and foremost, if you ever think you took too much medication, I can't recommend strongly enough that you contact the Poison Control Center at 1-800-222-1222, or visit their website (Poison.org), to be evaluated.
Accidentally Overdosing With Lexapro
In the case of taking an extra dose of Lexapro (escitalopram), while you certainly may experience some negative effects (more on this below), the good news is that it has a relatively wide dosage range when it comes to safety.
In fact, the SSRI (selective serotonin reuptake inhibitor) class of medication, in general, is thought to be among the safest when it comes to the serious negative consequences of overdose.
The FDA-approved prescribing information for Lexapro discusses cases of overdose and states that cases of overdose up to 600 mg were reported with no fatalities, though postmarketing data includes overdoses over 1000 mg with rare fatal outcomes:
In clinical trials of escitalopram, there were reports of escitalopram [Lexapro] overdose, including overdoses of up to 600 mg, with no associated fatalities. During the postmarketing evaluation of escitalopram, Lexapro overdoses involving overdoses of over 1000 mg have been reported. As with other SSRIs, a fatal outcome in a patient who has taken an overdose of escitalopram has been rarely reported.
In your question, you mentioned taking an extra dose of Lexapro (a second 20 mg tablet), bringing your total daily dose to 40 mg. This exceeds the FDA-approved maximum daily dose of 20 mg. However, in most cases, any adverse effects you experience are likely to be mild (I'd like to note as well that there are plenty of clinical studies that utilized 40 mg, which was reported to be well-tolerated).
Of course, it goes without saying that everyone's medical situation is different and you should reach out to your doctor or Poison Control (1-800-222-1222) if you are concerned or feeling any unusual symptoms.
Side Effects Of Taking Too Much Lexapro
As mentioned above, any side effects you experience will most likely be mild and would be similar to the usual side effects of the drug. This includes:
- Nausea
- Vomiting
- Diarrhea
- Low blood pressure
- Dizziness
One case study, in particular, looked at Lexapro intoxication in which an individual presented to the ER after taking 190mg. The reported symptoms in this patient were:
- Dizziness
- Low blood pressure
- Palpitations
- Confusion
The treatment utilized in this patient was gastric lavage (i.e. stomach pump/irrigation) and symptom management, and no lasting adverse effects were reported.
Final Words
If you accidentally did take an extra dose of Lexapro, you may be wondering how you should approach your next scheduled dose.
Because everyone's medical situation is different, check with your doctor or pharmacist before deciding how to proceed—but for most people, the general guidance is to take your next scheduled dose as planned rather than skip it.
References & sources
- Gold Standard, Inc. Lexapro Monograph — Clinical Pharmacology
- SSRI safety in overdose — PubMed
- Clinical effectiveness and safety of escitalopram and desvenlafaxine in patients of depression with anxiety: A randomized, open-label controlled trial — PubMed
- Lexapro Prescribing Information — AccessFDA
Glossary — Terms in This Answer
- SSRI
- A class of antidepressant medications that work by increasing serotonin levels in the brain by blocking its reabsorption.
- Escitalopram
- The generic chemical name for the medication commonly known as Lexapro.
- FDA-approved
- Officially authorized by the Food and Drug Administration, meaning the medication has been tested and deemed safe and effective for its intended use.
- Postmarketing
- Information or data collected after a drug has been approved and released to the public for general use.
- Palpitations
- A sensation of rapid, forceful, or irregular heartbeats that a person can feel in their chest.
- Gastric lavage
- A medical procedure in which the stomach is flushed with fluid to remove its contents, commonly known as a stomach pump.
- Adverse effects
- Unwanted or harmful side effects that occur as a result of taking a medication.
- Intoxication
- A state of poisoning or overdose caused by exposure to a toxic substance or excessive amount of a drug.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
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