How To Change Taking Lexapro From Night To Morning

In our latest question and answer, the pharmacist discusses how safety change the time of day you take Lexapro (escitalopram)

Question

I take one Lexapro (escitalopram) in the evening. I want to start taking it in the morning. How can I change the time I take the medication?

Asked by Kel On Jun 22, 2021

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Jun 22, 2021
Last updated Mar 27, 2024

Key points

  • There isn’t any specific guidance from the manufacturer on the best way to change the time of day.
  • Withdrawal symptoms from Lexapro, if they occur, generally start a few days after taking your last dose.
  • It is unlikely you would experience serious side effects, or a decrease in effectiveness, if making a one-time time of day switch with your Lexapro, but it would be prudent to check with your doctor first as they have your complete medical history.

Hi and thank you for your reaching out to us with your question.

I did a bit of background research and there doesn’t appear to be any specific advice from the manufacturer on the best way to reschedule the time of day you take your Lexapro.

That being said, I think I can offer some good advice on the best way to switch the timing of your dose.

First, Lexapro (or under the generic name escitalopram) lasts a pretty good amount of time in your system and has a half-life of about 30 hours in healthy adults. What this means is that the medication lasts well over a day in your system and this allows us to dose it once daily.

Additionally, the longer you take Lexapro, it is going to reach a 'steady-state' in your system, and missing a dose, or changing the time of day you take it (as a one-time measure) isn't likely to cause any negative clinical effects.

When Should You Take Lexapro?

Many drugs are recommended to be taken at a certain time of day, and this is certainly the case with antidepressants.

Some (e.g. amitriptyline) can make you feel tired or groggy and may be best before bed. Others (e.g. bupropion) can be you feel make you feel a bit more awake and alert, so morning may be recommended for them.

Now, for Lexapro specifically, according to the prescribing information, you can take it at any time of the day:

Lexapro should generally be administered once daily, morning or evening with or without food
Lexapro Prescribing Information

Lexapro is an SSRI (selective serotonin reuptake inhibitor), and the side effects of that class of drugs have been pretty well documented.

Drowsiness is a listed side effect of all SSRIs but they can also cause insomnia and a side effect known as 'activation'. Activation is characterized by a state of restlessness, agitation, and anxiety. These can of course cause sleep disturbances.

In fact, the guidelines for the treatment of major depressive disorder published by the American Psychiatric Associated list insomnia/activation as a major category of side effects caused by SSRIs (along with sexual dysfunction, gastrointestinal effects, effects on weight, and neurological effects). The good news is that these side effects tend to decrease in severity over time.

Circling back to Lexapro, again, it can be taken any time of day, and there is no preference for morning over evening dosing.  It is best to time the dosing of it based on your personal experience with it. If it makes you tired, bedtime may be best. If you feel more awake after taking it, the morning may be better.

Switching The Time Of Day You Take Lexapro

As discussed above, the time of day you take Lexapro doesn't necessarily matter. Unfortunately, if you want to change the time of day you currently take the drug, there is no real guidance available.

The manufacturer does not give any direction, nor does the prescribing information for the drug. I also could not find any published articles discussing the matter.

However, looking over studies that discuss how our bodies process Lexapro, and studies that discuss how adherence (i.e. taking a therapy as prescribed) can influence the clinical effects of antidepressants, missing one dose of Lexapro, or missing your scheduled time by a few hours, is likely to have little, if any, clinical effect.

Most studies report that although stopping Lexapro abruptly can cause withdrawal symptoms, these generally do not start for at least a few days after your last dose.

The prescribing information for Lexapro even states that if you miss a dose completely, and it's almost time for your next dose, don't double up. Just take your next dose as scheduled.

So, in your situation, taking your usual dose in the evening and wanting to switch to the morning, you likely can just skip your evening dose, start up the next morning at your new time, and just continue from there.

If you want to be extra cautious, I've seen some practitioners recommend taking a half-dose in the evening, then a full dose the next morning (and continuing from there), just to try to maintain the drug concentration in your body a little bit better than missing a dose completely.

Before we close here, I want to point out that everyone's medical situation is different, and before you do anything that involves changing your medication regimen, you speak to your physician first. They have your complete medical history and will be in a better position to provide you with a more personalized recommendation.

I hope this helps. Feel free to write us back in the future with any additional questions!

References

  • Lexapro Prescribing information, Allergan
  • Emerging Mania Following Escitalopram Withdrawal in a Patient with Unipolar Depression Managed with its Reintroduction, Journal of Psychiatric Practice
  • PRACTICE GUIDELINE FOR THE Treatment of Patients With Major Depressive Disorder, Psychiatry.org

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 13 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical, program development, and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Dr. Brian Staiger also has herbalist training and educational certificates in the field of medical ethnobotany. Feel free to send him an email at [email protected]! You can also connect with Dr. Brian Staiger on LinkedIn.

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