Lexapro (escitalopram) is one of the most widely prescribed medicines for depression and generalised anxiety, and for many people it is well tolerated. One side effect, though, tends to catch people off guard: waking up drenched in sweat. Increased sweating, including night sweats, is listed among the common side effects of escitalopram, and in clinical studies it appeared more often at higher doses.
Rather than a general overview, this guide follows the Lexapro journey through time, from the first weeks to long-term use and even after stopping, and shows how night sweats typically behave at each stage. Along the way, it explains how to tell whether the medicine is the likely culprit, what you can do at home, and the point at which a review with your prescriber makes sense.
The Night Sweats Timeline
Weeks 1 to 2: The adjustment phase
Early side effects of escitalopram often include nausea, headache, sleep changes and sometimes sweating. During this period your body is adjusting to new serotonin activity, and the brain’s temperature-control centre, the hypothalamus, may become more reactive. Some people notice sweats from the very first nights; others do not notice anything until later.
What to do now: Start a simple log (see below), make your bedroom as cool as practical, and avoid making changes to the medicine. Many early side effects settle with time. If you are also struggling with stomach upset, see our guide on Lexapro and nausea.
Weeks 3 to 6: Settling, or not
This is when the pattern usually becomes clearer. Some people find the sweats gradually fade. Others find they stay about the same. This window is also when mood benefits often start to appear, which can make the trade-off feel more significant: the medicine is helping, but the nights are miserable.
What to do now: Compare your log from week one with now. Is it better, the same or worse? If it is the same or worse and affecting your sleep, it is reasonable to mention it to your prescriber.
After a dose increase
Prescribers often start escitalopram at a lower dose and increase it if needed. Because sweating can be dose-related, a step up can bring sweats back or make them worse, even if they had settled.
What to do now: Note the date of any dose change in your log. If sweating clearly worsened after an increase, that is particularly useful information for your prescriber.
Months 2 and beyond: The long-term pattern
If night sweats are still present after two or three months at a stable dose, they are less likely to resolve on their own. That does not mean you have to accept them. At this stage, a planned review is often the most useful step.
What to do now: Request a review if the sweats affect your sleep, energy, work or relationships, or if they are making you consider stopping the medicine.
When stopping or reducing Lexapro
Stopping escitalopram suddenly, or reducing the dose too quickly, can cause discontinuation symptoms. These can include dizziness, irritability, flu-like feelings, vivid dreams, “brain zaps” and, notably, sweating. This means sweating can paradoxically appear or worsen when coming off the medicine.
What to do now: Any reduction should be planned with your prescriber, usually as a gradual taper. Never stop because of sweats without medical guidance.
Is Lexapro the Cause? Five Questions to Ask Yourself
Work through these questions in order. They will not give you a diagnosis, but they will help you understand whether the medicine is the likely cause or whether something else needs checking.
1. Did the sweats start after Lexapro or a dose change?
If the answer is yes, and within days to weeks, escitalopram is a reasonable suspect. If you had night sweats before starting, or they began long after a stable period, look further.
2. Do you have any other new symptoms?
Fever, chills, cough, unexplained weight loss, swollen glands or persistent fatigue alongside night sweats should prompt a medical check-up, regardless of your medicines. These can point to infection or other conditions.
3. Could hormones be involved?
Perimenopause and menopause are among the most common causes of night sweats. Interestingly, escitalopram has been studied as a treatment for menopausal hot flushes and night sweats in some women, so the relationship can work in both directions. If you are in your 40s or 50s and notice changes in your periods or daytime hot flushes, hormones may be a significant factor. It is worth raising this specifically with your doctor.
4. What else has changed?
New medicines, supplements, alcohol habits, caffeine intake, a warmer bedroom, a new duvet, or increased stress can all cause or worsen sweating. A change in your thyroid, blood sugar control (particularly if you take diabetes medicines), or the onset of sleep apnoea can also contribute.
5. Is the sweating part of a bigger reaction?
Heavy sweating with agitation, confusion, a racing heart, fever, muscle stiffness or twitching, or diarrhoea may indicate serotonin syndrome, a rare but serious reaction. It is more likely when escitalopram is combined with other serotonin-affecting medicines such as triptans, tramadol, other antidepressants, lithium or St John’s wort. This needs emergency care.
Your Bedroom and Evening Audit
Before your review, run through this checklist. Small changes often reduce the severity of night sweats, even if they do not remove them.
| Area | Check | Possible improvement |
|---|---|---|
| Room temperature | Is the bedroom warm or stuffy? | Lower the heating, open a window, use a fan |
| Bedding | Heavy duvet, synthetic sheets? | Lighter, breathable layers; cotton, linen or bamboo |
| Sleepwear | Synthetic fabrics or heavy pyjamas? | Light, moisture-wicking or cotton sleepwear, or less clothing |
| Mattress and pillow | Memory foam that retains heat? | A cooling mattress topper or breathable pillow cover |
| Evening drinks | Alcohol, coffee, tea, energy drinks? | Cut back, particularly after mid-afternoon |
| Evening meals | Spicy food or large meals late? | Lighter, earlier dinners |
| Pre-bed routine | Hot bath, intense exercise late? | Lukewarm shower; exercise earlier in the day |
| Bedside | Nothing to hand when you wake? | Spare sleepwear, towel and water within reach |
Good sleep habits also help protect your mood, which is especially important while you are being treated for depression or anxiety. For more ideas, see our guide on natural ways to improve sleep.
Lexapro Night Sweats Log
Keep this for two weeks before your appointment. It takes a minute each morning.
| Date | Lexapro dose and time | Times woken sweating | Severity (damp / soaked / changed bedding) | Alcohol or caffeine | Room comfortable? | Other symptoms |
|---|---|---|---|---|---|---|
When to Request a Review
Ask your prescriber for a review if:
- Night sweats continue beyond about four to six weeks without improving
- They return or worsen after a dose increase
- They regularly wake you and leave you exhausted the next day
- Daytime sweating is affecting work, socialising or confidence
- You are tempted to skip doses or stop the medicine
- You have other symptoms that make you wonder whether something else is going on
Seek urgent help if sweating comes with signs of serotonin syndrome, palpitations or fainting, or if you are having thoughts of harming yourself. In the U.S., the 988 Suicide & Crisis Lifeline is available by call or text.
Five Conversations to Have With Your Prescriber
A review is not just “the sweating is bad, what now?” It usually involves a few separate decisions. Being ready for each makes the appointment more productive.
Conversation 1: “Is the benefit worth it?”
Start by describing how Lexapro is helping your mood or anxiety. This helps your prescriber weigh how much room there is to change things. If the medicine is working well, the focus may be on reducing the sweating while keeping the benefit.
Conversation 2: “Could the dose be adjusted?”
Because sweating with escitalopram appears to be more common at higher doses, a lower dose may reduce it for some people. Whether that is suitable depends on how your symptoms respond at the lower dose.
Conversation 3: “Would a different time of day help?”
Some people find taking escitalopram in the morning reduces night sweats; others find evening dosing works better overall. It is a low-risk change to discuss, but evidence is mostly anecdotal, and responses vary.
Conversation 4: “Should we try a different medicine?”
Switching to another antidepressant is an option, though sweating is common across many antidepressants, so a switch does not guarantee improvement. If you switch, your prescriber will plan the transition to avoid discontinuation symptoms. Our comparisons of Zoloft and buspirone give background on some alternatives used for anxiety.
Conversation 5: “Is there a treatment for the sweating itself?”
In some cases, where the antidepressant needs to continue and the sweating is severe, prescribers may consider an additional medicine aimed at the sweating. This is a case-by-case decision with its own side effects and is usually reserved for persistent, troublesome sweating.
What’s Happening Inside: The Thermostat Explanation
Your body keeps its core temperature within a narrow range using a control centre in the hypothalamus. When it senses you are too warm, it triggers sweating and widens blood vessels in the skin to release heat. Serotonin is one of the chemical messengers involved in setting that thermostat.
Escitalopram increases serotonin activity. In some people, this seems to lower the threshold at which the body decides it is “too hot,” so sweating switches on more easily. Serotonin also acts on the nerves that control sweat glands. At night, when body temperature naturally shifts through sleep stages and bedding traps heat, those small changes can be enough to trigger a full sweat.
This is also why environmental changes help: if the thermostat is more sensitive, reducing the heat around you means it is triggered less often.
When Night Sweats Feel Like Anxiety
Lexapro is often prescribed for generalised anxiety disorder and panic. For people with anxiety, waking suddenly soaked, with a pounding heart, can feel alarmingly similar to the symptoms they are being treated for. This can create worry that the medicine is not working or that anxiety is getting worse.
A few points can help:
- Sweating as a side effect usually happens without the sense of dread or racing thoughts that accompany panic.
- Keeping a log can show whether night sweats and anxiety episodes are actually linked or separate.
- Grounding techniques, such as slow breathing and noticing physical surroundings, can help settle the body after waking.
- Tell your prescriber if you cannot tell the difference, or if anxiety seems to be worsening. That information matters for your treatment.
Exercise and Sweating on Lexapro
Regular exercise is good for mood and sleep, and it is often recommended alongside antidepressants. Some people notice they sweat more heavily during exercise on escitalopram. Exercising earlier in the day, wearing breathable clothing, and staying well hydrated can help. Avoid intense workouts close to bedtime, as they can raise body temperature and make night sweats more likely.
Teenagers and Young Adults on Lexapro
Escitalopram is sometimes prescribed for adolescents with depression or anxiety. Young people may be embarrassed by sweating, particularly at school or around friends, and may quietly skip doses rather than mention it. Parents and carers can help by asking openly about side effects, normalising the conversation, and making practical changes such as a cooler bedroom and breathable bedding. Because antidepressants carry a warning about suicidal thoughts in young people, any change in mood, behaviour or sleep should be reported promptly, and a young person should never stop the medicine suddenly.
Older Adults and Lexapro
Older adults are often started on lower doses of escitalopram. Night sweats in an older person warrant a broader look, because other causes such as infection, thyroid changes or medicines for other conditions become more common with age. Older adults are also more prone to low sodium on SSRIs, which can cause confusion, unsteadiness or falls. Family members should watch for these changes and report them.
Myths About Lexapro Night Sweats
“Drinking less water will reduce sweating.”
Restricting fluids does not stop medicine-related sweating and risks dehydration. Keep drinking normally.
“If I stop Lexapro, the sweats will stop immediately.”
Stopping suddenly can cause discontinuation symptoms that include sweating, and risks a return of depression or anxiety. Any change should be planned with your prescriber.
“Everyone on Lexapro gets night sweats.”
Most people do not. Sweating is listed as common, but the majority of people taking escitalopram do not experience significant night sweats.
Lexapro vs Celexa for Sweating
Escitalopram is derived from citalopram (Celexa) and works in a very similar way. Both list increased sweating as a side effect. Some people find they sweat less on one than the other, but there is no reliable way to predict this in advance. If you have previously taken Celexa, tell your prescriber how you got on. For the citalopram-specific picture, see Celexa and night sweats.
Lexapro, Menopause and Hot Flushes: A Closer Look
The relationship between escitalopram and menopausal symptoms is genuinely two-sided. On one hand, SSRIs can cause sweating. On the other, low-dose escitalopram has been studied as a non-hormonal option for reducing hot flushes and night sweats in some women going through menopause, and some studies found that symptoms returned in a proportion of women after stopping it.
What this means in practice:
- If you are perimenopausal and started Lexapro, your night sweats could be hormonal, medicine-related, or a combination.
- Some women find escitalopram reduces menopausal sweats; others find it adds to them.
- If you stop escitalopram, hot flushes that it had been dampening may return.
- A doctor can help weigh up hormonal and non-hormonal options if menopause symptoms are significant.
A Bad Night: Step-by-Step
When you wake up drenched, having a plan reduces disruption and helps you get back to sleep faster.
- Stay calm. Remind yourself it is a known side effect.
- Cool down quickly. Throw off a layer, turn on the fan, or open a window.
- Change into dry clothes you have left within reach.
- Swap or cover damp bedding with a towel or a spare sheet.
- Sip water to replace fluids.
- Keep lights low and avoid your phone, which can make it harder to fall back asleep.
- Use slow breathing if your heart is racing: breathe in for four counts, out for six.
- Note it in your log in the morning, not in the middle of the night.
Your Pre-Appointment Checklist
- Two weeks of your night sweats log
- Dates of starting Lexapro and any dose changes
- A list of all medicines, supplements and herbal products
- Notes on alcohol and caffeine habits
- Any other symptoms: hot flushes, period changes, fever, weight change, palpitations
- How Lexapro is helping your mood or anxiety
- Your main goal: fewer sweats, better sleep, keeping the mood benefit
Other Safety Points Worth Knowing
- Low sodium: SSRIs can occasionally lower sodium levels, particularly in older adults. Confusion, headache, weakness or unsteadiness should be reported.
- Bleeding risk: SSRIs can increase bleeding risk, especially with anti-inflammatory painkillers or blood thinners.
- Heart rhythm: Escitalopram can affect heart rhythm in some people, particularly at higher doses or with other medicines that affect the QT interval. Report palpitations or fainting.
- Alcohol: Alcohol can worsen sweats, disturb sleep and affect mood. It is generally best avoided or limited while taking escitalopram.
- Young people: Antidepressants carry a warning about suicidal thoughts in children, teenagers and young adults, especially early in treatment.
Reliable Sources
For further information, see MedlinePlus: Escitalopram, the NHS escitalopram guide and the NHS overview of night sweats. Prescribing information is available on DailyMed.
Frequently Asked Questions
Do Lexapro night sweats go away?
Sometimes. For some people, sweating eases over the first several weeks. For others, it continues as long as they take the medicine. If it has not improved after a month or two, a review is worthwhile.
Is sweating on Lexapro a sign it’s working?
No. Sweating is a side effect and does not indicate whether the medicine is helping your mood or anxiety. Those are separate effects.
Can I take Lexapro in the morning to stop night sweats?
Some people find this helps. Discuss it with your prescriber before changing, then keep the new time consistent so you can judge the effect.
Does a lower dose of Lexapro cause less sweating?
Sweating was reported more often at higher doses in clinical studies, so a lower dose may help some people. Whether a lower dose is right for you depends on your symptoms; it is a decision to make with your prescriber.
Can I use antiperspirant for daytime sweating?
Yes. A clinical-strength antiperspirant applied at night to dry skin is often more effective than one applied in the morning.
Why am I sweating after stopping Lexapro?
Sweating can be a discontinuation symptom when escitalopram is stopped or reduced. It usually improves over time, but if it is troublesome, speak to your prescriber about the tapering plan.
Could my night sweats be menopause rather than Lexapro?
Possibly. Menopause is a very common cause of night sweats. Timing, other symptoms such as hot flushes and changes in periods, and your age can help your doctor work out which is more likely, or whether both play a part.
Do Lexapro night sweats mean I’m having serotonin syndrome?
Usually not. Isolated sweating is a common side effect. Serotonin syndrome involves sweating alongside other symptoms such as agitation, confusion, fever, a racing heart and muscle twitching or stiffness, and needs emergency care.
Takeaway
Night sweats on Lexapro are common, often appear in the early weeks or after a dose increase, and may fade or persist. Track them, optimise your sleep environment, and use the five self-check questions to spot other possible causes. If the sweats are still disrupting your nights after a month or so, or you are tempted to stop the medicine, request a review and go prepared to discuss dose, timing, alternatives and the balance of benefits. And never stop escitalopram suddenly; plan any change with your prescriber.
This article is for general information and does not replace professional advice. If you are worried about your mental health or any side effect, speak to your doctor, psychiatrist or pharmacist.
