Can Lexapro cause nightmares?
By
Dr Milena Locci de Oliveira (PhD)
Author bio
Dr Milena Locci de Oliveira is a Pharmacist and Doctor of Philosophy in Sciences from the University of São Paulo (USP). She has experience in microbiology, analytical toxicology, and clinical pharmacokinetics. She writes and reviews content on these topics.
Dr Milena’s Highlights:
-PhD in Sciences, University of São Paulo, Brazil, 2019.
-University College London (UCL) – Semester of remote collaboration in the areas of Pharmacometrics and Population Pharmacokinetics, 2018.
-Bachelor in Biochemical Pharmacy, University of São Paulo, Brazil, 2013.
“Science can be translated, and it is essential that everyone has access to quality information to make informed decisions” – Dr Milena Oliveira, PhD.
Professional Experience:
With a decade-long career as a researcher, Dr Milena has amassed extensive experience in conducting research projects in microbiology, analytical toxicology, and clinical pharmacokinetics.
Her expertise also extends to the preparation of technical and scientific reports, literature reviews, data analysis, and scientific communication, both oral and written.
Dr Milena has served as a Clinical Pharmacist, providing expert supervision and guidance to teams during the challenging times of the COVID-19 pandemic, particularly in the ICUs of two reference hospitals for patient hospitalization.
In her most recent role, Dr Milena worked on the implementation of the deliberatives of the São Paulo State Government Pharmaceutical Assistance Coordination. These decisions were aimed at ensuring medication access within the Unified Health System.
A widely multidisciplinary background enabled Dr Milena to become a professional capable of integrating scientific knowledge into private initiatives, education, and healthcare, delivering consistent services in patient safety and population health.
Professional Memberships & Affiliations:
Dr Milena Oliveira is a member of the Regional Council of Pharmacy of the State of São Paulo, Brazil.
Education:
-PhD in Sciences, University of São Paulo, Brazil, 2019.
-University College London (UCL) – Semester of remote collaboration, 2018.
-Bachelor in Biochemical Pharmacy, University of São Paulo, Brazil, 2013.
Relevant Published Work & Citations:
Oliveira ML de, Rocha A, Nardotto GHB, Pippa LF, Simões BP, Lanchote VL. Analysis of daunorubicin and its metabolite daunorubicinol in plasma and urine with application in the evaluation of total, renal and metabolic formation clearances in patients with acute myeloid leukemia. Journal of Pharmaceutical and Biomedical Analysis. Nov 2020. 191:113-124.
Abstracts. CPT: Pharmacometrics & Systems Pharmacology. 2020 Nov; 9 (S1).
Pippa LF, Oliveira ML de, Rocha A, de Andrade JM, Lanchote VL. Total, renal and hepatic clearances of doxorubicin and formation clearance of doxorubicinol in patients with breast cancer: Estimation of doxorubicin hepatic extraction ratio. Journal of Pharmaceutical and Biomedical Analysis. 2020 Jun 5; 185:113-231.
Godoy ALPC, De Jesus C, De Oliveira ML, Rocha A, Pereira MPM, Larangeira DF, Lanchote VL, Barrouin-Melo SM. Determination of Allopurinol and Oxypurinol in Dogs Plasma by High-Performance Liquid Chromatography with an Ultraviolet Detector: Application for Pharmacokinetic Studies. J Chromatogr Sep Tech. 2017; 8 (4).
Clímaco EC, Oliveira ML de, Pitondo-Silva A, Oliveira MG, Medeiros M, Lincopan N, et al. Clonal complexes 104, 109 and 113 playing a major role in the dissemination of OXA-carbapenemase-producing Acinetobacter baumannii in Southeast Brazil. Infection, Genetics and Evolution. 2013 Oct;19:127–33.
Conference Papers:
Oliveira, M. L.; NARDOTTO, G. H. B.; PIPPA, L. F.; ROCHA, A.; SIMOES, B. P.; LANCHOTE, V. L. . Daunorubicin metabolism and urinary excretion in patients with acute myeloid leukemia. In: 84th Annual Meeting of the German Society for Experimental and Clinical Pharmacology and Toxicology (DGPT) and the 20th Annual Meeting of the Association of the Clinical Pharmacology Germany (VKliPha), 2018, Göttingen. Naunyn-Schmiedeberg’s Arch Pharmacol, 2018. v. 391. p. S76-S76.
Oliveira, M. L.; NARDOTTO, G. H. B. ; ROCHA, A. ; SIMOES, B. P. ; LANCHOTE, V. L. . The low contribution of urinary excretion in the elimination of daunorubicin and its metabolite daunorubicinol in patients with acute myeloid leukemia. In: 49th Brazilian Congress of Pharmacology and Experimental Therapeutics., 2017, Ribeirão Preto. Livro de Resumos, 2017. p. 64-64.
Oliveira, M. L.; PIPPA, L. F. ; ROCHA, A. ; SIMOES, B. P. ; LANCHOTE, V. L. . Quantification of daunorubicin and its metabolite daunorubicinol in human plasma by LC-MS/MS. In: I International Meeting of Environmental Health and Toxicology (IMEHTOX), 2016, Ribeirão Preto. Livro de Resumos, 2016.
Oliveira, M. L.; Clímaco, E.C. ; OLIVEIRA, M. G. ; Lincopan, N. ; Darini A.L.C. . PFGE typing of Carbapenem-Resistant Acinetobacter baumannii isolated from different University Hospitals. In: V International Postgraduate and Research Symposium, 2012.
Clímaco, E.C. ; SILVA, A. P. ; Oliveira, M. L. ; OLIVEIRA, M. G. ; Lincopan, N. ; Darini A.L.C. Relação clonal entre linhagens de Acinetobacter baumannii produtoras de carbapenemases da família OXA em quatro hospitais no Brasil. In: XXI Latin American Congress of Microbiology, 2012, Santos. XXI Latin American Congress of Microbiology, 2012.
Oliveira, M. L.; Clímaco, E.C. ; OLIVEIRA, M. G. ; Darini A.L.C. . Dissemintion of OXA carbapenemases genes in carbapenem-resistant Acinetobacter baumannii in University Hospital of Juiz de Fora, MG. In: 8th CIFARP – International Congress of Pharmaceutical Sciences, 2011, Ribeirão Preto.
Clímaco, E.C. ; Oliveira, M. L. ; OLIVEIRA, M. G. ; Darini A.L.C. . Avaliação do sequenciamento parcial do gene rpoB e de seus flanqueadores para identificação de espécies de Acinetobacter na rotina laroratorial. In: 2° International Symposium on Clinical Microbiology, 2010, Florianópolis.
You can view some of Dr Milena’s work below and links to her professional profile.
Linkedin: https://www.linkedin.com/in/dra-milena-locci-de-oliveira-28986042/?locale=en_US
ResearchGate: https://www.researchgate.net/profile/Milena-Oliveira-6
Escavador: https://www.escavador.com/sobre/5394254/milena-locci-de-oliveira
Lattes: https://buscatextual.cnpq.br/buscatextual/busca.do
Scopus: https://www.scopus.com/authid/detail.uri?authorId=57199779361
Scholar: https://scholar.google.com/citations?view_op=list_works&hl=pt-BR&user=1YUBDIQAAAAJ
Can Lexapro cause nightmares?
Yes, Lexapro and other SSRIs are associated with nightmares and generally longer, vivid, and emotional dreams. This is because medications like Lexapro affect your sleep architecture and normal psychological functioning (1).
When your nervous system tries to adjust to the medication, that’s when people normally experience more intense and violent nightmares. This usually happens when you’re just starting your journey with Lexapro or when your dose is escalated.
Either way, most people experience nightmares throughout the course of their treatment, with varying intensities.
The incidence of nightmares on Lexapro
The incidence of nightmares as a side effect of Lexapro is relatively low, meaning it does not occur in a significant number of people. However, it is still listed as a possible side effect because a small percentage of individuals have reported experiencing this symptom (2).
Generally, SSRI antidepressants can cause nightmares, including other commonly prescribed SSRIs like Zoloft, Prozac, etc. If you are concerned about the possibility of nightmares while taking Lexapro, it’s best to discuss your concerns with your healthcare provider.
Possible mechanisms of Lexapro-induced nightmares
The exact mechanisms by which Lexapro may contribute to nightmares are not fully understood. However, there are a few theories that could help explain this possible connection:
Impact on Serotonin
Lexapro, being an SSRI, works by increasing the levels of serotonin, a neurotransmitter, in the brain. Serotonin plays a role in regulating sleep cycles and dreaming.
It is believed that the increase in serotonin levels caused by Lexapro may influence the content or intensity of dreams, including the occurrence of nightmares (2,3).
Sleep Architecture
Lexapro can potentially affect the structure and quality of sleep. Sleep consists of different stages, including rapid eye movement (REM) sleep, which is associated with dreaming (1,4).
Some studies suggest that Lexapro might impact REM sleep, potentially leading to changes in dream patterns, including the occurrence of nightmares.
Individual Sensitivity
Each person’s brain chemistry and response to medications can vary. Some individuals may be more susceptible to experiencing certain side effects, including nightmares while taking Lexapro (2).
Factors such as personal predisposition, underlying mental health conditions, and individual differences in how the body processes medications can influence the occurrence of nightmares.
What to do if Lexapro causes nightmares?
There’s not much you can do to get rid of nightmares except for stopping the use of Lexapro. Nightmares on Lexapro are extremely common. Some people may get better on their own when they adjust to the medication or to their newly increased dose.
However, increasing the dose gradually and not making longer jumps can help prevent these nightmares from coming back if you do get rid of them after adjusting to the medication.
These side effects are always expected from antidepressants and most doctors discuss them prior to prescribing the medication. Make sure you talk to your doctor if your nightmares are intense and unbearable.
I don’t recommend stopping Lexapro abruptly. Doing so will cause withdrawal symptoms which could be worse than your nightmares.
Your doctor may switch you to another antidepressant, but other SSRIs will most likely cause a similar problem. I recommend giving some time to Lexapro, especially if you’re new to this medication or antidepressants in general.
Lexapro is a well-tolerated antidepressant and is considered safer than other options available out there. See if it works well for your depression and makes you feel better. It if does elevate your mood and diminish depression, your nightmares may go away.
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References
1.-
Wichniak A, Wierzbicka A, Walęcka M, Jernajczyk W. Effects of Antidepressants on Sleep. Curr Psychiatry Rep. 2017 Aug 9;19(9):63. doi: 10.1007/s11920-017-0816-4. PMID: 28791566; PMCID: PMC5548844. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5548844/
2.-
Landy K, Rosani A, Estevez R. Escitalopram. 2022 Oct 24. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 32491666. https://www.ncbi.nlm.nih.gov/books/NBK557734
3.-
Garnock-Jones KP, McCormack PL. Escitalopram: a review of its use in the management of major depressive disorder in adults. CNS Drugs. 2010 Sep;24(9):769-96. doi: 10.2165/11204760-000000000-00000. PMID: 20806989. https://pubmed.ncbi.nlm.nih.gov/20806989/
4.-
Nicolas A, Ruby PM. Dreams, Sleep, and Psychotropic Drugs. Front Neurol. 2020 Nov 5;11:507495. doi: 10.3389/fneur.2020.507495. PMID: 33224081; PMCID: PMC7674595. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7674595/
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