Does Lexapro Cause Bipolar Disorder? (+3 Factors)

By Dr Drielli Vital-Fujii (PhD)

Page last updated: 02/01/2024 | Next review date: 02/01/2026

Author bio

Dr Drielli Vital-Fujii, PhD, is a Pharmacist with expertise in Drug Design and Development, Enzymes, Molecular Modelling, and Photodynamic Therapy. She writes and reviews content on these topics.

Dr Drielli Vital-Fujii’s Highlights:

Postdoctoral fellow at the Department of Biochemistry at the University of São Paulo, emphasizing therapy of neglected diseases using light.

PhD in Pharmaceutical Sciences focusing on drug design and development at the Faculty of Pharmaceutical Sciences of the University of São Paulo.

Six months as an international researcher at the Center for Discovery and Innovation in Parasitic Diseases (University of California San Diego)

Master’s degree in Pharmaceutical Sciences focusing on drug design and development at the Faculty of Pharmaceutical Sciences of the University of São Paulo.

Bachelor of Pharmacy at the University of Mogi das Cruzes – São Paulo / Brazil

Professional Experience:

2012 – 2018 Project manager at University of São Paulo – Pharmacy Department

Dr Drielli Vital-Fujii has worked with computational studies, synthesis, biological evaluation, design, and development of new inhibitor candidates for Chagas Disease and Leishmaniasis.

2017 – 2017 International research fellow at University of California San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences – Center for Discovery and Innovation in Parasitic Diseases.

She used Virtual Screening (VS) and High-Throughput Screening (HTS) Integration in the Discovery of new drugs against neglected tropical diseases (NTDs).

2018 – 2019 Faculdades Oswaldo Cruz

Dr Drielli Vital-Fujii was a professor in the Faculty of Pharmacy, teaching the subjects of Pharmaceutical Chemistry and Drug Development.

2019 – 2021 Researcher in Biochemistry University of São Paulo – Biochemistry Department

She applied Photodynamic Therapy in Leishmaniasis Treatment, mentored undergraduate students in scientific activities, and wrote, executed, translated, and reported scientific projects with funding agencies.

2023-2023 UniPiaget – University Center.

Dr Drielli Vital-Fujii was a Biology, Nutrition, Physiotherapy, and Pharmacy professor.

Education:

2018 -2021 Postdoctoral at the Department of Biochemistry at the University of São Paulo

2013 -2018 PhD of Science: Drugs and Medicines at Department of Pharmacy at University of São Paulo

2012 -2013 M.Sc. of Sciences: Drugs and Medicines at the Department of Pharmacy at the University of São Paulo

2005-2008 Bachelor of Pharmacy at the University of Mogi das Cruzes

The leading publications of Dr Drielli Vital-Fujii are:

Vital-Fujii, D.G, Baptista, M.S. (2021). Progress in the photodynamic therapy treatment of Leishmaniasis. Brazilian Journal of Medical and Biological Research, 54, 1-11.

Gatti, F. M., Gomes, R.A., da Fonseca, A.L., Lima, E.J.C., Vital-Fujii, D.G., Taranto, A.G., Varotti, F.P., Trossini, G.H.G. (2020). Antiplasmodial activity of sulfonylhydrazones: in vitro and in silico approaches. Future medicinal chemistry, 13, 233-250.

Silva, E.J., Bezerra-Souza, A., Passero, L.F., Laurenti, M.D., Ferreira, G.M., Fujii, D.G.V., et al. (2018). Synthesis, leishmanicidal activity, structural descriptors and structure-activity relationship of quinoline derivatives. Future medicinal chemistry, 10, 2069-2085.

Leite, F.H.A., Froes, T.Q., da Silva, S.G., de Souza, E.I.M., Vital-Fuji,i D.G., Trossini, G.H.G., et al. (2017). An integrated approach towards the discovery of novel non-nucleoside Leishmania major pteridine reductase 1 inhibitors. European Journal of Medicinal Chemistry, 132, 322-332.

Vital, D.G., Damasceno, F.S., Rapado, L.N., Silber, A.M., Vilella, F.S., Ferreira, R.S., et al. (2017). Application of bioisosterism in design of the semicarbazone derivatives as cruzain inhibitors: a theoretical and experimental study. Journal of Biomolecular Structure and Dynamics, 35, 1244–1259.

Mello, J. F.R., Gomes, R.A., Vital-Fujii, D.G., Ferreira, G.M., Trossini, G.H.G. (2017). Fragment-based drug discovery as alternative strategy to the drug development for neglected diseases. Chemical Biology & Drug Design, 90, 1067-1078.

Pantaleao, S.Q., Fujii, D.G.V., Maltarollo, V.G., da C. Silva, D., Trossini, G.H.G., Weber, K.C., et al. (2017). The Role of QSAR and Virtual Screening Studies in Type 2 Diabetes Drug Discovery. Medicinal Chemistry, 13, 706-720.

Vital, D., Arribas, M., Trossini, G. (2014). Molecular Modeling and Docking Application to Evaluate Cruzain Inhibitory Activity by Chalcones and Hydrazides. Letters in Drug Design and Discovery, 11, 249-255.

Blau, L., Menegon, R.F., Trossini, G.H.G., Molino, J.V.D., Vital, D.G., Cicarelli, R.M.B., et al. (2013). Design, synthesis and biological evaluation of new aryl thiosemicarbazone as antichagasic candidates. European Journal of Medicinal Chemistry, 67, 142-151.

You can view some of Dr Drielli’s work below and links to her professional profile.

Orcid: https://orcid.org/0000-0001-9270-0466

Research Gate: https://www.researchgate.net/profile/Drielli-Gomes-Vital-Fujii

Scopus: https://www.scopus.com/authid/detail.uri?authorId=55829534000

Google Scholar: https://scholar.google.com/citations?user=F9U50AEAAAAJ&hl=pt-BR

Linkedin: linkedin.com/in/driellivital

Escavador: https://www.escavador.com/sobre/6101380/drielli-gomes-vital

CDIPD: https://cdipd.org/index.php/about-us/visiting-scientists

Dr Drielli Vital-Fujii (PhD)

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In this article, we will discuss Lexapro (Escitalopram) induced bipolar disorder. We will also discuss some research studies and how to manage if this side effect occurs.

Does Lexapro cause bipolar disorder?

Lexapro (Escitalopram) does not cause bipolar disorder and this is not a commonly reported side effect. However, it can aggravate the symptoms of an already existing bipolar disorder.

Lexapro, a selective serotonin reuptake inhibitor, is generally used for the treatment of anxiety or depression (1). It is not known to cause bipolar disorder. However, there have been some reports of antidepressants, like Lexapro, potentially triggering manic or hypomanic episodes in individuals who have a predisposition to bipolar disorder.

In some cases, individuals with bipolar disorder may initially be misdiagnosed with unipolar depression (major depressive disorder) because the depressive episodes are more prominent and they seek treatment for depression.

If such individuals are prescribed an antidepressant like Lexapro without a mood stabilizer, it can potentially lead to a manic or hypomanic episode.

Therefore healthcare professionals must conduct a thorough evaluation of a person’s mental health history and symptoms before prescribing medications like Lexapro.

What does research suggest?

There is a limited study indicating Lexapro-induced dipolar disorder. Bipolar disorder is a mental health condition characterized by extreme mood swings between manic and depressive episodes.

One study indicated that manic episodes occurred when the dose of Lexapro was increased in depressed patients. Although Lexapro is generally well-tolerated, close monitoring is necessary for any signs of mania (2).

Another study also indicated the dose-dependent occurrence of bipolar disorder in patients taking Lexapro to treat depression. The researchers suggested that to reduce the chances of mood shifts in patients with bipolar depression or major depressive disorder, it may be wise to start treatment at lower doses and gradually increase them with caution (3).

Another study indicated that bipolar disorder may be produced when people abruptly stop using psychiatric medication like Lexapro. This shows that long-term use of this medication makes the body’s system fragile and easily disrupted by sudden discontinuation (4).

If you have concerns about the potential for bipolar disorder or other mood-related disorders like anger while using Lexapro, it is important to discuss it with your healthcare provider.

What factors can contribute to bipolar disorder while taking Lexapro?

While there is no definitive way to predict the development of bipolar disorder, there are certain risk factors that may increase the likelihood of developing bipolar disorder while taking Lexapro or other antidepressants. These risk factors include:

Family history: Having a history of bipolar disorder increases the risk of developing this condition. Genetic factors can play a role in the development of bipolar disorder.

Personal history: If you have a personal history of manic or hypomanic episodes, even before taking Lexapro, you may be at a higher risk.

Misdiagnosis: Being initially misdiagnosed with unipolar depression when you actually have bipolar disorder can lead to an increased risk. Prescribing an antidepressant without a mood stabilizer to someone with undiagnosed bipolar disorder can trigger manic or hypomanic episodes.

Stress: High levels of stress or traumatic life events may contribute to the onset of bipolar disorder in individuals who are genetically predisposed.

Substance abuse: Alcohol or other drug abuse can increase the risk of developing bipolar disorder or trigger manic episodes.

Co-occurring mental health conditions: Underlying mental health conditions, such as anxiety disorders, may increase the risk of developing mood episodes while on antidepressant medications.

It is essential to work closely with a healthcare provider who can conduct a thorough evaluation of your mental health history and symptoms before prescribing or adjusting medication.

Discontinuation syndrome

Skipping the doses or abrupt discontinuation of Lexapro without consulting your healthcare provider can lead to discontinuation syndrome characterized by symptoms such as (5):

Hallucinations
Agitation
Headache
Tremors
Mood disorders

What to do if Lexapro causes bipolar disorder?

If you are experiencing bipolar disorder while taking Lexapro, reach out to your healthcare provider. They will conduct a thorough evaluation to determine whether Lexapro is the causative agent.

Your healthcare provider may recommend adjusting the dose of the medication to see if it works for you. If dose adjustment does not work, they may discontinue Lexapro and switch to another treatment plan, such as:

Mood stabilizers:

Lithium
Valproate (Depakote)
Lamotrigine.

Antipsychotic medications:

Aripiprazole (Abilify)
Quetiapine (Seroquel)
Olanzapine (Zyprexa)

Depending on the severity of the symptoms, you might be referred to a psychiatrist for further evaluation and treatment.

Conclusion

In my opinion, Lexapro (Escitalopram) does not cause bipolar disorder as a side effect but it has the ability to aggravate the symptoms of pre-existing bipolar disorder. If you have concerns about the impact of Lexapro on your mental health, I suggest discussing them with your healthcare provider to determine the best course of action.