Does Lexapro Cause Psychosis? (3+ Risk Factors)

By Ivan Kahwa

Page last updated: 05/02/2024 | Next review date: 05/02/2026

Author bio

Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.

Mr Ivan Kahwa’s Highlights:

Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.

Professional Experience:

Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.

With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.

With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.

Education:

2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.

2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.

2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.

Publications:

▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7

▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60

▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.

https://ethnobotanyjournal.org/index.php/era/article/view/4683

▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.

https://doi.org/10.53388/TMRIM202307004

▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.

https://doi.org/10.1186/s43094-021-00296-2

▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.

https://doi.org/10.5799/jmid.951600

Published book Chapter

▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.

https://doi.org/10.1016/B978-0-323-91942-5.00012-4

Submitted manuscripts Under Review:

▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience

▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine

▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology

Submitted book chapters under review

1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.

2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press

You can view my works on the following professional sites:

Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa

Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en

ORCID: https://orcid.org/0000-0002-6440-3437

Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159

Ivan Kahwa

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In this article, we will discuss whether Lexapro causes psychosis as a potential side effect or not. We will also discuss what research suggests on this, the link between Lexapro and psychosis, symptoms of psychosis related to Lexapro usage, risk factors of developing psychosis while on Lexapro and management and treatment options for psychosis caused by Lexapro.

Does Lexapro cause psychosis?

Yes, Lexapro may cause psychotic symptoms in some individuals as a rare side effect. Although it’s extremely uncommon, there have been some rare reports of antidepressants including SSRIs like Lexapro being associated with the development of psychosis. (1)

Lexapro (escitalopram) is an antidepressant primarily used for the treatment of depression and anxiety. It belongs to the class of drugs known as selective serotonin reuptake inhibitors SSRIs, which work by increasing the levels of a neurotransmitter in the brain called serotonin that helps boost mood. (3)

Psychosis is a mental health condition which may disconnect a person from reality. Individuals who are experiencing psychosis may have altered thoughts, perceptions and emotions that can significantly impair their ability to function normally in their daily lives. They might see, hear or believe things that aren’t real. (4)

Physhosis is not a typical side effect of Lexapro. However, it’s important to note that individual responses to medications can vary and some rare reactions may occur.

If you or someone you know is experiencing symptoms of psychosis such as delusions or hallucinations, it’s important to seek medical attention promptly.

How does Lexapro cause psychosis?

The exact mechanisms by which antidepressants like Lexapro might lead to psychosis as a side effect are not fully understood. However, there are some theoretical explanations for how such side effects could occur.

Lexapro (escitalopram) like other SSRIs works by increasing the levels of serotonin in the brain. In some cases, this increase in serotonin may lead to an imbalance in other neurotransmitters like dopamine. Disruptions in dopamine levels can lead to psychotic symptoms in a person. (3,5)

People’s brains can respond differently to medications. Some individuals may be more sensitive to imbalances in neurotransmitter levels than others. Their genetic factors or other individual differences could contribute to the risk of psychosis. (5)

In some cases, If an individual has a pre-existing psychiatric condition then antidepressants may not directly cause psychosis but rather they could exacerbate the symptoms of an underlying condition.

What does research suggest?

According to research, more and more people are using antidepressants like SSRIs because they are safe and well-tolerated. However, this has led to concerns about an increase in negative reactions to these drugs. (2)

In a study, the psychiatric units of a general hospital were reviewed for 14 months. The researchers found that 8.1% of patients (43 out of 533) were admitted because they were experiencing mania and psychosis related to taking antidepressants like Lexapro. (2)

It’s crucial for individuals taking antidepressants to communicate openly with their healthcare providers about any changes in symptoms or unusual reactions to the medication.

What are the symptoms of psychosis related to Lexapro usage?

Symptoms of psychosis might include: (6)

Hallucinations: Seeing, hearing, feeling or smelling things that others do not. Auditory hallucinations can occur with other types of antidepressants as well like Wellbutrin (bupropion) but it’s very rare.
Delusions: Holding false and strong beliefs that are not based on reality.
Disorganized thinking: Finding it hard to organize thoughts or speak clearly.
Paranoia: Feeling suspicious or extreme distrust, like everyone is against them for no reason.
Disrupted behaviour: Unusual behaviour, doing things that are not common for them.

It’s important to understand that these symptoms are not common side effects of Lexapro. These symptoms could be indicative of some serious reaction or an underlying condition that may need immediate medical attention.

What are the risk factors for psychosis induced by Lexapro?

Risk factors that could potentially contribute to the development of psychosis while taking Lexapro in rare cases, may include: (5,6)

Individual variations: People respond differently to medications and individual differences in brain chemistry may play a role. Some individuals are more sensitive to neurotransmitter imbalance than others.

Pre-existing psychiatric conditions: Individuals with a history of bipolar disorder or schizophrenia may be at a higher risk of experiencing psychotic symptoms.

Personal or family history: A personal or family history of mental health disorders especially those involving psychosis, may increase the risk.

Drug interactions: If you’re taking other medications or substances that could interact with Lexapro, the risk of adverse effects including psychosis greatly increases.

Underlying medical conditions: If you are experiencing certain medical conditions that affect the brain, it may increase susceptibility to adverse reactions.

Age: The risk of developing psychosis is higher in young adults as it is a critical period for brain development. Some mental health disorders including schizophrenia often emerge during this time. However, in older adults dementia or delirium can contribute to psychosis.

If you are experiencing symptoms of psychosis or if there are concerns about mental health, regardless of age, it’s important to seek professional help.

What are the treatment options for Lexapro-induced psychosis?

Psychosis caused by Lexapro (escitalopram) is very rare. However, treatment options for psychosis may include: (7)

Discontinuation of Lexapro: In some cases, healthcare providers decide to stop or reduce the dose of Lexapro to see if the psychotic symptoms resolve. However, this decision should be made by a qualified healthcare professional.

Switching to another medication: Depending on the individual’s mental health needs, the healthcare provider may consider switching to a different antidepressant or adjusting the treatment plan.

Antipsychotic medications: If the psychotic symptoms are severe then antipsychotic medications can be prescribed. These medications can address the symptoms like hallucinations and delusions. (6)

Psychotherapy: Supportive counselling, such as talking to a therapist can help deal with the emotions and thoughts associated with psychotic symptoms.

If you are experiencing symptoms of psychosis, talk to your doctor right away. Early intervention and appropriate treatment can significantly improve outcomes for individuals experiencing psychotic symptoms.

In my opinion, it’s important to prioritise your mental health and seek professional guidance when facing any concerns or unusual experiences, especially while taking medications like Lexapro.

While the occurrence of psychosis due to Lexapro is exceptionally rare, it’s important to be aware of potential symptoms and act promptly if they arise. Remember that everyone’s experience is unique and personalized care is vital in addressing individual’s needs and promoting overall well-being.