Does Lexapro Cause PVCS? (+10 Helpful Tips)

In this article, we will discuss the potential connection between Lexapro (Escitalopram) and the incidence of Premature Ventricular Contractions (PVCs). 

Does Lexapro Cause PVCs?

Lexapro (Escitalopram) is not commonly associated with causing Premature Ventricular Contractions (PVCs) and there is limited evidence to suggest a direct link between Lexapro use and the development of irregular heartbeats.

PVCs refer to early heartbeats initiated by the Purkinje fibres rather than the SA (sinoatrial) node. There is a pause before the subsequent regular heartbeat since a PVC happens before a regular heartbeat. PVCs can appear singly or repeatedly in patterns (1). 

The most common sensation associated with PVCs is a sensation of fluttering that is followed by a missed heartbeat. Heart palpitations are a common complaint among patients. Since the palpitations are not accompanied by any symptoms, the great majority of individuals are completely asymptomatic (1). 

Lexapro (Escitalopram) is primarily prescribed for the treatment of major depressive disorder and generalized anxiety disorders. It is also used off-label in the treatment of social anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder, panic disorder, vasomotor symptoms of menopause, and premenstrual dysphoric disorder (2).  

However, like any medication. Lexapro can have varying effects on different individuals, and there have been isolated reports of patients experiencing changes in heart rhythm or heart palpitations while taking this medication. It is crucial to understand that these instances are rare, and the medication is generally considered safe when taken as prescribed (3,4). 

How Lexapro use increase the risk of PVCs?

The exact mechanism, through which Lexapro might contribute to PVCs is not fully understood. However, it is theorized that changes in neurotransmitter levels, electrolyte imbalances, or individual patient factors could play a role. 

Patients with a history of heart conditions, electrolyte imbalances, or those who take other medications that may affect heart rhythm could potentially be at a higher risk. Therefore, a thorough medical evaluation is essential before initiating Lexapro, especially for individuals with known cardiac issues. 

Patients prescribed Lexapro should have regular follow-up appointments with their healthcare provider to monitor for any appointments with their healthcare provider to monitor potential side effects, including changes in heart rhythm. If you are experiencing palpitations, dizziness, or other symptoms suggestive of PVCs, seek medical attention immediately. 

In cases where Lexapro is suspected to be contributing to PVCs, the healthcare provider may consider adjusting the dosage, switching medications, or implementing additional monitoring to ensure patient safety. 

What are the common side effects of Lexapro?

Some common side effects of Lexapro are as follows (2):

  • Nausea
  • Headache
  • Drowsiness
  • Insomnia
  • Fatigue
  • Sweating 
  • Dry mouth
  • Reduced appetite
  • Increased anxiety or restlessness

Serious side effects include

  • Serotonin syndrome
  • Suicidal thoughts
  • Bleeding
  • Mania


Stopping Lexapro suddenly can result in withdrawal symptoms. To prevent this, the dose should be gradually reduced under the guidance of a healthcare provider (2). 

What are the underlying potential causes of PVCs?

PVCs can be associated with various underlying conditions or triggers. Here are some potential causes and contributing factors:

  • Heart diseases such as ischemic heart disease, cardiomyopathy, heart valve disease, and heart failure.
  • Hugh blood pressure
  • Electrolyte imbalance
  • Medications
  • Stimulants such as caffeine, alcohol, tobacco, and certain over-the-counter medications like cough and cold medicines. 
  • Increase adrenaline due to exercise, stress or anxiety.
  • Structural changes in the heart are possibly due to previous heart attacks or other heart conditions. 
  • Viral infections that affect the heart.
  • Sleep apnea can increase the risk of PVCs.
  • Genetic factors can also contribute to PVCs.
  • Idiopathic (of unknown origin).

What are some helpful tips to reduce the occurrence of PVCs? 

Experiencing PVCs can be unsettling, but there are steps you can take to manage them and potentially reduce their occurrence. Some helpful tips are as follows:

  • If you are experiencing PVCs frequently or if they are accompanied by symptoms like dizziness, chest pain, or shortness of breath, consult a healthcare provider for a thorough evaluation. 
  • Keep a note of when the PBVs occur, noting any potential triggers like caffeine intake, stress, or lack of sleep. 
  • Practice stress-reducing techniques such as deep breathing, meditation, yoga, or progressive muscle relaxation.
  • Adopt a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. 
  • Ensure regular physical activity, but consult with your doctor regarding the appropriate level of exercise for you. 
  • Maintain a healthy weight.
  • Cut back on or eliminate caffeine, nicotine, and alcohol, as they can trigger PVCs. 
  • Drink plenty of water throughout the day.
  • Ensure you are getting enough restful sleep each night. Address any sleep disorders, such as sleep apnea, with your healthcare provider. 
  • Some cold and cough medications contain stimulants that could increase the risk of PVCs. Read labels carefully to consult with your healthcare provider if you are unsure. 
  • Review all your current medications with your healthcare provider to ensure that they are not contributing to your PVCs. 
  • If PVCs are frequent or bothersome, a referral to a cardiologist for further evaluation and management might be beneficial. 
  • Practices like mindfulness and relaxation techniques can help calm the nervous system and may reduce the frequency of PVCs. 


While Lexapro is not commonly associated with PVCs, patients need to be vigilant and monitor for any potential cardiac symptoms. Timely medical evaluation and appropriate management may help reduce risks and ensure that you receive the most suitable and safe treatment for your mental health conditions.

As with any medication, the benefits of Lexapro should be weighed against the potential risks, and decisions should be made collaboratively between you and your healthcare provider. 

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Farzam K, Richards JR. Premature Ventricular Contraction. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from:


Landy K, Rosani A, Estevez R. Escitalopram. [Updated 2023 Jan 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from:


Qirjazi E, McArthur E, Nash DM, Dixon SN, Weir MA, Vasudev A, Jandoc R, Gula LJ, Oliver MJ, Wald R, Garg AX. Risk of Ventricular Arrhythmia with Citalopram and Escitalopram: A Population-Based Study. PLoS One. 2016 Aug 11;11(8):e0160768. doi: 10.1371/journal.pone.0160768. PMID: 27513855; PMCID: PMC4981428.


Aakjær, M, Werther, SK, De Bruin, ML, Andersen, M. Serious arrhythmia in initiators of citalopram, escitalopram, and other selective serotonin reuptake inhibitors: A population-based cohort study in older adults. Clin Transl Sci. 2022; 15: 2105-2115. doi:10.1111/cts.13319

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