The first week on Lexapro was rough to say the least, though it wasn’t unbearable. My doctor had told me it could take up to 4 weeks to begin to feel improvement, but that 6-8 weeks is the norm. While that timeline isn’t the longest, it can feel like an eternity when you’re dealing with side effects. My first week consisted of fatigue, nausea, insomnia, dry mouth, low libido, increased anxiety, lack of motivation, and spaciness. Most of the more irritating symptoms have thankfully subsided, but unfortunately a few remain and feel more present than ever.
Dry mouth persisted throughout the second week, but it became much less noticeable and much more bearable as I continued to hydrate. The first COVID saliva test I’d taken on Lexapro was so difficult. That was during the first week on the medication but luckily I had a strategy going into the second one. As gross as it sounds, it was so much easier to “save spit” while I waited in line. Not glamorous, I know, but when you can’t create saliva quickly enough to spit into a tube it helps to just let it collect for a few minutes until the time to spit in the tube comes. If you’re suffering from dry mouth for any reason, this could help you for your next COVID test.
Luckily, the fatigue caused by the pill didn’t disrupt my day throughout the second week, but the insomnia was unfortunately still present. Before starting Lexapro, I was struggling with anxiety-induced insomnia and hoped that starting medication while working on my anxiety would help. Unfortunately, one of the side effects of SSRI’s is increased anxiety, which obviously does not help with insomnia caused by anxiety. Insomnia is also a common side effect from SSRI’s but is said to be part of the adjustment period. This period can last for several weeks for some, but may only be a couple weeks for others. It’s completely individual, so you can’t really compare journeys as far as certain side effects go. That being said, I’m hopeful that my sleep will improve with time and consistent medication use. I’m theorizing that my insomnia will decrease as my anxiety levels out. For now though, I just have to push through it.
To deal with the insomnia, I’ve tried various things. Nothing has gotten me a full night’s sleep, but I am just grateful to get some rest every night. Melatonin has been helpful for some people, but personally I’ve not had much help from melatonin since my freshman year of college 3 years ago. I do, however, like the Irwin Naturals CBD and melatonin combo supplement. The serving size is 4 capsules, but prior to my insomnia I found that 2 would knock me out. With insomnia, I take all 4 and I can get a few hours of sleep before I wake up. Sometimes I fall back asleep for an hour or so and other times I lay awake and restless until the sun rises. I definitely like these supplements to help me get to sleep though.
On other nights, I use ZZZquil sleep aids. These don’t interact with the Lexapro in a dangerous way, so I’ve liked using them. Most nights they get me to sleep within the hour after taking them. I am more careful with these since they aren’t supposed to be taken long term. I also don’t take these sleep aids if I’ve consumed alcohol that day. In those cases, I prefer to take the CBD, though I will say the label on the Irwin Naturals bottle does say to avoid taking them with alcohol. (I want to note that it isn’t recommended to drink with Lexapro and various doctors will offer different guidance. I would recommend discussing this with your doctor and if you have determined that you can drink on Lexapro or another SSRI, please proceed slowly and with caution. It affects everyone differently. Make sure to pay attention to how you feel and drink much less than you usually would to gauge how you react.) After research, though, the main reason to avoid them with alcohol is heightened impairment and fatigue, which is a risk I take because I only take them if I can’t get to sleep. That being said, always consult your doctor for medication combinations. I ask my doctor before I mix anything and she probably thinks I’m paranoid, but I’m okay with that.
During the second week, my other biggest symptom was increased anxiety. It has caused and still does cause me to feel a bit shaky. I find that I can combat this symptom with walks outside to get a chai latte or see houses in my neighborhood. I tend to listen to a podcast as well because it helps to get my mind off of being anxious. Even though nothing is actively causing me to have anxiety, I know my body is just adjusting to the serotonin levels in my brain. Reminding myself of this fact and the notion that it’s just temporary also prevents me from feeling more anxiety myself. The increase in anxiety isn’t constant and comes at random times, but I can always tell when it’s coming and that it’s due to the medication and not a life trigger. When starting an SSRI, it’s prudent to pay attention to your body and make note of how you’re feeling so that you can discuss it with your doctor and have a written record of your symptoms. It can also help to later establish that it isn’t the right medication for you or, in my case, help you remember that the medication is changing the way your brain works and you aren’t just “anxious for no reason.” While it’s important to stick with a medication to allow it to work, it’s also important to listen to your own body.
*Content warning for following text: sex*
Unfortunately, another persistent side effect has been a low libido. I was hoping and praying that I would just skip this symptom, but I wasn’t that lucky. I do, however, have a very understanding partner that wants to work with me to figure it out and doesn’t make me feel like I’m broken. It’s definitely frustrating to discover that all of a sudden you can’t orgasm like you had previously. I will say, some people note that this side effect was temporary for them and eventually returned while still on medication. Others say it didn’t come back until after they got off the medication. Whatever the case, there is a light at the end of the tunnel. As I struggled with this symptom, I realized that the desire to orgasm can sometimes cloud the actual experience of having sex. Sex can be so much more than just the orgasm at the end and lasting longer isn’t such a bad thing. It can be disappointing to think about not being able to orgasm or having an extreme delay, but this gives you the opportunity to learn more about yourself and what you like, as well as what it might take to get you there.
If you have a partner, make sure to discuss this with them. Tell them how your medication might affect you and prepare them. That gives you room to figure out new fun things to try. If you haven’t used toys with a partner before, now might be the perfect time to try. If there are positions and other things you want to try with your partner, do it now! There’s no time like the present, especially when you aren’t focused on just one aspect of sex. I’ve found that being open helps you have much more fun. And if you don’t have a steady partner, there’s no reason you can’t experiment “solo.”
Most importantly, you’ve got to do what’s best for you. If you find that you can’t deal with the sexual side effects, there are always other options. Your doctor might prescribe you a supplemental medication that can help with these side effects or you may find yourself switching medications. There’s nothing wrong with that either. One size definitely does not fit all, so if you hate your medication, it isn’t “end all be all.” You can try other ones out and find the one that works best for you. As I’m only a few weeks in, it makes sense to stick it out until I see some benefits, or at least until the point I’m supposed to start seeing them.
The first two weeks for me were definitely not as bad as some of the experiences I’ve read about on Reddit. I still have enough hope to keep going and pushing through it for a few more weeks. Even though I am exhausted every day from a lack of sleep, I am banking on my combination of talk therapy, lifestyle adjustments, and medication to help my overall mental health and sleep.