Medical Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice. Consult your doctor or pharmacist for advice specific to your medications.
If you accidentally took two Lexapro pills, call for advice now. The Lexapro Medication Guide says: "If you or your child take too much Lexapro, call your healthcare provider or Poison Help Line at 1-800-222-1222, or go to the nearest hospital emergency room right away." Escitalopram has a half-life of 27 to 32 hours, which means your body processes it slowly and steadily. Ask the person you speak with when to take your next dose.
How a double dose of Lexapro compares with the label's limits
Lexapro (escitalopram) is an SSRI, and doctors prescribe it across a range of doses. The FDA-approved maximum is 20 mg per day. Lexapro tablets come in 5, 10, and 20 mg strengths.
Where a double dose lands depends on your usual dose, as the table below shows. For most older adults and people with liver problems, the label's recommended dose is 10 mg once daily, so 20 mg is already double it. Poison Control notes that medicines taken at or very near their maximum dose have "the least room for error."
A study of 421 escitalopram overdoses managed in hospitals and reported to six U.S. poison centers found fewer serious outcomes than with citalopram, and far fewer seizures (1 case versus 30). Those overdoses were typically far larger than a double dose (median reported dose: 130 mg). Higher doses went with more severe outcomes, and the authors advised heart monitoring in early overdose care.
If you accidentally doubled a typical dose, here is how that compares:
| Your prescribed dose | You accidentally took | Max approved daily | How it compares |
|---|---|---|---|
| 5 mg | 10 mg | 20 mg | Below the max approved dose |
| 10 mg | 20 mg | 20 mg | At the max approved dose |
| 20 mg | 40 mg | 20 mg | Twice the max approved dose |
The table shows where your total lands, not whether you need help. For that, follow the Medication Guide's call-now step at the top of this page.
What to do right now
- Call now, even if you feel fine. Call your healthcare provider or Poison Help Line at 1-800-222-1222, or go to the nearest hospital emergency room, as the Medication Guide says. The label's overdose section notes that seizures and heart rhythm problems after an overdose may be delayed, and MedlinePlus first-aid guidance says not to wait for symptoms to develop.
- Have the details ready. Note when you took each pill, the strength on your bottle, and every other medicine or supplement you take.
- Ask about your next dose. Let the person you speak with tell you when to take it, and do not stop Lexapro unless they tell you to.
- Do not drink alcohol. The Medication Guide says: "Do not drink alcohol during treatment with Lexapro."
- Do not make yourself vomit. MedlinePlus says not to make a person throw up unless poison control or a health care professional tells you to.
Symptoms to watch for
Milder symptoms
These are common side effects of escitalopram that may be more noticeable after a double dose:
- Nausea
- Drowsiness or fatigue
- Dizziness
- Headache
- Trouble sleeping
Mention any of these when you call. With a half-life of 27 to 32 hours, most of the excess should be out of your bloodstream within 2 to 3 days, or a little longer if you are 65 or older.
Serious symptoms (call right away)
The Medication Guide says to call your healthcare provider or go to the nearest hospital emergency room right away if signs of serotonin syndrome appear, including:
- Nausea, vomiting, or diarrhea
- A fast heartbeat (the label's overdose section also lists heart rhythm changes)
- Agitation or confusion
- Shaking (tremors), stiff muscles, or muscle twitching
Emergency symptoms (call 911)
Call 911 if you experience:
- Seizures
- Loss of consciousness
- Trouble breathing
- Very rapid or irregular heartbeat
- Signs of serotonin syndrome: high fever, severe muscle rigidity, or rapid changes in heart rate or blood pressure
The Lexapro label says SSRIs, including Lexapro, can cause serotonin syndrome, a potentially life-threatening condition, and that the risk is higher with other serotonergic drugs, such as triptans for migraine, tricyclic antidepressants, tramadol, lithium, or St. John's Wort. It also lists serotonin syndrome among the effects reported with Lexapro overdose.
When to call your doctor or Poison Control
Right away, whatever your usual dose. The Lexapro Medication Guide says: "If you or your child take too much Lexapro, call your healthcare provider or Poison Help Line at 1-800-222-1222, or go to the nearest hospital emergency room right away." When you call, tell them if:
- You took more than one extra dose (three pills instead of one, for example)
- You take other serotonergic medications (MAOIs, triptans, tramadol, lithium, other SSRIs or SNRIs, St. John's Wort)
- You are on 20 mg and doubled to 40 mg. That is twice the label's 20 mg daily maximum.
- You have any of the symptoms listed above
Contact numbers:
- Poison Control at 1-800-222-1222 in the U.S., free, confidential, and available 24 hours a day
- Your healthcare provider, meaning the doctor who prescribes your Lexapro
- 911 right away if the person has collapsed, had a seizure, has trouble breathing, or can't be awakened, as MedlinePlus advises
How to prevent accidental double dosing
One way it happens: you take your Lexapro, get distracted, and 20 minutes later you cannot remember whether you actually took it. Because Lexapro is a once-daily medication, this "did I or didn't I?" moment can happen on any given morning or evening. A few approaches that solve this:
Track every dose with a medication reminder app
Regular phone alarms tell you when to take a pill, but they do not record whether you actually did. A pill reminder app logs every confirmed dose, so you always have a clear answer to "did I already take this?"
Pillo tracks every dose you confirm, uses persistent alarms that will not stop until you respond, and keeps a history of exactly what you took and when. If you are taking Lexapro alongside other medications, that dose log becomes your safety net against double dosing.
Use a weekly pill organizer
A 7-day organizer with AM/PM compartments gives you instant visual confirmation. Compartment empty? You took it. Compartment full? You have not taken that dose yet.
Take Lexapro at the same time every day
Consistency makes it harder to forget or lose track. If you are deciding between morning and evening dosing, our guide on the best time to take Lexapro breaks down the pros and cons of each.
Build it into an existing habit
Pair your Lexapro with something you already do every day, like your morning coffee or brushing your teeth at night. Learn more about this approach in our medication routine guide.
Frequently asked questions
Is a double dose of Lexapro dangerous?
It can be. Poison Control names depression medicines among those where a double dose can cause significant problems. If you take too much Lexapro, the Medication Guide says to call your healthcare provider or Poison Help Line at 1-800-222-1222, or go to the nearest hospital emergency room right away. Doubling 10 mg brings you to the label's 20 mg daily maximum, and doubling 20 mg is twice that maximum.
Can a double dose of Lexapro cause serotonin syndrome?
It is possible. The Lexapro label lists serotonin syndrome among the effects reported with Lexapro overdose, and says the risk is higher with other drugs that raise serotonin, such as triptans, tramadol, or St. John's Wort. The Medication Guide says not to take Lexapro with an MAOI or within 14 days of stopping one. Tell whoever you call about every medicine and supplement you take. The Medication Guide says to call your healthcare provider or go to the nearest hospital emergency room right away for signs such as agitation, confusion, a fast heartbeat, muscle twitching, or a high body temperature.
Should I skip my next dose of Lexapro after doubling up?
Do not decide this on your own. When you call your healthcare provider or Poison Control about the extra dose, ask when to take your next one. Do not stop taking Lexapro without talking to your doctor: the Medication Guide warns that suddenly stopping it may cause serious side effects. For what to do on a day you missed a dose instead of doubling, see our guide on a missed dose of Lexapro.
How long until the extra Lexapro wears off?
Escitalopram has a half-life of 27 to 32 hours, about 50% longer in people 65 and older, according to the label. Most of the extra dose should clear your system within 2 to 3 days (a bit longer at 65 and up). Report any side effects in that time to your healthcare provider or Poison Control.
What is the difference between Lexapro and other SSRIs for double dosing?
Lexapro (escitalopram) has a half-life of 27 to 32 hours, which is similar to sertraline (about 26 hours). Fluoxetine (Prozac) stays in the body much longer: its label gives a half-life of 4 to 6 days with regular use. A longer half-life means the extra drug takes longer to leave your body. The Medication Guides for all three say to call for help right away if you take too much. For comparison, see our guide on accidentally doubling sertraline.
What if I am not sure whether I already took my Lexapro?
Do not take another pill yet. Poison Control lists forgetting about a dose already taken, then taking a second, as one way double doses happen. Call your pharmacist or Poison Control at 1-800-222-1222 and ask what to do. For more guidance on this exact situation, read our guide on what to do when you cannot remember if you took your medication.
Related guides
- Missed a dose of Lexapro? Here is what to do
- Best time to take Lexapro: morning vs night
- Accidentally doubled your sertraline (Zoloft)
- Missed a dose of your antidepressant
Medical Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your doctor or pharmacist for advice specific to your medications. If you think you may have a medical emergency, call 911 or your local emergency number immediately.
Reviewed sources: FDA Escitalopram Label, Escitalopram overdose case review, Poison Control
Sources
- FDA Prescribing Information (DailyMed). FDA-approved maximum is 20 mg per day
- Peer-reviewed study (DOI: 10.1016/j.jemermed.2008.06.030). Escitalopram overdose case review
- National Capital Poison Center (Poison Control). 1-800-222-1222
- MedlinePlus (National Library of Medicine). Escitalopram: in case of emergency or overdose
- MedlinePlus (National Library of Medicine). Poisoning first aid
- FDA prescribing information on DailyMed. Zoloft (sertraline) half-life and Prozac (fluoxetine) half-life
Reviewed under our Medical Review Policy.
