Understanding and Managing Lexapro Night Sweats: What You Need to Know

Does Lexapro Cause Night Sweats?

Yes. Sweating is a recognized side effect of Lexapro (escitalopram) and other SSRIs, often most noticeable at night when it disrupts sleep. It may begin when starting the medication or changing doses. It can also be a withdrawal symptom if the dose is lowered or stopped.

Profuse sweating is among the side effects people report on SSRIs. The Maudsley Deprescribing Guidelines, a clinical reference on stopping psychiatric drugs, include it among the effects patients in primary and secondary care attributed to their antidepressant in a naturalistic study, while noting that such self-reports have no placebo comparison (Horowitz & Taylor, 2024). Dr. Mark Horowitz, co-author of the guidelines, is Outro Health's clinical co-founder.

That is one reason Lexapro night sweats are worth raising with your clinician rather than putting up with. They are common, they have a plausible physiological explanation, and there is usually something that can be looked at.

Does Lexapro Make You Sweat During the Day Too?

It can. Lexapro sweating is not limited to the night. Some people notice heavier sweating through the day, in the palms, feet, underarms or face, or a general feeling of being hot or flushed without a clear reason. Night sweats tend to get the attention because they wake people up and leave clothes or bedding damp, even in a cool room.

So if you are asking "does Lexapro make you sweat more?", the answer is yes for a minority of people. Daytime sweating and night sweats from escitalopram are usually the same side effect showing up at different times. The practical difference is that sweating at night also disturbs sleep, which can add tiredness and low energy the next day.

Feeling hot and having hot flashes on Lexapro sit in the same family. They are changes in how the body regulates its temperature rather than a fever. A true fever, especially with other symptoms, is different and is covered in the warning signs below.

Why Does Lexapro Make You Sweat?

Lexapro belongs to the selective serotonin reuptake inhibitors (SSRIs). Escitalopram blocks the serotonin transporter, the protein that clears serotonin from the gaps between nerve cells, and the brain and body then adapt to that ongoing blockade (Horowitz & Taylor, 2024). Serotonin signaling is involved in many functions beyond mood, including the control of body temperature and sweating.

Sweating is controlled by the autonomic nervous system, the part of the nervous system that runs involuntary functions such as heart rate and temperature. Changes to serotonin signaling in the brain areas that set body temperature, and in the pathways that drive the sweat glands, are thought to explain why SSRIs can switch on sweating when there is no heat or exercise to call for it. The exact mechanism is not fully worked out.

Why the Dose Matters

The relationship between an escitalopram dose and how much of the serotonin transporter it occupies is hyperbolic (Horowitz & Taylor, 2024). Small changes at low doses have a larger effect than the same change at high doses.

"Very small doses can still have big effects on the brain—often 1/10 of the minimum standard dose will have about half the effect of the maximum dose."
Dr. Mark Horowitz, Clinical Co-Founder of Outro Health (Psychology Today, 2025)

Some people notice their sweating changes after a dose change, in either direction, which is worth telling your clinician about.

Sweating Versus Serotonin Syndrome

Ordinary medication-related sweating is uncomfortable but not dangerous. Serotonin syndrome is different. It is a rare but potentially serious reaction in which sweating comes with high fever, a fast heart rate, muscle stiffness or twitching, confusion or agitation, usually soon after starting a serotonergic drug, raising the dose or combining two of them. Those symptoms need urgent medical attention.

How Common Is Sweating on Lexapro?

How often people report sweating depends on how the question is asked. Short clinical trials, which compare the drug with a placebo, tend to record fewer side effects than studies that follow people in everyday care for longer.

In the naturalistic study reported in the Maudsley Deprescribing Guidelines, profuse sweating was among the side effects people taking SSRIs attributed to their medication, alongside dry mouth, sexual problems, weight gain and daytime sleepiness (Horowitz & Taylor, 2024). Those are self-attributed effects without a placebo group, so they should be read with some caution. The same source notes that the risk of side effects rose with each year of use.

Put together, Lexapro night sweats are common enough that they are not unusual, and not so universal that they should be dismissed as something everyone has to live with.

Do Lexapro Night Sweats Go Away?

For some people they do. Sweating that starts in the first weeks of treatment or after a dose increase can ease as the body adjusts over the following weeks. For others, sweating from Lexapro persists for as long as they take the medication. There is little good data on how many people adapt and how long it takes, and it varies from person to person.

A few questions help make sense of it:

• When did the sweating start? New sweating in the first weeks on Lexapro, or after a dose increase, points to a side effect.
• Has it changed with the dose? Sweating that got worse after an increase points to a side effect of the medication.
• Did it start after a dose was lowered or missed? That points to withdrawal, which is covered next.

If Lexapro sweating has not settled and it is disrupting your sleep or daily life, it is a reasonable thing to raise with your clinician. What makes sense depends on your situation, and it is a decision to make together.

Night Sweats When Reducing or Stopping Lexapro

Sweating can be a side effect of taking Lexapro. It can also be a withdrawal symptom. The Maudsley Deprescribing Guidelines list sweating, flushing and chills among the physical symptoms of withdrawal from SSRIs and SNRIs, alongside many other symptoms across the body's systems (Horowitz & Taylor, 2024).

"Antidepressants aren't addictive...they cause physical dependence."
Dr. Mark Horowitz, Clinical Co-Founder of Outro Health (Journey's Dream, 2024)

Withdrawal from escitalopram is common. After 24 weeks of treatment with escitalopram at doses from 5mg to 20mg, 15–22% of patients experienced a withdrawal syndrome, and in a self-selected survey of people on long-term antidepressants, 75% of those who stopped escitalopram reported withdrawal effects (Horowitz & Taylor, 2024). Longer treatment is associated with more frequent and more severe withdrawal.

How long withdrawal lasts is highly individual. Some people have mild symptoms for days or weeks, while others have symptoms for months, and a smaller group for longer. Protracted withdrawal is described in the research literature, including a descriptive analysis of self-reported accounts on a large online withdrawal forum (Hengartner et al., 2020). Escitalopram's half-life is about 30 hours (Horowitz & Taylor, 2024), but the drug leaving your body does not mean the brain's adaptations to it have reversed, which is why withdrawal symptoms can continue as the brain adjusts to the absence of the medication. Our Lexapro withdrawal timeline covers this in more detail, and the phases of SSRI withdrawal explains how symptoms tend to change over time.

The size of each dose reduction matters. Because the dose-to-effect relationship is hyperbolic, the last few milligrams of escitalopram have a large effect on the serotonin transporter, so the final steps usually need to be smaller than the first ones (Horowitz & Taylor, 2019). This is the idea behind hyperbolic tapering. Any reduction plan is made with a clinician, never alone, and Lexapro should not be stopped suddenly.

Side Effect or Withdrawal? How to Tell the Difference

Medication-Related Sweating

Sweating that occurs as a direct side effect of Lexapro typically develops within the first few weeks of starting treatment or increasing the dose. It tends to be steady rather than coming in waves, and it often sits alongside other early side effects such as nausea, dizziness, fatigue, or sleep disturbances. It may be generalized or more noticeable in the hands, feet or underarms.

Withdrawal-Related Sweating

Sweating as a withdrawal symptom usually appears within days of a dose reduction or a missed dose, and it often comes with other withdrawal symptoms, such as:

• Dizziness and light-headedness
• Flu-like symptoms, chills or flushing
• Fatigue and malaise
• Sleep disturbances and vivid dreams
• Irritability, anxiety or low mood
• Electric-shock sensations, often called brain zaps

Withdrawal can include low mood and anxiety, so it is often mistaken for relapse. NICE advises that relapse does not usually happen as soon as someone stops or lowers an antidepressant, and that withdrawal can include symptoms that are not typical of depression, such as dizziness or electric-shock sensations (NICE, 2022). Timing alone is not decisive, though. Withdrawal symptoms can be delayed for several weeks or even months after a dose reduction or the last dose, often called delayed onset withdrawal, and that delay is one reason late symptoms get read as relapse. If sweating and other symptoms start after a dose change, ask your clinician to consider withdrawal before concluding that it is relapse.

How to Manage Lexapro Night Sweats

These measures will not change the cause, but they can make nights more comfortable while you and your clinician look at the bigger picture.

Cool the Room and the Bed

• Keep the bedroom cooler than usual and use a fan for air flow.
• Choose light, breathable bedding and moisture-wicking or natural-fiber sleepwear.
• Keep a spare set of sleepwear and a towel by the bed, so a sweat does not mean a full wake-up.

Look at Triggers

• Cut back on caffeine, alcohol and spicy food in the evening, which can all add to sweating.
• Drink enough water through the day to replace what you lose.
• Stress and anxiety can make sweating worse, so wind-down routines before bed may help.

Ask About Timing and Dose

Some people ask their clinician whether taking Lexapro at a different time of day, or reviewing the dose, might help. These are decisions to make with your clinician, not changes to try on your own.

When to Talk to a Clinician

• Sweating with a high temperature, fast heart rate, muscle stiffness, confusion or agitation: seek urgent care, as this can be serotonin syndrome.
• Sweating that is disrupting your sleep or daily life.
• Sweating that started after a dose was lowered, missed or stopped.
• New or worsening sweating after a period of being stable on the same dose.

If withdrawal or any other symptoms bring thoughts of self-harm or suicide, call or text 988 in the US, or see our crisis resources.

Night Sweats on Other Antidepressants

Sweating is not specific to Lexapro. It is reported across SSRIs and SNRIs, and in the naturalistic study reported in the Maudsley Deprescribing Guidelines, profuse sweating was reported more often with venlafaxine than with SSRIs (Horowitz & Taylor, 2024). If you have taken more than one antidepressant, these guides cover the others:

• Zoloft (sertraline) night sweats
• Prozac (fluoxetine) night sweats
• Effexor (venlafaxine) night sweats
• SSRI sweating in general

Conclusion

Lexapro night sweats are a frequently reported side effect of escitalopram, and sweating can also be a withdrawal symptom when the dose comes down. When the sweating started is the most useful clue: new sweating on starting or increasing Lexapro points to a side effect, while sweating that begins within days of a reduction or missed dose points to withdrawal. Some people find the sweating settles with time; for others it lasts as long as they take the medication. Either way, it is a legitimate reason to talk to your clinician. If you decide together to reduce, slower, proportional reductions are intended to keep withdrawal symptoms, sweating included, more tolerable (Horowitz & Taylor, 2019).

How Outro Health Can Help

If Lexapro night sweats or other side effects are part of why you are thinking about your medication, Outro Health's clinicians specialize in helping people who have decided, with their clinician, to come off antidepressants. Outro Health uses hyperbolic tapering based on the Maudsley Deprescribing Guidelines, with personalized tapering schedules that slow down when withdrawal symptoms such as sweating flare. You can read more about tapering off Lexapro (escitalopram), and if you would like to talk it through, an evaluation can help you and a clinician see whether the program fits your situation.