If you’re starting any new medication, doctors typically recommend taking it at the same time every day. Why? Simply because inserting it into an existing routine makes it less likely you’ll forget to take it. This can be especially helpful for people with anxiety, as establishing routines can help you manage stress more effectively to reduce symptoms, per Northwestern Medicine. But for people taking medication like Lexapro (the brand name for the drug escitalopram), there may be more to it. Is there a best time to take Lexapro for anxiety that will maximize its benefits beyond just making sure you remember to take it?

Meet the experts: Jason Kellogg, M.D., the medical director at Hotel California By the Sea and CEO of Progeny Psychiatric Group; Barbara Sparacino, M.D., psychiatrist and founder of The Aging Parent Coach.

“Lexapro is taken to help your quality of life,” says psychiatrist Jason Kellogg, M.D., the medical director at Hotel California By the Sea and CEO of Progeny Psychiatric Group. “The most important thing to do is remain consistent. After figuring out what the side effects are and which time of day to take the medication helps most, maintaining the time of dose will help steady its levels and effectiveness.”

Here, discover the best time to take Lexapro for anxiety based on your symptoms and schedule, plus how to make it work best for you.

The best time to take Lexapro for anxiety

“The best time to take Lexapro is the one that fits your body,” says psychiatrist Barbara Sparacino, M.D., founder of The Aging Parent Coach. “Some people feel it gives them a gentle boost, others find it more calming.” Determining how you feel after taking Lexapro, as every individual can be different, will likely play a role in when you choose to take it. It’s also not necessary to take the medication with food, but you can if you wish.

“Most choose to take Lexapro in the morning, as it is helpful to remember as part of a ‘getting ready for the day’ routine,” says Dr. Kellogg. “It is also helpful to have the drug in your system before points of high anxiety, so pinpointing when that may be during your day is helpful.” According to the National Library of Medicine, Lexapro reaches peak absorption in the body about five hours after ingestion. So if you work backwards five hours from the time of day when anxiety most often rears its head, you may find the best time to take it in order to get the benefits.

That said, the effects of Lexapro come more from taking it consistently over time, says Dr. Sparacino. “Lexapro is more of a marathon than a sprint, and it usually takes a few weeks to feel the full benefit,” she explains. Per the National Alliance on Mental Illness (NAMI), you may see an improvement in physical symptoms related to anxiety or depression, like sleep, energy, or appetite, within the first week or two of taking the drug, but it may take up to six to eight weeks for it to begin to act on your anxious thoughts or mood.

Morning vs. evening dosing

Side effects of Lexapro may subside after a few days, while others may last longer; every body is different. One impact of the medication may include drowsiness. “Some become fatigued or sleepy when taking Lexapro and have issues with staying alert throughout the day,” explains Dr. Kellogg. “Using caffeine may seem helpful in this case, but may worsen anxiety when mixed with Lexapro.” If this sounds like you, or if there isn’t a specific time of day when your anxiety is at its peak, you may benefit from taking Lexapro at night instead of in the morning.

That said, there are other factors that could steer you away from taking Lexapro at night. “Insomnia and sleep disturbances are common issues that may happen when taking antidepressants later on in the day or in the evening before bed,” Dr. Kellogg says. In fact, being unable to sleep is also listed as a side effect. “If this is the case, carefully switching the time/medication schedule should be discussed immediately with your doctor. Sleep is extremely important for cognitive functioning and mental health and should be prioritized.” A review published in Sleep Medicine Reviews found that improving sleep quality may reduce symptoms of anxiety, so you don’t want your meds to mess with your sleep.

Is there anything I should not take with Lexapro?

The most important thing to avoid when taking Lexapro is other medications that also raise serotonin, says Dr. Sparacino. These can increase your risk of serotonin syndrome, or having too much serotonin in the body, which may be life-threatening. Per NAMI, serotonin boosters include other antidepressants, migraine medications in the triptan family, some pain medications, amphetamines, and the antibiotic linezolid.

Lexapro may also exacerbate the side effects of a few other medications, including pimozide, methadone, monoamine oxidase inhibitors (MAOIs), medications that can cause bleeding, and certain antiarrhythmics, antipsychotics, and antibiotics, so it’s important to talk to your provider about any other drugs you are taking before you start Lexapro.

“Alcohol is almost always warned against when mixing with medications,” adds Dr. Kellogg. “The drowsiness that comes as a possible side effect of Lexapro may be worsened by mixing it with alcohol and can decrease alertness.” While alcohol isn’t strictly off limits, you don’t want it to interfere with Lexapro’s ability to do its job. “Moderation and awareness are key,” Dr. Sparacino says.

The bottom line

With this type of medication, it is vital to speak with your provider before making any adjustments. Do not double up on doses if you forget to take one; be sure to speak with your doctor before stopping the medication, per the Mayo Clinic. While it’s important to keep all these considerations and restrictions in mind if you’re taking Lexapro for anxiety, it’s equally key to remember to instate a routine that sets you up for success, says Dr. Sparacino. “The medication can help, but pairing it with honest self-care is where healing really happens.”

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