Escitalopram Cardiac Risk: What You Need to Know About Heart Safety

When you take escitalopram, a common SSRI antidepressant used to treat depression and anxiety. Also known as Lexapro, it works by balancing brain chemicals—but it doesn’t just affect your mood. A small but real concern is its effect on your heart, specifically the risk of QT prolongation, a change in the heart’s electrical cycle that can lead to dangerous irregular rhythms. This isn’t something that happens to most people, but if you have other risk factors, it’s something your doctor needs to know about.

QT prolongation doesn’t cause symptoms on its own, but it can lead to a life-threatening arrhythmia called torsades de pointes. The risk goes up if you’re taking high doses of escitalopram, have a history of heart problems, are older, or are on other medications that also affect heart rhythm—like certain antibiotics, antifungals, or antiarrhythmics. People with low potassium or magnesium levels are also more vulnerable. It’s not about avoiding escitalopram entirely, but about knowing your personal risk profile. Your doctor might check your ECG before starting or after increasing your dose, especially if you’ve had heart issues before.

Other SSRIs, a class of antidepressants that includes fluoxetine, sertraline, and citalopram can carry similar risks, but escitalopram is among the ones with the clearest data linking it to QT changes. That’s why the FDA recommends not exceeding 20 mg per day. If you’ve been on a higher dose for years, your doctor may consider lowering it—not because you’re in danger, but because safety margins matter more the longer you’re on it. It’s also why switching to another antidepressant might make sense if you’re already at risk for heart rhythm problems.

You won’t feel your heart’s electrical activity changing. But if you suddenly feel dizzy, faint, have palpitations, or experience shortness of breath out of nowhere, don’t ignore it. These aren’t normal side effects of escitalopram—they could signal something serious. Keep track of any new symptoms, especially if you’re also taking other meds or have a family history of sudden cardiac events. Most people take escitalopram safely for years without issue, but knowing the signs and having a plan helps you stay in control.

The posts below give you real, practical insights into how medications like escitalopram interact with your body, what to watch for, and how to protect yourself. You’ll find guides on how to spot hidden risks in generic drugs, why some meds need blood monitoring, and how to talk to your doctor about side effects that don’t seem like a big deal—until they are. This isn’t about fear. It’s about being informed so you can take your meds with confidence.