Can you take Lexapro (escitalopram) and Xanax (alprazolam) together?
In many cases, doctors prescribe Lexapro (escitalopram) and Xanax (alprazolam) together because they treat different parts of anxiety and depression: Lexapro is a daily antidepressant/anti-anxiety medicine, while Xanax is a fast-acting benzodiazepine used for short-term relief. However, taking them together can increase side effects and needs medical guidance.
The main safety issue is that both drugs can affect the brain and nervous system, which can lead to:
- more sedation or drowsiness
- dizziness or trouble concentrating
- impaired coordination and reaction time
- increased risk of falls or accidents
What side effects are people most concerned about?
People commonly report feeling overly tired or slowed down, especially when starting one of the medicines or increasing the dose. Higher-risk side effects include:
- extreme sleepiness
- confusion
- fainting
- breathing problems (especially if combined with other sedating substances)
If you notice severe sleepiness, confusion, or breathing difficulty, get urgent medical help.
Is it safe to drink alcohol or take other sedating medicines with them?
No—alcohol and other sedatives can significantly raise the risk of dangerous sedation. Avoid combining this regimen with:
- alcohol
- opioids (like oxycodone, hydrocodone, fentanyl)
- other benzodiazepines
- sleep medicines (sedative-hypnotics)
- some antihistamines or other drugs that cause strong drowsiness
How does the timing matter (morning vs night, starting doses)?
Timing can help reduce side effects. Many clinicians use:
- Lexapro once daily (often morning or evening depending on how it affects you)
- Xanax only as needed or for a short period, sometimes at night at first
Your prescriber should tell you the exact schedule. Changing timing or dose without guidance can increase side effects.
What should you do if you already took them?
If you already took Lexapro and Xanax and you feel only mild drowsiness, monitor yourself and avoid driving or hazardous activities. If you feel very sedated, confused, have trouble staying awake, or have breathing issues, seek emergency care.
Who should be extra cautious?
You should be especially careful and talk to a clinician before combining them if you have:
- sleep apnea or breathing disorders
- a history of substance use disorder
- serious liver problems
- older age (higher fall and confusion risk)
- you’re taking opioids or other sedating medications
Tell me what you’re taking so I can give safer, more specific guidance
If you share:
1) your Lexapro dose (mg) and when you take it,
2) your Xanax dose (mg) and when/if it’s “as needed” or scheduled, and
3) any other meds (especially opioids, sleep meds, antihistamines) and whether you drink alcohol,
I can help you think through the main risks and what to ask your prescriber or pharmacist.