Lexapro is a selective serotonin reuptake inhibitor (SSRI) — a class of medications that increases the levels of the chemical serotonin in the brain, commonly used to treat both depression and generalized anxiety disorder (GAD), according to the National Alliance on Mental Illness (NAMI). And though plenty of people find it successful in doing so, like any medication or remedy, it has potential side effects. If you are considering going on Lexapro, keep these possible effects in mind — and be sure to always discuss with your doctor.

Common Side Effects

According to NAMI, some of the most common side effects of Lexapro include the following:

  • Headaches
  • Nausea
  • Diarrhea
  • Dry mouth
  • Sweating
  • Restlessness
  • Sleep issues — both feelings of fatigue and insomnia (confusing, we know).

YouBeauty’s executive editor Jessica Wakeman, who had been on Lexapro on and off since 2005, and consistently since 2008, has experienced some of it firsthand. “The biggest side effect has been drowsiness — sometimes very intense drowsiness,” she says. “When I went back on Lexapro in 2008, it used to put me to sleep within an hour of taking the pill. I’m not exaggerating — I could only take it at night, right before bed.” Though the drowsiness has improved a bit over time as her body adapted to the medication, she still has limited energy and typically needs to take naps every weekend day.

It’s also common to experience sexual side effects, such as lowered libido and difficulty climaxing, which don’t usually go away with time, according to NAMI.

Rare Side Effects

Some patients who take Lexapro may experience some less likely side effects, including:

  • Bleeding problems, especially when combining the medication with blood thinners such as Advil, Aleve, or Celebrex
  • Teeth grinding
  • Gas and indigestion
  • Breast tenderness (Though not a published side effect, according to Mayo Clinic, some studies have linked breast tenderness with Lexapro, as the drug interferes with the normal processing of prolactin which in turn affects breast tissue.)

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Serious Side Effects

If you experience any of the below side effects, you should consult your doctor immediately. It’s important, though, to not stop taking the medication “cold turkey,” or without the guidance of a doctor, as you could experience severe withdrawal symptoms.

  • Confusion and memory problems
  • Muscle rigidity and pain
  • Convulsions or seizures
  • Vomiting or severe nausea and diarrhea
  • Shortness of breath
  • Increased thirst and decreased urine output
  • Irritable behavior and increased depressive thoughts

Some of the above symptoms could be indicative of serotonin syndrome, which according to the Mayo Clinic, occurs when you either increase the dosage or start a new medication that increases serotonin levels. Others could be related to hyponatremia, which is low sodium in the blood.

As for the increase in negative and depressive thoughts, though it may seem counterintuitive, it is a possible result of taking certain antidepressants, including Lexapro. According to NAMI, this is most common in teenagers and young adults (generally, patients younger than 24), but this side effect, and the presence of suicidal thoughts and behaviors, can occur for any patient. In fact, Wakeman and her doctor did speak most specifically about this side effect before she started on Lexapro — but she, fortunately, hasn’t experienced it. “Being on Lexapro hasn’t increased any negative or depressive thoughts — quite the opposite,” she said. “I was severely depressed, lethargic, and had suicidal ideation without Lexapro and therapy.”

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Aside from these side effects, it’s important to be careful about combining Lexapro with any other drugs, as well as alcohol. According to Wakeman, it’s wise to take it slowly when drinking, especially if you’ve only recently begun taking an anti-depressant. “See how your body feels with one drink, then the next time try two,” she says. Plus, according to NOMI, alcohol and other drugs could decrease the effectiveness of Lexapro.

And if you’re interested in or trying to get pregnant, consult your doctor. According to NOMI, pregnant women who take antidepressants during their second and third trimesters could risk giving birth before the baby is fully developed. There is also a small chance (less than 1%) of infants developing pulmonary hypertension, which is potentially fatal. That said, there are risks for women who discontinue use of antidepressants, so this is something that needs to be evaluated on a case by case basis, with very thoughtful and thorough communication between you and your doctor.

For Wakeman, the decision to take Lexapro has proven to be a positive one. “In general, going on Lexapro has helped me manage my depression enormously,” she said. “As far as medication goes, it does what it’s supposed to do with minor side effects. But Lexapro is just one tool in a whole toolbox of ways that I treat my depression and anxiety — the other main ones being weekly cognitive behavioral therapy appointments, getting enough sleep, generally avoiding drugs and alcohol, and keeping stress in my life to a minimum as much as I can.”

READ MORE: Most People Suffering From Depression Aren’t Getting Help