Lexapro & Elevated Liver Enzymes

Patients who suffer from depression and other mood disorders are often prescribed medications from the drug class known as selective serotonin reuptake inhibitors, or SSRIs. Lexapro is an SSRI that is commonly prescribed for depression and other mental health disorders. Unfortunately, the use of Lexapro has the potential to cause injury to the liver resulting in hepatitis and elevated liver enzymes.

Lexapro is a medication used for depression. (Image: dolgachov/iStock/Getty Images)


Marketed under the brand name Lexapro by Forest Laboratories, escitalopram is a selective serotonin reuptake inhibitor that is FDA-approved for the treatment of depression and anxiety disorders. Escitalopram works by increasing the availability of serotonin, an important neurotransmitter that acts within the central nervous system. According to the Lexapro product package insert, increased serotonergic activity has positives outcomes in the treatment of depression and anxiety.


Escitalopram is primarily metabolized by cytochrome P450 enzymes that are found within the liver. Since these enzymes are responsible for metabolizing many other prescription medications, the use of Lexapro includes potential drug interactions. Although the exact mechanism of potential liver injury from Lexapro use has not been determined, liver damage from medication use is often a result of either direct toxicity or an increased burden of drug metabolism.


According to the Lexapro product package insert, post-marketing data from clinical trials and case studies have included occasional reports of hepatitis and hepatic failure in patients who were taking Lexapro. Symptoms of hepatitis include fatigue, weakness, torso pain, and jaundice. If left untreated, hepatits can result in irreversible damage and liver failure.

Liver Enzymes

Liver enzymes including alanine aminotransferase, or ALT, and aspartate aminotransferase, or AST, are found within liver cells. During hepatic injury and liver cell death, these enzymes are released into the bloodstream. As a result, elevated amounts of ALT and AST enzymes found within the bloodstream can be an indicator of liver injury. Patients who are taking Lexapro may require monitoring of liver enzymes during therapy. Patients should speak with a physician with concerns regarding mood disorders or the use of Lexapro for therapy.

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