About one in six adults take an antidepressant – and more than half of them take selective serotonin reuptake inhibitors (SSRIs).
Since they have been around for almost four decades, we know a lot about their benefits, risks and side effects.
But the authors of a new case study say one side effect in particular is underreported and could be mistaken for a pressing medical emergency or neurological problem.
They share the strange story of a 44-year-old single mother of five from rural Rwanda who started taking escitalopram, aka Lexapro, and yawning constantly.
She yawned six times every 15 minutes, all day.
The woman was referred for psychiatric evaluation in May 2026 after an emotional crisis that coincided with the anniversary of the country’s 1994 genocide, the authors wrote.
She reported five months of worsening depression, including persistent low mood, loss of interest and pleasure in things she once enjoyed, loss of appetite, fatigue, insomnia, and functioning at work.
Doctors determined she was suffering from a severe depressive episode and post-traumatic stress disorder. They started her on 10 mg of Lexapro, a standard starting dose, with supportive psychotherapy.
She noticed something was wrong within a few days – she was having six yawning “episodes” every 15 minutes.
Oddly, she said she didn’t feel sleepy or dizzy. She was also not confused, weak, or had other neurological symptoms.
As she yawned, the medicine took effect. The authors noted that his sleep and mood had improved.
Doctors suspected Lexapro was the cause, but systematically ruled out other possibilities. Ultimately, they decided to continue using SSRIs because they worked and the side effects, although strange, were bearable.
After two weeks, the yawning decreased “significantly” and his depression continued to improve.
Why it matters
We yawn to wake up our brains and cool them down, and we do it up to 20 times a day. But when people overdo it — more than three times in 15 minutes, several times a day — it can lead to problems.
This could be a sign of sleep problems or conditions like narcolepsy, or something serious and neurological, like ALS, epilepsy, or head trauma. Some causes require urgent care, such as a stroke or heart attack.
Yawning is a well-known side effect of Lexapro and a number of other SSRIs, including fluoxetine (Prozac). But researchers aren’t sure why this happens.
One theory is that increased serotonin from SSRIs reduces dopamine, which is responsible for triggering yawning. Serotonin could also affect the frontal lobe, responsible for wakefulness and alertness.
The authors of the case study say the importance of this woman’s story is that it shows that doctors do not necessarily need to stop their patients or reduce the dose of their SSRIs, as has been done in other case studies.
“When the symptom is tolerable and the antidepressant is effective, reassurance and monitoring may allow treatment to continue, avoiding unnecessary investigations and premature discontinuation,” they wrote.
Gn Health
