i’m a male, 170 pounds, 5’10”. my doctor prescribed me 5mg of lexapro for anxiety. naturally, i went down the internet rabbit hole after seeing people say that 10mg is the “minimum therapeutic dose.” but i already started noticing some effects from just 5mg. is that just a placebo? or is 5mg actually enough?

turns out, it’s not that simple—and that’s exactly what makes this topic worth exploring.

the 10mg myth: where it comes from

first, let’s talk about that idea that 10mg is the “starting dose.” technically, yes—according to many clinical guidelines and fda documentation, 10mg is often cited as the standard starting dose for treating generalized anxiety disorder (gad) and depression. it’s considered the “therapeutic” dose in the sense that most participants in large-scale trials responded around that level.

but that doesn’t mean 5mg is useless.

the assumption that lower doses aren’t effective is often based on population averages. but in real life, averages don’t tell the whole story. some people respond well to lower doses, while others need more. that’s just how brain chemistry rolls.

the research: 5mg might actually be more effective

this isn’t just reddit speculation—there’s actual peer-reviewed data to back this up.

a 2016 meta-analysis published in European Neuropsychopharmacology analyzed several studies on lexapro (escitalopram) and found something surprising: 5mg led to a larger reduction in anxiety symptoms (measured by the liebowitz social anxiety scale, or lsas) than 10mg or even 20mg.

📄 study link

here’s the breakdown:

• 5mg: 41% reduction in lsas scores
• 10mg: 33%
• 20mg: 38.6%
• placebo: 27.8%

not only that, but the montgomery–åsberg depression rating scale (madrs), which measures depression symptoms, also showed better results at 5mg than higher doses in some participants.

another earlier study published in Journal of Clinical Psychiatry in 2004 also hinted at strong efficacy for lower doses, although most clinical trials still start with 10mg simply to “cover the bases.”
link to the study

real people, real stories

scrolling through r/lexapro, you’ll see a wide spectrum of experiences:

some users say 5mg completely turned their life around. one person wrote, “i’ve been on 5mg for almost a year and it helped a ton with anxiety attacks.”

another said, “10mg was too much—I felt emotionally numb and tired all the time. i switched to 5mg and feel so much better.”

others started on 5mg, saw limited results, and increased to 10mg or 7.5mg with better outcomes.

some felt relief within days; others needed 6–8 weeks to notice a difference.

there’s no one-size-fits-all. some people need 15 or 20mg, while others feel like even 5mg is too strong. you’ll even find users tapering to 2.5mg and doing just fine.

why might 5mg be enough?

lexapro (escitalopram) is a very potent ssri. it has one of the highest affinities for the serotonin transporter among its class, meaning it does a lot with a relatively small amount.

this isn’t like tylenol where 500mg doesn’t do much but 1000mg knocks out the headache. with ssris, more isn’t always better. in fact, higher doses can increase the risk of side effects like:

• emotional blunting
• fatigue
• sexual dysfunction
• weight gain

so if 5mg works for you—great. some psychiatrists even start sensitive patients at 2.5mg.

so… is it a placebo?

let’s address the elephant in the room. if you feel better on 5mg, is it just placebo?

probably not.

yes, placebo effects are real and strong when it comes to mood disorders. but clinical trials show that even when placebo accounts for some early improvement, 5mg lexapro consistently outperforms placebo across various anxiety and depression scales. if you’re noticing reduced anxiety, improved sleep, or more balanced emotions, there’s a good chance it’s the drug doing its job—even at this lower dose.

should you stay at 5mg?

if you’re feeling better, your side effects are manageable, and you’re not spiraling into anxiety again—5mg might be enough.

but if you find that your symptoms are creeping back, or you plateau after a few weeks, don’t hesitate to talk to your doctor about adjusting. some people bump up to 7.5mg or 10mg and find their sweet spot there.

bottom line? the “therapeutic dose” is not a fixed number—it’s whatever dose helps you function and feel like yourself again.

additional reading & sources

• efficacy of escitalopram in anxiety: meta-analysis of dose-response studies
• escitalopram in major depressive disorder
• liebowitz social anxiety scale (lsas)
• madrs scoring guide (depression assessment)

if you’re just starting out and questioning everything—you’re not alone. lexapro doesn’t work overnight, and some ups and downs are normal in the first few weeks. give it time, track your symptoms, and work with your doctor to find what works for you.

and don’t let the internet bully you into thinking your dose is “too small to matter.” if 5mg helps, then it’s enough.

let your brain heal at its own pace.