Excessive Yawning Could Be More Than Tiredness, Especially If You're Taking This Antidepressant

Six yawns every 15 minutes, without feeling sleepy, began just three days after a woman in Rwanda started taking the antidepressant escitalopram. In a case report published in October 2026, researchers described the unusual reaction and warned that excessive yawning may be an under-recognised medication side effect that can be mistaken for a neurological or other medical problem.

Yawning is a recognised side effect of escitalopram, also sold under the brand name Lexapro, and other selective serotonin reuptake inhibitors, or SSRIs. A 2025 US survey found that about one in six adults reported taking an antidepressant. SSRIs, including escitalopram, are among the most commonly prescribed antidepressants.

A Case From Rwanda

The report describes a 44-year-old mother of five from rural Rwanda. She was referred for psychiatric evaluation in May 2026 after an emotional crisis that coincided with the anniversary of the 1994 genocide.

She reported five months of worsening depression, including low mood, loss of interest, reduced appetite, fatigue and insomnia. Doctors diagnosed a severe depressive episode and post-traumatic stress disorder.

She started 10mg of escitalopram, a standard starting dose, with supportive psychotherapy. Within days, she had six yawning episodes every 15 minutes.

She was not sleepy, dizzy, confused or weak, and had no other neurological symptoms. Doctors suspected escitalopram but considered other causes and judged them unlikely.

They continued the SSRI because it was working and the side effect was bearable. After two weeks, the yawning decreased substantially while her depression kept improving.

Not Just a Sign of Sleepiness

Yawning is a normal physiological response associated with changes in alertness, tiredness and transitions between sleep and wakefulness. Adults typically yawn several times a day, with some people yawning up to 20 times.

Excessive yawning can point to sleep problems such as narcolepsy, or to neurological conditions such as ALS, epilepsy or head trauma. Some causes, including stroke or heart attack, need urgent care.

A separate case report noted that most case reports found no direct link between yawning and daytime sleepiness. Its patient, a 41-year-old teacher, was not tired and got enough sleep.

By her account, she developed yawning within two weeks on every antidepressant she tried, including escitalopram, and it worsened at higher doses. It stopped within days of discontinuing each drug, though fluoxetine took two weeks.

What the Research Shows

A prospective study enrolled 150 adults with major depressive disorder who had not used SSRIs. Among the 110 who completed follow-up, the prevalence of excessive yawning rose from 5.4 per cent to 15.4 per cent after one month.

Yawning severity correlated with depression and insomnia scores. It decreased in treatment responders and rose significantly among non-responders, though the link's clinical relevance remains to be determined.

It is not clear why SSRIs cause yawning. Serotonin and dopamine are among several neurotransmitters involved in regulating the behaviour, but the precise mechanism remains unclear.

Reports also describe yawning with duloxetine, clomipramine, citalopram, sertraline and paroxetine, so Lexapro is not alone. Fluoxetine, sold as Prozac, is also a recognised cause.

What Doctors Can Do

The case illustrates that excessive yawning does not automatically require an antidepressant to be discontinued. When the symptom is tolerable and treatment is effective, clinicians may consider monitoring the patient while assessing whether the benefits of continuing medication outweigh the side effects. Researchers behind the prospective study urged doctors to monitor yawning in patients with depression who start an SSRI.

Anyone who experiences severe breathing difficulties, confusion, high fever, a racing heartbeat or other sudden, serious symptoms should seek urgent medical attention. These can indicate a potentially serious medical reaction and should not be dismissed as ordinary medication side effects.