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The usual timeline Reports describe tiredness starting in the first week to 1 to 2 weeks after beginning treatment, with improvement over the next 2 to 4 weeks as the body adapts, according to this overview on when Lexapro fatigue starts and improves

You may be at an elevated risk for a B12 deficiency if you follow a vegan diet, if youve had weight loss surgery, have diabetes, HIV, or Crohns disease, or if you have a family history of the problem

If symptoms persist, speaking to a clinician is the best first step