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Lexapro (escitalopram) is a commonly prescribed selective serotonin reuptake inhibitor (SSRI). It’s an antidepressant that can relieve symptoms of depression, anxiety, obsessive-compulsive disorder, and more. Getting off of Lexapro can sound scary, but so long as you work with your doctor to develop a tapering schedule that works for you, you can significantly reduce the chance of experiencing side effects. In this article, we’ll break down how you’ll get off of Lexapro. We’ll also cover the common side effects and provide some guidance on how you can cope with these symptoms should they occur.
How to Wean Off Lexapro
Talk to your doctor to come up with a plan to taper off of Lexapro. Take lower and lower doses per your doctor’s instructions to avoid side effects and withdrawal. Try to take Lexapro for at least 6 weeks before stopping, and stop when you’re in a stable situation and mindset.
Steps
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Talk to your doctor before stopping Lexapro. Stopping Lexapro abruptly can have negative side effects, some of which can be dangerous. Even if you don’t think the Lexapro doing anything, you’re much better off working with your doctor if you want to be safe. Tell your doc you’d like to stop taking the Lexapro and consult with them. [1] X Research source
- Abruptly stopping the Lexapro can cause antidepressant withdrawal syndrome (aka antidepressant discontinuation syndrome). [2] X Trustworthy Source PubMed Central Journal archive from the U.S. National Institutes of Health Go to source The symptoms are unpleasant and include flu-like symptoms, insomnia, trouble balancing, and sensory issues. [3] X Trustworthy Source American Academy of Family Physicians Organization devoted to improving the health of patients, families, and communities Go to source
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Wait until the symptoms of the condition you're treating have stabilized. Lexapro can take up to 6 weeks to fully kick in. As a result, quitting the Lexapro early can make it difficult to figure out if your subsequent symptoms are withdrawal from the SSRI, or a continuation of your underlying condition. If possible, wait at least 6 weeks before you talk to your doctor about quitting Lexapro. [4] X Trustworthy Source National Health Service (UK) Public healthcare system of the UK Go to source
- Wait until the life situation that caused your depression, anxiety, or underlying condition has resolved or stabilized, or until you have found other forms of support before stopping.
- Your doctor can help you figure out if your condition has improved.
- In most cases, it's best to take your antidepressant for at least 6-9 months before stopping it, although it depends on your reaction to the medication and the condition you’re treating.
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Aim to begin tapering when there are no major stressors in your life. Stopping your medication will be much more difficult if you're dealing with a lot of stress. If possible, wait until things are going well for you so you can more easily cope with any withdrawal you may experience. [5] X Trustworthy Source PubMed Central Journal archive from the U.S. National Institutes of Health Go to source For example, it may not be a good idea to stop your Lexapro if you're currently dealing with any of the following:
- Separation
- Divorce
- Job loss
- Moving
- Illness
- Grief
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Understand why tapering is so important. Lexapro has a short half-life, meaning it leaves your body quickly. In fact, it takes about 27-32 hours for Lexapro to be halfway out of your body, and about 6 days for it to be 99% gone. Since Lexapro withdrawal is uncomfortable, you need to give your body time to slowly adjust to the increasingly lower Lexapro levels. [6] X Trustworthy Source Harvard Medical School Harvard Medical School's Educational Site for the Public Go to source
- It may take more or less time to stop taking Lexapro depending on your circumstances. Everybody reacts differently to a Lexapro taper, so your doctor will need to monitor you closely.
- Many people have extreme reactions to radical drops in a tapering schedule, like suicidal thoughts. That’s why going slowly is so important. [7] X Trustworthy Source PubMed Central Journal archive from the U.S. National Institutes of Health Go to source
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Collaborate with your doctor to craft the best tapering schedule for you. Most tapering schedules will last for a few weeks or months. Your doctor will wean you off the dose you're taking in small increments. During this time, you will lower your dose every few days or weeks, according to your doctor's instructions. [8] X Trustworthy Source Harvard Medical School Harvard Medical School's Educational Site for the Public Go to source
- The length of your tapering schedule will depend on how long you've been taking your medication, as well as the dosage you're taking.
- As an example, you may take 20 mg for 5 days, then 15 mg for 5 days, and 10 mg for 10 days. You might finish by slowly moving from 5 mg twice a day to 5 mg once a day.
- In some cases, your doctor may want to start decreasing your dosage by ½ or â…“. For example, if you're currently taking 20 mg doses, then you may take a pill every other day instead.
- If you have any symptoms of withdrawal, your dosage might increase or you may need to taper slowly. Talk to your doctor if you notice any side effects.
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Follow all of your doctor's instructions to wean yourself off. Don't deviate from the tapering schedule—even if you're feeling really good! It may be tempting to reduce your dose earlier than recommended, but your doctor prescribed each tapered dosage for a reason. Do not take matters into your own hand; work with a doctor to slowly get yourself off of the Lexapro. [9] X Trustworthy Source MedlinePlus Collection of medical information sourced from the US National Library of Medicine Go to source
- If you have any questions about your tapering schedule, talk to your doctor.
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Monitor your mood every day while you’re tapering. You could keep a journal and write, “I feel upbeat, but I had trouble sleeping last night,” or simply check in with yourself daily to see how you felt. This helps you keep track of how you're feeling. Additionally, it makes it easier to watch for potential withdrawal symptoms, which can develop slowly. [10] X Trustworthy Source American Psychological Association Leading scientific and professional organization of licensed psychologists Go to source
- For instance, if you notice a pattern that you've experienced headaches for the past 3 days, that might be a withdrawal symptom. However, if you just had a single headache, it may have been caused by something else.
- If you think something may be a symptom, contact your doctor and ask them for guidance.
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Watch for withdrawal symptoms . Roughly 40% of people who stop taking Lexapro will experience withdrawal symptoms. They can be frustrating when they occur, but try to remember this is temporary. Here are the symptoms you may potentially experience: [11] X Research source
- Mood changes, such as irritability, fatigue, agitation, insomnia, and/or nightmares.
- Cardiovascular issues, like increased heart rate or intermittent palpitations.
- Gastrointestinal problems, such as nausea, vomiting, or food aversion.
- Sensory confusion, like prickling/tingling sensations, general confusion, paranoia, or anxiety.
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Distinguish between withdrawal and returning symptoms. When you stop taking Lexapro, it's possible the condition you were treating (such as depression, anxiety, or obsessive-compulsive disorder) will come back. This means you might start experiencing your prior symptoms again. It's possible to mistake these symptoms for withdrawal, but there are ways to tell the difference: [12] X Trustworthy Source PubMed Central Journal archive from the U.S. National Institutes of Health Go to source
- Withdrawal symptoms will often appear rapidly, and they’ll be transient. The symptoms may feel nonspecific or vague, and you’re likely to feel “not like yourself.”
- Rebound symptoms will resemble your old psychiatric condition, they’ll come on slowly, and they’ll be more persistent. If you used to deal with obsessive thoughts, the obsessive thoughts will likely come on strong and stick around.
- Consider if your current symptoms include physical as well as emotional symptoms. For example, muscle pain and prickling sensations aren't usually caused by depression, but they are part of withdrawal.
- Consult with your doctor for more insight into your unique situation.
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Create a support system to help you through the tapering process. Ask your friends and relatives to be available when you need emotional support. Then, call, text, or meet with them when you're feeling down. Don’t hesitate to ask for help with your daily tasks if you experience any withdrawal symptoms and you need a hand. [13] X Trustworthy Source Mind U.K.-based mental health charity focused on providing advice and resources to anyone facing mental health problems. Go to source
- You might ask a close friend, “I'm going to be weaning myself off of Lexapro. Can I call you if I need to talk about it?”
- If you need help, you might ask, “I'm feeling a lot of muscle pain and fatigue right now, so do you think you could load the dishwasher tonight?” or “I'm feeling dizzy and have a headache, so would it be okay if you gave the presentation without me?”
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Take a few days off of work or school once symptoms develop. If you’re part of the 60% of SSRI users who never have a withdrawal symptom, you may never need to take a day off. If you start feeling symptoms coming on though, call out. Spend the day engaging in self-care and treating yourself to some relaxation. Take it easy and give yourself time to recover. [14] X Trustworthy Source Mind U.K.-based mental health charity focused on providing advice and resources to anyone facing mental health problems. Go to source
- Lay on the couch and watch some movies, bundle up in bed with a good book, or take a long bath and listen to some relaxing tunes.
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Stay active to help boost your mood and reduce the risk of relapse. Exercising naturally releases feel-good hormones in your body, which helps you feel better. Getting at least 30 minutes of activity every day will help you cope with both your withdrawal symptoms and any returning symptoms you might experience. Here are some ways to get active: [15] X Trustworthy Source Harvard Medical School Harvard Medical School's Educational Site for the Public Go to source
- Go for an evening walk.
- Jog around your neighborhood.
- Take a dance class .
- Work out at the gym.
- Do an aerobic workout .
- Swim laps around a pool.
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Treat your mind and body right to reduce your stress levels. Although stress is a normal part of life, too much stress can become a problem, especially when you're stopping an antidepressant. Dealing with your stress will make it a lot easier to cope with side effects. Here are some ways to take good care of yourself: [16] X Trustworthy Source Harvard Medical School Harvard Medical School's Educational Site for the Public Go to source
- Get a good night's sleep by following a sleep routine .
- Meditate for 5-10 minutes daily to calm your mind.
- Eat a healthy diet of fresh produce and lean protein for good nutrition.
- Avoid drinking alcohol .
- Relax by engaging in your hobbies, being creative, or resting.
- Spend time with loved ones and pets.
- Use positive self-talk to boost your mood.
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Meet with a therapist or psychiatrist to process what you feel. Your therapist or psychiatrist will help you process what you're going through so that you can make sense of things during this messy time. In addition to helping you through withdrawal, they'll watch for signs your original condition is recurring. If this happens, they can recommend a new course of treatment. [17] X Trustworthy Source Mind U.K.-based mental health charity focused on providing advice and resources to anyone facing mental health problems. Go to source
- Ask your doctor for a referral to a therapist who can help you. Alternatively, look for a therapist online.
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Talk to your doctor about medications to relieve severe symptoms. If your symptoms interfere with your quality of life, your doctor might be able to prescribe you a short-term medication to get you through especially painful withdrawal symptoms. For example, they may offer you a sleeping pill or anti-nausea medication for 1-2 weeks, if you really need it. [18] X Research source
- Do not take your Lexapro again to relieve symptoms. While it seems logical that your old SSRI would help with withdrawal symptoms from SSRIs, this can actually make your symptoms worse. [19] X Research source
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References
- ↑ https://www.drugs.com/escitalopram.html
- ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7970174/
- ↑ https://www.aafp.org/pubs/afp/issues/2006/0801/p449.html
- ↑ https://www.nhs.uk/medicines/escitalopram/common-questions-about-escitalopram/
- ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7970174/
- ↑ https://www.health.harvard.edu/diseases-and-conditions/going-off-antidepressants
- ↑ https://pubmed.ncbi.nlm.nih.gov/19758520/
- ↑ https://www.health.harvard.edu/diseases-and-conditions/going-off-antidepressants
- ↑ https://medlineplus.gov/druginfo/meds/a603005.html
- ↑ https://www.apa.org/monitor/2020/04/stop-antidepressants
- ↑ https://www.psychiatrictimes.com/view/sorting-out-antidepressant-withdrawal-controversy
- ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6637660/
- ↑ https://www.mind.org.uk/information-support/drugs-and-treatments/medication-coming-off/planning-for-withdrawal/
- ↑ https://www.mind.org.uk/information-support/drugs-and-treatments/medication-coming-off/planning-for-withdrawal/
- ↑ https://www.health.harvard.edu/diseases-and-conditions/going-off-antidepressants
- ↑ https://www.health.harvard.edu/diseases-and-conditions/going-off-antidepressants
- ↑ https://www.mind.org.uk/information-support/drugs-and-treatments/medication-coming-off/planning-for-withdrawal/#MakeATaperingPlan
- ↑ https://www.psychiatrist.com/jcp/depression/understanding-and-managing-antidepressant-withdrawal-syndromes/
- ↑ https://www.psychiatrist.com/jcp/depression/understanding-and-managing-antidepressant-withdrawal-syndromes/
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