Lexapro Withdrawal Symptoms and Treatment
In This Article
- Lexapro is a brand name for the drug escitalopram
- Withdrawal symptoms typically start within a few days after stopping the medication
- Signs of Lexapro withdrawal include nausea, tremors, and sound sensitivity
- Doctors advise against abruptly discontinuing antidepressant medication to avoid withdrawal symptoms
- Tapering off Lexapro is the safest way to stop taking the antidepressant medication
Lexapro Withdrawal Symptoms and Treatment
People on antidepressants may want to stop taking their medication at some point. This usually happens when they feel they don’t need medication anymore or if the side effects are too much to handle.
These side effects can include:
- Reduced sex drive
- Vivid dreaming
- Abdominal pain
Antidepressants alter the levels of brain chemicals called neurotransmitters. These are responsible for influencing nerve cell activities, which affect people’s moods and emotions.
A sudden change in neurotransmitter levels can cause mild to severe withdrawal symptoms. Occurrence of these symptoms is called antidepressant discontinuation syndrome (ADS). This does not mean a person is addicted to their medication.
If a person is addicted to antidepressants, they will feel intense cravings and the need to increase their dosage steadily. However, antidepressants aren’t addictive, and it’s rarely necessary to increase the Lexapro dosage past 10 to 20 mg.
People who take high doses of antidepressants, like Lexapro, for at least 6 weeks are more likely to experience ADS if they abruptly stop.
What is Lexapro?
Lexapro is one of the brand names of a drug called escitalopram. It’s an antidepressant that falls under selective serotonin reuptake inhibitors (SSRIs), which increase serotonin levels in the brain.
Doctors prescribe Lexapro to treat major depressive disorder (MDD) in people aged 12 years old and above. Lexapro also treats certain anxiety disorders.
Escitalopram can take 4 to 6 weeks to fully work. Side effects are usually mild and can go away after a few weeks.1
People who are allergic to escitalopram or citalopram should not take Lexapro. They should also avoid these drugs if they’ve taken a monoamine oxidase inhibitor (MAOI) in the last 14 days. MAOIs are another kind of antidepressant.
Before prescribing Lexapro, the healthcare provider should know whether or not someone is taking other medications. These include:
- Herbal supplements
- Other antidepressants
- Medication for Parkinson’s disease
- Migraine medication
- Medication for infection
- Nausea or vomiting medication
- Blood pressure medication
They will also ask if a person has ever had:
- Liver or kidney disease
- Low sodium levels in the blood
- Cardiovascular problems
- Bleeding problems
- Sexual problems
- Drug addiction
- Suicidal thoughts
Signs and Symptoms of Lexapro Withdrawal
Lexapro withdrawal, or ADS, occurs in 20% of people who abruptly stop treatment after taking the antidepressant for at least 6 weeks. However, it’s essential to distinguish between withdrawal symptoms and depressive relapse.
Withdrawal symptoms can start within a few days of stopping medication. Relapse symptoms develop more gradually.
Signs of Lexapro withdrawal include:
- Loss of appetite
- Excessive sweating
- Trouble sleeping
- Restless legs
- Poor movement coordination
- Sound sensitivity
If these symptoms worsen, a person is most likely experiencing a relapse instead of withdrawal. As the body adjusts to the different levels of neurotransmitters, the withdrawal symptoms should go away.
Depressive relapse symptoms occur at least 2 to 3 weeks after stopping medication. In some cases, it can take longer for them to start.2
Doctors often identify a relapse through the gradual worsening of depression, insomnia, and/or psychomotor symptoms.
Lexapro Withdrawal Timeline
There is no standard timeline for Lexapro withdrawal symptoms. However, mild ADS symptoms like insomnia, nausea, and sensory sensitivity usually appear within 3 days of stopping the medication. These can last for 1 to 2 weeks.
In some cases, people experience withdrawal symptoms within the first hour of a missed dose. However, these symptoms may subside as soon as they begin taking the medication again.
In rare cases, some people may develop severe withdrawal symptoms. These include psychosis, catatonia, and severe cognitive impairment. People should seek psychiatric help if they notice these symptoms occurring.
How to Cope with Lexapro Withdrawal
There are some ways doctors recommend coping with withdrawal symptoms. These include:
- Cognitive behavioral therapy (CBT)
- Patient education
- Symptomatic treatment with other medications
- Close monitoring
CBT is a type of therapy that helps people shift their beliefs about their withdrawal symptoms. It’s common for people to take withdrawl symptoms as a sign that they can’t cope without medication. But CBT can help build a more positive understanding about the medication discontinuation process.
Patient education can reassure people. People who lack sufficient knowledge of the antidepressant discontinuation process usually experience more significant adverse effects during withdrawal.
Doctors will also closely monitor people discontinuing antidepressants to address suicidality concerns. This is especially important when people stop taking SSRI medications like Lexapro.
If the symptoms are too much for a person to handle, doctors can start a short course of different antidepressants to treat specific symptoms. This helps make the discontinuation process more manageable.
How to Prevent Lexapro Withdrawal
Doctors advise against abruptly stopping Lexapro or other antidepressant medication because it can cause withdrawal symptoms. If a person wants to stop taking medication, they need to consult their healthcare provider.
The best way to prevent withdrawal symptoms and a depressive relapse is to start a tapering process. This allows the body to adapt to changes in the brain’s chemicals without shocking the system.
Tapering Off of Lexapro
Tapering involves the gradual decrease of medication doses. There is no standard timeline because each process should cater to a person’s individual needs.
A tapering process can last anywhere from a few weeks to a few months. People should ask their doctor how to decrease their dose correctly.
Tapering off Lexapro typically involves reducing the dose in 5 mg increments. If a person’s starting dose is 20 mg, their first dose reduction should be 15 mg until they don’t have to take the medication anymore.4 Also, remember that every person is different, and a healthcare provider can determine which taper regimen is best.
If the withdrawal symptoms are unmanageable, the doctor may add back half of the first dose reduction and continue in smaller increments. Some people can taper off medication in weeks, while others may take longer.
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- “About escitalopram.” NHS, Crown, 24 Feb. 2022
- “Going off antidepressants.” Harvard Health Publishing, The President and Fellows of Harvard College, 25 Mar. 2020
- Horowitz, MA. and Taylor, D. “Tapering of SSRI treatment to mitigate withdrawal symptoms.” Lancet Psychiatry, Elsevier Ltd., 5 Mar. 2019
- “How to taper off your antidepressant.” Harvard Health Publishing, The President and Fellows of Harvard College, 29 Jan. 2020
- “Lexapro Uses, Dosage, Side Effects & Warnings.” Drugs.com, Cerner Multum, Inc., 1 Dec. 2021
- “List of Common SSRIs + Uses & Side Effects.” Drugs.com, Cerner Multum Inc., 27 Apr. 2018
- Warner et al. “Antidepressant Discontinuation Syndrome.” AAFP, American Academy of Family Physicians, 1 Aug. 2006
- Wilson, E. and Lader, M. “A review of the management of antidepressant discontinuation symptoms.” SAGE Journals, SAGE Publications Ltd., 28 Oct. 2015
- Yasui-Furukuri et al. “Characteristics of Escitalopram Discontinuation Syndrome: A Preliminary Study.” Clinical Neuropharmacology, Wolters Kluwer Health, Inc., June 2016