Lexapro Overview

What Is Lexapro?

Lexapro is the brand name of a prescription medication containing the generic escitalopram. It belongs to a group of antidepressant medications called selective serotonin reuptake inhibitors (SSRIs). Lexapro is an effective treatment for anxiety and depression.

If you have been prescribed Lexapro and are doing well on it without any intolerable side effects, you can take it long-term to keep your depression and anxiety symptoms under control. However, if you have undesirable side effects and want to come off Lexapro, or you feel you no longer need to take an antidepressant medication, you should talk to your healthcare provider before stopping Lexapro. In other words, it’s important to discontinue Lexapro under medical guidance.

This medical guidance is because self-discontinuation (stopping Lexapro “cold turkey”) can result in serious side effects called antidepressant discontinuation syndrome. Common Lexapro discontinuation symptoms include flu-like symptoms, insomnia, nausea, imbalance, sensory disturbances, and hyperarousal.

Uses of Lexapro and Other Selective Serotonin Reuptake Inhibitors

Lexapro is used to treat:

Major depressive disorder in adults and children 12 years of age and older.
Generalized anxiety disorder in adults and children seven years of age and older.

Other SSRIs, such as fluoxetine (Prozac), citalopram (Celexa), paroxetine (Paxil), and sertraline (Zoloft) are used to treat mental health conditions such as eating disorders (bulimia nervosa); bipolar depression; anxiety disorders such as panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, and social anxiety disorder; and premenstrual dysphoric disorder (PMDD). Lexapro may be used off-label for these conditions. Stopping other SSRI medications abruptly or too rapidly can also result in SSRI discontinuation symptoms.

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Do Lexapro Withdrawal Symptoms Exist?

When using the term ‘withdrawal,’ it is important to note that antidepressant medications are not considered habit-forming and not associated with drug misuse. Therefore stopping SSRIs too quickly or suddenly can cause symptoms of antidepressant withdrawal called antidepressant discontinuation syndrome.

Why Do Antidepressant Discontinuation Symptoms Occur?

Stopping Lexapro and other SSRIs too quickly or suddenly can cause symptoms of antidepressant withdrawal called antidepressant discontinuation syndrome. This happens because of rapid changes in the levels of neurotransmitters in the brain while the body adjusts to the absence of the antidepressant drug.

Antidepressant drugs, including Lexapro, work by increasing the levels of neurotransmitters in the central nervous system (CNS). Neurotransmitters are natural chemicals that act as messengers between neurons (nerve cells). They attach to receptors on neurons and influence brain activity.

SSRIs such as Lexapro prevent the reuptake (reabsorption) of a neurotransmitter called serotonin. Serotonin plays a key role in regulating mood. Lexapro works by making more serotonin available to nerve cells.

After you have been taking Lexapro for some time, the neurons in your brain adapt to higher serotonin levels. If you suddenly stop taking Lexapro, the sudden drop in serotonin levels can result in an SSRI discontinuation syndrome with Lexapro discontinuation symptoms. That’s why it’s essential to stop Lexapro therapy under medical supervision.

Note: Withdrawal symptoms are common during addiction treatment for substance use disorder. However, antidepressant discontinuation syndrome is not the same thing as drug withdrawal and is not a culprit in substance use disorder.

Is Lexapro Discontinuation Dangerous?

Lexapro discontinuation symptoms are typically not dangerous or life-threatening. The syndrome is self-limited and reversible and usually runs its course in 1 to 2 weeks. However, intense discontinuation symptoms may require you to seek support and medical care.

Common Lexapro Discontinuation Symptoms

Common symptoms of Lexapro discontinuation syndrome are listed below.

Physical Symptoms

Flu-like symptoms: headache, lethargy, malaise, and muscle aches.
Gastrointestinal symptoms: stomach pain, stomach cramps, nausea, vomiting, diarrhea, loss of appetite, and weight loss.
Vascular symptoms: excessive sweating, flushing, and heat intolerance.
Sleep disturbances: insomnia (trouble falling asleep or staying asleep), unusual dreams, vivid dreams, and nightmares.
Balance problems: dizziness, lightheadedness, and feeling wobbly while walking(“sea legs”).
Movement disturbances: tremors, restless legs, gait problems (difficulty walking), speech problems, and chewing difficulties.
Sensory disturbances: pain, burning, tingling, numbness, increased sensitivity to lights and sounds, and tinnitus (ringing in the ears).
Cognitive symptoms: difficulty concentrating and memory problems.
Brain zaps or brain shivers, which feel like electric shock sensations in the head.

Emotional Symptoms

Hyperarousal: mood changes, agitation, aggression, irritability, confusion.
Paranoia: distrust or suspicion of others).
Suicidal thoughts or behaviors (risk of self-harm).
Mania.

How to Differentiate Between Severe Withdrawal Symptoms and Discontinuation

Antidepressant discontinuation syndrome can resemble withdrawal symptoms, such as the return of anxiety and depression, which are typically the reason you were prescribed an antidepressant medication in the first place.

Lexapro discontinuation symptoms appear within a few days to weeks of stopping the medication. Withdrawal symptoms develop based on the drug of abuse (e.g., alcohol, cocaine, heroin). Antidepressant discontinuation symptoms subside as the body readjusts to the new levels of neurotransmitters.

Lexapro Discontinuation Timeline

How Long Do Discontinuation Symptoms from Lexapro Last?

Lexapro discontinuation symptoms usually develop within three days of stopping the medication but can occur within a few hours of the last dose. The symptoms are generally mild and resolve on their own within one to two weeks without specific treatment. The most severe symptoms resolve within three days and typically last less than 24 hours. Milder symptoms may continue for one to two weeks.

How Long Do Brain Zaps Last After Stopping Lexapro?

Brain zaps typically last one to two weeks after stopping antidepressants such as Lexapro.

Risk Factors That Can Affect The Discontinuation Timeline and Severity

Duration of Treatment

The longer the duration of treatment with antidepressant treatment, the higher the risk of experiencing discontinuation symptoms. Antidepressant discontinuation syndrome typically occurs if you are on medication for at least six weeks. This condition is rare in people who stop SSRIs after less than 6 to 8 weeks of treatment.

Half-Life of Antidepressant Drugs

The elimination half-lives of different SSRIs vary. Half-life is the time it takes for the blood concentration of the drug to fall to half its original level. Antidepressant discontinuation syndrome is more common after stopping SSRIs with a short half-life, such as paroxetine (half-life 24 hours), compared to SSRIs with a longer half-life, such as fluoxetine (half-life 4-6 days). Lexapro has a half-life of 27 to 32 hours and carries a medium risk of SSRI discontinuation syndrome.

Weaning Off Lexapro Safely

Recommended Tapering Methods: How To Wean Off 10 mg Lexapro?

Lexapro 10 mg is the standard dose of the medication, although some people take 20 mg daily. Doctors recommend supervised tapering (gradually lowering the dose) of Lexapro over 6 to 8 weeks to minimize the risk and severity of discontinuation symptoms. It may be possible to discontinue Lexapro more quickly if you were on a low dose or if you took Lexapro for a relatively short duration. It may take you longer (12 weeks or more) to come off Lexapro if you have been on this medication long-term or are taking higher doses. It is sometimes possible to stop short-acting SSRIs like fluoxetine without tapering.

Importance of Professional Oversight

It’s important to gradually reduce and discontinue Lexapro under the medical supervision of your healthcare professional. There are no standard tapering guidelines or recommendations during the discontinuation process. Your doctor will tell you how to reduce your Lexapro dose slowly. Follow your doctor’s dosing schedule carefully to avoid severe symptoms.

Coping Strategies For Lexapro Discontinuation

Medical Support and Guidance

If you develop antidepressant discontinuation syndrome, your healthcare provider will first rule out other potentially serious causes of your symptoms. If you have severe discontinuation symptoms, your doctor may:

Restart Lexapro and recommend a more gradual dose taper.
Start you on another selective serotonin reuptake inhibitor (SSRI) with a longer half-life, such as fluoxetine.
Give you other antidepressants that are less likely to cause discontinuation syndrome.
Offer support and other medications to manage your discontinuation symptoms.

Self-Care Practices: What Can Help With Lexapro Discontinuation?

The following self-care practices can help to manage your symptoms during discontinuation from an antidepressant drug such as Lexapro:

Eat a healthy diet.
Stay well hydrated.
Exercise regularly.
Get enough sleep.
Talk to your healthcare provider about taking natural remedies and dietary supplements that can boost mental health and energy levels.
Practice mindfulness, meditation, and other relaxation techniques to regulate mood.
Join support groups for people with mental health conditions.