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How to wean off lexapro?

Lexapro (escitalopram) is an SSRI used for major depressive disorder and generalized anxiety disorder. Stopping abruptly can cause discontinuation syndrome in about 56% of people. A gradual taper under provider guidance minimizes withdrawal.

Common withdrawal symptoms

Physical

  • Flu‑like (muscle aches, sweating, headache, fatigue)
  • GI (nausea, vomiting, cramps, diarrhea, appetite loss, weight loss)
  • Sleep issues (insomnia, vivid dreams, nightmares)
  • Balance (dizziness, lightheadedness, unsteady gait)
  • Movement (tremors, restless legs, jaw clenching)
  • Sensory (tingling, burning, numbness, tinnitus, light/sound sensitivity)
  • Cognitive (memory lapses, concentration difficulty, speech problems)
  • Brain zaps (electric‑shock sensations)

Emotional

  • Mood swings, irritability, agitation
  • Paranoia
  • Return or worsening of depression
  • Suicidal thoughts or behaviors
  • Mania

Tapering strategy

  • Work with your provider to design a taper based on dose, duration, and response
  • Short tapers (2–4 weeks) often cause fewer symptoms, but some may require months
  • Reduce dose gradually to allow brain adaptation
  • No taper may be needed if on Lexapro < 1 month, switching within SSRIs, or experiencing severe side effects

Supportive measures

  • Engage family, friends, or support groups
  • Continue psychotherapy or counseling
  • Maintain healthy diet, regular exercise, good sleep, stress management
  • Monitor and report withdrawal symptoms to your provider

Timeline

Individual taper length varies. Some complete in 2–4 weeks; others need several months. Follow your provider’s schedule for best outcomes.

Sources

  • Physician’s Digital Reference. Escitalopram oxalate – drug summary. Accessed Jan 27, 2025.
  • U.S. National Library of Medicine. Escitalopram. Accessed Jan 27, 2025.
  • Horowitz MA, Taylor D. Tapering of SSRI treatment to mitigate withdrawal symptoms. Lancet Psychiatry. 2019;6(6):538‑546.
  • Davies J, et al. Incidence, severity and duration of antidepressant withdrawal effects: systematic review. Accessed Jan 27, 2025.