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
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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.
