Suggestions for Weaning Off Lexapro

Escitalopram, commonly known by its trade names Lexapro or Cipralex, is an SSRI-class antidepressant. SSRI stands for selective serotonin reuptake inhibitor, and drugs like Lexapro work by blocking the reuptake of the neurotransmitter serotonin. Lexapro is approved by the U.S. Food and Drug Administration for treatment of major depressive disorder and generalized anxiety disorder, as well as social anxiety disorder, panic disorder, and OCD (obsessive-compulsive disorder). Discontinuing the use of Lexapro can have unpleasant side effects, but use of a few techniques can help reduce withdrawal symptoms

SSRI Discontinuation Syndrome

• After a period of about four weeks of taking an SSRI like Lexapro, the human body becomes adjusted to the increased levels of serotonin; after this time period, stopping the use of the drug should only be done on a doctor's recommendation. After discontinuation, interruption, or lowering of dosage, withdrawal symptoms might develop after a period of 1 to 7 days, depending on the half-life of the drug (for Lexapro, the half life is about 27 to 32 hours). Intensity and length of withdrawal varies between individuals: some patients experience only mild discomfort and symptoms, typically for between one week and several weeks, while other patients experience distressing symptoms which can persist for months.

Symptoms and As-Needed Symptom Treatments

• SSRI discontinuation symptoms for Lexapro are both physical and psychological. Physically, patients report problems with balance, diarrhea, fatigue, headache, tremors, nausea and gastrointestinal symptoms (sometimes flu-like), and trouble sleeping. Psychologically, patients are likely to report anxiety, agitation, crying spells, irritability and aggressiveness. Treat the symptoms of SSRI discontinuation syndrome on an as-needed basis to ease the weaning-off process (take ibuprofen for headache, an antiacid medication for upset stomach, etc.). However, some symptoms of SSRI discontinuation syndrome may be untreatable, such as "brain zaps" - a withdrawal symptom where patients experience strange sensations of dizziness, sweating, vertigo, or the feeling of "brain shivers," which some people have described as like having strobe lights pulse inside your brain.

Dose Reduction

• Doctors use dosage reduction techniques to help patients come off of Lexapro and other SSRIs. One common method is to reduce the dosage slowly over a period of weeks or months, which is sometimes done by physically breaking pills into smaller doses. Depending on the severity of the discontinuation reaction, doctors decide how to proceed with weaning a patient off of an SSRI; for most, weaning is done quickly but a doctor may choose to reinstate the antidepressant if the discontinuation reaction is severe. Another technique is to switch to an SSRI such as fluoxetine while stopping Lexapro; fluoxetine has a higher half-life and therefore stays in the body longer which helps reduce symptoms.