Stopping Lexapro (Escitalopram) Safely
No, you should not stop Lexapro (escitalopram) right away. Stopping Lexapro abruptly can cause withdrawal symptoms that can be uncomfortable and potentially serious. A gradual tapering schedule under medical supervision is strongly recommended.
Risks of Abrupt Discontinuation
- Stopping Lexapro suddenly can cause withdrawal symptoms including anxiety, irritability, high or low mood, feeling restless, changes in sleep habits, headache, sweating, nausea, dizziness, electric shock-like sensations, shaking, and confusion 1
- These withdrawal symptoms can be severe enough to compel patients to restart their medication 2
- Discontinuation symptoms are more likely with higher doses and in patients with lower drug clearance 3
Withdrawal Syndrome Characteristics
- Common withdrawal symptoms include:
- Symptoms typically begin within 24-48 hours after stopping or significantly reducing the dose 4
- Withdrawal symptoms can be mistaken for recurrence of the underlying condition, potentially leading to unnecessary long-term medication 2
Proper Discontinuation Approach
- The FDA recommends a gradual reduction in dose rather than abrupt cessation whenever possible 1
- If intolerable symptoms occur during tapering, resuming the previously prescribed dose may be considered before continuing with a more gradual taper 1
- Traditional guidelines recommend short tapers of 2-4 weeks, but evidence suggests this may be insufficient 2
- Current evidence supports tapering over a period of months and reducing to doses much lower than minimum therapeutic doses to minimize withdrawal symptoms 2
- Very slow tapering is recommended for all patients, especially those on higher doses 3
Risk Factors for Severe Withdrawal
- Higher treatment doses and plasma concentrations of escitalopram are significantly associated with more severe withdrawal symptoms 3
- Longer duration of treatment may increase risk of withdrawal symptoms 5
- SSRIs like escitalopram are among the drug classes known to cause potentially severe withdrawal symptoms when stopped abruptly 5
When to Seek Medical Help
- Contact your healthcare provider immediately if you experience:
- Severe mood changes or suicidal thoughts 1
- Symptoms of serotonin syndrome (agitation, hallucinations, fever, muscle rigidity, racing heartbeat) 1
- Severe allergic reactions (trouble breathing, swelling, rash) 1
- Seizures or convulsions 1
- Symptoms of mania (greatly increased energy, racing thoughts, reckless behavior) 1
Conclusion
Escitalopram (Lexapro) should never be stopped abruptly. Work with your healthcare provider to develop a personalized tapering schedule that gradually reduces your dose over an extended period to minimize withdrawal symptoms. This is particularly important if you've been taking a higher dose or have been on the medication for a long time.