From the Guidelines
The duration of withdrawal from Lexapro (escitalopram) generally requires a gradual tapering process of 2-6 weeks or longer to minimize withdrawal symptoms. Never stop Lexapro abruptly as this can cause withdrawal symptoms such as dizziness, nausea, headaches, electric shock-like sensations, anxiety, and irritability 1. A common tapering schedule might involve reducing your dose by 5mg every 2-4 weeks under medical supervision. For example, if you're taking 20mg daily, you might decrease to 15mg for 2-4 weeks, then 10mg, then 5mg, before stopping completely.
Key Considerations
- People who have been on higher doses or taking the medication for longer periods typically need more gradual tapering schedules.
- Factors affecting withdrawal duration include your current dose, how long you've been taking the medication, your individual metabolism, and overall health status.
- Throughout this process, it's essential to work closely with your healthcare provider who can adjust the tapering schedule based on your specific symptoms and needs.
Tapering Schedule
- A gradual tapering process can help minimize withdrawal symptoms, with some studies suggesting a tapering period of 10 to 14 days to limit withdrawal symptoms 1.
- However, more recent guidelines suggest a longer tapering period of 2-6 weeks or longer for SSRIs like escitalopram 1.
Importance of Medical Supervision
- Medical education, training, and experience are necessary to safely and effectively prescribe antidepressant medications, including tapering off Lexapro 1.
- A conservative medication trial for mild to moderate anxiety presentations may entail increasing the dose as tolerated within the therapeutic dosage range in the smallest available increments at approximately 1- to 2-week intervals when prescribing shorter half-life SSRIs like escitalopram 1.
From the Research
Duration of Withdrawal from Lexapro (Escitalopram)
- The duration of withdrawal from Lexapro (escitalopram) can vary depending on several factors, including the dosage and duration of treatment, as well as the individual's overall health and medical history.
- According to a study published in 2000 2, serotonin re-uptake inhibitor withdrawal syndrome, which includes Lexapro, generally begins within 24 to 48 hours after discontinuing the drug, reaches its maximum on day 5, and usually resolves within 2 to 3 weeks.
- However, another study published in 2019 3 suggests that withdrawal symptoms can persist for longer than a few weeks and may be associated with other manifestations of behavioral toxicity.
- A study published in 2019 4 recommends tapering SSRI treatment, including Lexapro, hyperbolically and slowly to doses much lower than those of therapeutic minimums to minimize withdrawal symptoms.
Factors Influencing Withdrawal Duration
- The intensity of withdrawal symptoms can depend on the daily dose and duration of treatment with Lexapro 2.
- Risk factors for withdrawal syndrome include poor treatment compliance, previous withdrawal syndrome with another drug, concomitant medication, and alcohol consumption 2.
- Tapering off the dose and patient education can help prevent withdrawal syndrome 2.
Tapering Strategies
- Guidelines recommend short tapers, of between 2 weeks and 4 weeks, down to therapeutic minimum doses, or half-minimum doses, before complete cessation 4.
- However, studies have shown that these tapers may not be effective in reducing withdrawal symptoms, and slower tapering regimens may be more effective 4.
- A study published in 2021 5 found that most tapering regimens were limited to four weeks or less, and that there is an urgent need for trials that adequately address withdrawal confounding bias and carefully distinguish relapse from withdrawal symptoms.