From the Research
To taper escitalopram from 20mg, I recommend a gradual reduction over 4-8 weeks under medical supervision, as there is no specific tapering schedule provided in the given evidence. Start by decreasing from 20mg to 15mg daily for 1-2 weeks, then to 10mg daily for 1-2 weeks, followed by 5mg daily for 1-2 weeks, and finally 5mg every other day for 1-2 weeks before stopping completely. The specific timeline should be adjusted based on your individual response, with longer periods between dose reductions if you experience withdrawal symptoms. Common withdrawal symptoms include dizziness, headaches, flu-like symptoms, irritability, anxiety, insomnia, and sensory disturbances like "brain zaps" 1, 2, 3, 4, 5. These occur because your brain needs time to adjust to decreasing levels of serotonin regulation. Never stop escitalopram abruptly as this can cause more severe withdrawal symptoms. If you experience troublesome symptoms during the taper, contact your healthcare provider immediately as they may recommend slowing the taper schedule. Continue any therapy or other mental health support during this transition period to help manage any re-emerging symptoms of your original condition.
Key Considerations
- The tapering schedule should be individualized based on the patient's response and tolerance to dose reductions.
- Medical supervision is essential to monitor for withdrawal symptoms and adjust the taper schedule as needed.
- The evidence provided does not specifically address the tapering schedule for escitalopram, but it is generally recommended to taper gradually over several weeks to minimize withdrawal symptoms.
- The patient should be aware of the potential for withdrawal symptoms and the importance of not stopping escitalopram abruptly.
Potential Withdrawal Symptoms
- Dizziness
- Headaches
- Flu-like symptoms
- Irritability
- Anxiety
- Insomnia
- Sensory disturbances like "brain zaps"
Importance of Medical Supervision
- To monitor for withdrawal symptoms and adjust the taper schedule as needed.
- To provide guidance and support during the tapering process.
- To ensure the patient's safety and well-being during the transition period.