Stopping Escitalopram After 2 Weeks of Use
Yes, you can safely stop escitalopram after only 2 weeks of use, but you should still taper gradually over 1-2 weeks rather than stopping abruptly to minimize withdrawal symptoms, even though the risk is lower with such short-term use.
Why Tapering is Still Recommended
The FDA label explicitly warns that "stopping escitalopram too quickly may cause serious symptoms" including anxiety, irritability, mood changes, headache, sweating, nausea, dizziness, electric shock-like sensations, shaking, and confusion 1
The FDA recommends "a gradual reduction in the dose rather than abrupt cessation is recommended whenever possible" for all patients discontinuing escitalopram 1
While antidepressant discontinuation syndrome (ADS) is well-documented with longer-term use, the risk after only 2 weeks is substantially lower because steady-state plasma concentrations are just being achieved (7-10 days) and neuroadaptive changes are minimal 2
Practical Tapering Approach for Short-Term Use
For 2 weeks of use, a brief taper of 5-7 days is sufficient:
If on 10 mg daily: reduce to 5 mg for 3-5 days, then stop 1
If on 20 mg daily: reduce to 10 mg for 3-4 days, then 5 mg for 3-4 days, then stop 1
This abbreviated taper is appropriate because you have not been on the medication long enough for significant neuroadaptation to occur 2
Risk Factors That Would Favor More Cautious Tapering
Even with short-term use, certain factors increase discontinuation syndrome risk:
Higher doses: Research shows that higher doses and plasma concentrations significantly increase ADS risk, with symptoms occurring in 56% of patients (14 of 25) who discontinued escitalopram 3
Rapid metabolizers: Patients with lower clearance (slower metabolism) are at higher risk for withdrawal symptoms 3
Previous withdrawal reactions: If you've had discontinuation symptoms from other antidepressants, taper more slowly 3
Monitoring During Discontinuation
Watch for these specific withdrawal symptoms in the first 24-48 hours after dose reduction:
Dizziness, muscle tension, and chills (most common, occurring in 44% of patients with ADS) 3
Confusion, trouble concentrating, or memory problems (40% of patients) 3
Emotional symptoms like crying or irritability (28% of patients) 3
Electric shock-like sensations, headache, or nausea 1
Critical Safety Consideration
Screen for bipolar disorder history before stopping: One case report documented emergence of mania following abrupt escitalopram withdrawal in a patient with unipolar depression, which resolved when escitalopram was reintroduced 4
If you develop manic symptoms (greatly increased energy, severe insomnia, racing thoughts, reckless behavior) during or after discontinuation, contact your healthcare provider immediately 1
When You Can Stop More Quickly
If intolerable side effects occur (severe nausea, allergic reaction, serotonin syndrome symptoms), the medication should be stopped immediately without tapering 1
The short duration of use (2 weeks) means you have minimal drug accumulation and can tolerate a faster taper than someone on long-term therapy 2
Common Pitfall to Avoid
Do not confuse the tapering recommendations for long-term use (which require 6-10 weeks of gradual reduction) with your situation of only 2 weeks of exposure 5
The American Academy of Pediatrics guidelines for slow tapering (reducing by 5mg every 1-2 weeks) apply to patients on long-term therapy, not short-term use like yours 5