Lexapro (Escitalopram) Withdrawal: Symptoms, Duration, & How to Cope

What Is Lexapro?

Lexapro (escitalopram) is known as a selective serotonin reuptake inhibitor or SSRI. This means the drug works in the nervous system to increase the amount of active serotonin. Serotonin is responsible for a wide range of behaviors including mood, fear, stress response, appetite, addiction, and sexuality.²

Lexapro is used to treat a range of mental health issues including:^3,4

• FDA-approved for major depressive disorder (MDD), either short-term or maintenance treatment in adults and children 12-17 (FDA approved)
• FDA-approved for generalized anxiety disorder (GAD), short-term treatment in adults (FDA approved)
• Off-label use for obsessive-compulsive disorder (OCD)
• Off-label use for eating disorders such as binge eating disorder and bulimia nervosa
• Off-label use for panic disorder
• Off-label use for posttraumatic stress disorder (PTSD)
• Off-label use for premenstrual dysphoric disorder (PMDD)

What is Lexapro Withdrawal?

Lexapro withdrawal is the experience of unwanted symptoms associated with the stopping of treatment. It is the result of your body adjusting to not taking Lexapro. Since this can occur with most antidepressants it has been well-documented and studied. The phenomenon is also known as antidepressant discontinuation syndrome or ADS.¹

True clinical addiction to Lexapro is uncommon, but when Lexapro is taken for more than a few months, a person’s body develops mild physical dependence.⁵ Since stopping Lexapro causes effects like those of a true addiction withdrawal, the term withdrawal has been used to describe these symptoms.

Causes of Lexapro Withdrawal

Lexapro withdrawal is caused by suddenly stopping taking the medication. This can happen by forgetting to take a few doses in a row, switching antidepressant medications, or quitting the medication altogether. About 20% of patients who stop taking an antidepressant like Lexapro experience withdrawal symptoms. Most patients who experience negative symptoms report taking Lexapro for at least 4-6 weeks before stopping.¹ Of all antidepressant medications, Lexapro carries only a moderate risk for withdrawal symptoms.⁵

The risk of experiencing withdrawal symptoms increases the longer someone has been taking Lexapro. Also, the higher the dose of Lexapro a person is taking, the more likely that person will experience withdrawal symptoms when stopping. Finally, the more quickly someone lowers the dose of Lexapro, the more likely withdrawal symptoms will be experienced.¹ Working with your doctor to establish a gradual decrease to your Lexapro dose is a great way to reduce the chances of experiencing Lexapro withdrawal.⁶

Lexapro Withdrawal Symptoms

It is important to recognize the symptoms of Lexapro withdrawal. Symptoms usually begin within a few days of stopping the medication. While only about 20% of patients stopping Lexapro will experience symptoms, identifying the symptoms early can help you and your doctor manage them right away.¹ It is important to remember that most symptoms are self-limiting and will go away as your body becomes used to no longer taking Lexapro.⁶

Lexapro (escitalopram) withdrawal symptoms may include:¹

• Flu-like symptoms, including fever and chills
• Fatigue
• Fast heartbeat, also known as tachycardia.
• Nausea or vomiting
• Diarrhea
• Mood swings
• Headache
• Dizziness
• Muscle tremors or instability that can make walking difficult
• Brain zaps, which are unpleasant shock-like sensations.
• Anxiety
• Depression
• Suicidal ideation
• Nightmares or vivid dreams

The more slowly you taper or gradually lower the dose of Lexapro, the less likely you will experience significant withdrawal symptoms. Working closely with your doctor during the stopping process will help keep you safe and allow for personalized recommendations to limit withdrawal symptoms. Stopping Lexapro immediately can lead to very severe symptoms that can require further care and medical attention.⁷

Some severe symptoms of Lexapro withdrawal that need immediate medical attention include:⁷

• Engaging in self-destructive behavior
• Having thoughts of suicide or gathering the means to commit suicide
• Confusion and delirium
• Increased blood pressure and irregular heartbeat
• Severe anxiety and panic attacks

Discontinuation Vs. Relapse of Depression Symptoms

There is also a risk of depression relapse when stopping Lexapro. While many symptoms are similar, symptoms of relapse usually take longer to show up after stopping the medication. The symptoms of relapse are more psychological like worsening mood and depression and less physical like fatigue and flu-like symptoms.¹ During this time it is especially important to continue non-medication treatments for managing depression and anxiety.

Another distinguishing factor of relapse is the longer time it takes to get better. Lexapro withdrawal symptoms usually go away on their own, or quickly when a new antidepressant is taken. Symptoms of depression relapse will linger and take much longer to resolve with the introduction of a new antidepressant.¹

Discontinuation of Escitalopram After Long-Term Treatment

After long-term treatment with Lexapro, and especially at a higher dose, special care must be taken to stop the medication. It is not uncommon for your doctor to recommend a 4- 8-week tapering schedule. Frequent check-ins with your doctor are recommended as depending on symptoms, you may be prescribed a different SSRI. This method can ease short-term symptoms, while still working to wean your body off of Lexapro.⁷

Lexapro Withdrawal Timeline

Knowing when to expect symptoms of withdrawal can help better identify and treat unwanted symptoms. Withdrawal symptoms are likely to happen when most of the Lexapro is gone from the body. This is based on the half-life of a medication, or the time it takes for half of the medication to leave your body. Lexapro has a half-life of about 30 hours, which is right in the middle compared to other antidepressants.

After about 3 days of not taking Lexapro, most of the medication will have left your body. If you experience symptoms this would be the most likely time for symptoms to start.¹ Once symptoms begin they can last a few weeks up to a month. It is important to communicate with your doctor during this time to monitor the severity and duration of symptoms. In rare cases, some patients have experienced long-term withdrawal effects.⁶

Coping With Escitalopram Withdrawal Symptoms

Managing symptoms of withdrawal is an important part of stopping Lexapro. Utilizing any number of the strategies below can help relieve symptoms and make the process of stopping Lexapro easier on your body. Employing healthy coping mechanisms should always be the goal over other substance use. These coping strategies will prove more beneficial to you in the short and long term.

It is always difficult to think clearly under the stress of negative side effects and flu-like symptoms. Having a plan to cope with symptoms before you experience them will make following your own strategies much easier.

9 strategies to help relieve symptoms of Lexapro withdrawal include:⁷

1. Get Adequate Sleep

The impact of sleep on mental health is significant. Getting enough quality sleep can help your body have the energy to handle the symptoms of withdrawal. Limit caffeine and screen time close to bedtime if possible.

2. Stick to a Regular Exercise Routine

Regular exercise has many mental health benefits for those experiencing depression and anxiety. If possible, continue to exercise as a way to relieve stress and anxiety and take your mind off of the symptoms.

3. Let Friends and Family Know You Are Stopping Lexapro

A potential symptom of withdrawal is thoughts of self-harm or harm to others. Being with people you trust during this time is important for your safety. They can call for help on your behalf and help monitor your mental status.

4. Eat a Healthy Diet

Like sleep, your body needs the right fuel during this stressful time. Come up with a meal plan and stick to it. Before you stop Lexapro, stock the house with healthy food you can enjoy.

5. Create a Plan With Your Doctor

Creating a plan is essential to safely discontinue Lexapro. Your doctor will tell you exactly when to lower your dose and for how long you will need to be at each lower dose. You should check in routinely to make sure things are going well and adjust the plan if needed.

6. Use OTC Medications to Help Manage Symptoms

Many mild symptoms can be relieved with over-the-counter (OTC) medications. Use Tylenol and ibuprofen for flu-like symptoms, meclizine for nausea, and melatonin for difficulty sleeping. Always ask a pharmacist or doctor if OTC medications are safe for you.

7. Speak with a Therapist

Speaking with a therapist, whether you already work with one or not, can help support you through withdrawal. If you do not have a therapist, working with one is always a great idea. They can help monitor your withdrawal process and help make the transition off of Lexapro easier.

8. Find a Support Group

Having the support of others in similar situations can be very beneficial. Stories of others stopping Lexapro can help provide perspective and validation for your own experiences. Both in-person or online support groups can be helpful, whichever is best for your situation.

9. Switch to Another Antidepressant

In some instances when withdrawal symptoms are severe, your doctor may prescribe another antidepressant. This is most often a temporary measure taken to relieve withdrawal symptoms while your body establishes a new normal. This should only be done at the direction of your doctor.

Discontinuation of Lexapro While Pregnant

Using any antidepressant during pregnancy requires close supervision by a medical professional. If you think you would like to stop using Lexapro while you are pregnant, it is important to have a conversation with your doctor first. Any withdrawal symptoms you experience have the potential to affect your baby. It is important to understand the risks and benefits of discontinuing Lexapro before stopping.

Questions to Ask Your Health Team About Stopping Lexapro

Speak with a psychiatrist, doctor, or other licensed prescriber before stopping Lexapro. It is unsafe to stop your medication without medical supervision. Together, you will decide the best way to discontinue Lexapro and formulate a plan to help prevent severe symptoms.

Questions to ask your care team about discontinuing Lexapro include:

• Why do you think I should stop this medication?
• Is it going to be dangerous to stop taking Lexapro?
• Should I stop taking Lexapro all at once or over some time?
• What are the risks of stopping Lexapro?
• What will symptoms of Lexapro Withdrawal look like?
• What are signs that something worse is wrong?
• When should I expect to notice the influence of Lexapro withdrawal?
• What should I do if something feels off during my withdrawal process?
• Who should I call, and what should I do if I get sick?
• Would starting a new medication help limit the withdrawal symptoms?
• Could my depression get worse after I stopped taking Lexapro?

Final Thoughts

Lexapro withdrawal is a risk for anyone stopping or changing their antidepressant medication. It is important to understand what withdrawal looks like and how to cope with the unwanted symptoms. Working with your doctor to stop Lexapro correctly will reduce the risk of experiencing Lexapro withdrawal symptoms. While most people will not experience withdrawal symptoms, being prepared can help lessen the negative effects if withdrawal does happen.