Lexapro (escitalopram) is a prescription medication used to treat depression and anxiety. It belongs to a class of drugs known as selective serotonin reuptake inhibitors (SSRIs).
SSRIs have long been associated with withdrawal symptoms. While doctors still refer to these symptoms as antidepressant discontinuation syndrome, some many people believe the name minimizes the seriousness of the problem.
Antidepressants are among the most commonly prescribed medications in the U.S. Of the more than 40 million people who take them in a given month, about one quarter have been taking them for more than ten years.1 Ten years may seem like a long time, but people are afraid that stopping their antidepressants will lead to relapse of their symptoms or withdrawal.
Whether you are stopping Lexapro because it is not currently effective or you’re better off and you’ve decided with your doctor it makes sense to come off, the quitting process can be a real pain. More than half (56 percent) of people who quit antidepressants experience withdrawal symptoms.2
If you are one of the people who experience withdrawal symptoms, you can expect those symptoms to range from mild to severe. The most common symptoms of Lexapro withdrawal are dizziness, muscle tension, and chills, which each affect about 44 percent of users. Many people also experience confusion and difficulty concentrating. Other symptoms include cognitive issues and bouts of crying. 3
Signs & Symptoms
Lexapro withdrawal can take a real toll on your life, both physically and emotionally. SSRIs like Lexapro work by increasing serotonin levels in your brain. When you stop taking them, it takes your brain a while to get used to the drug’s absence. Unfortunately, the amount of time this takes can vary widely.
Lexapro withdrawal symptoms typically arrive one to three days after your last dose. There are, however, cases where it started sooner (within hours) or later (more than a week). Symptoms generally resolve within a few weeks, although they can potentially continue longer.
Recent research has found that the severity of SSRI withdrawal is much worse than previously believed. On average, about 46 percent of people experiencing SSRI withdrawal symptoms describe them as severe. 2 Severe symptoms indicate that withdrawal can potentially interfere with your ability to meet responsibilities at home and at work.
There is a checklist for measuring the severity of antidepressant withdrawal that you may find helpful. It is known as the Discontinuation-Emergent Signs and Symptoms Scale, or DESS.
There are several different SSRI medications available that each affect the brain in unique ways. On a range of lowest to highest chance of severe withdrawal symptoms, Lexapro sits around the middle. The most common symptoms of Lexapro withdrawal—occurring in more than one in four people—are as follows:3
- muscle tension
- trouble concentrating
- trouble remembering things
The following is a more complete list of symptoms associated with SSRI withdrawal:4
- Digestive. You may experience nausea, vomiting, cramps, diarrhea, or appetite loss.
- Balance. You may become dizzy or lightheaded, sometimes making it difficult to walk.
- Sleep Problems. You may have nightmares, unusual dreams, excessive/vivid dreams, or insomnia.
- Overall. You may have flu-like symptoms including headache, muscle pain, weakness, and tiredness.
- Mood. You may have anxiety, agitation, panic, suicidal ideation, depression, irritability, anger, mania, or mood swings.
- Bizarre Sensations. You may experience brain zaps (like an electrical shock or shiver in your brain), pins and needles, ringing in the ears, strange tastes, or hypersensitivity to sound.
- Motor Control. You may have tremors, muscle tension, restless legs, unsteady gait, or difficulty controlling speech and chewing movements.
Coping & Relief
The best way to find relief from Lexapro withdrawal is to avoid it altogether. First off, avoid quitting cold turkey, because doing so may increase the likelihood of severe withdrawal. Second, set up an appointment with your prescribing doctor to discuss your reasons for quitting and your quitting plan. If you are still suffering from symptoms of depression, your doctor may want to transition you to another medication or combination of medications.
In the past, doctors have recommended a quick medication taper down to the minimum therapeutic dose. (A taper involves taking progressively smaller doses over the course of days or weeks). 5
Recent research published in a prestigious medical journal outlines new recommendations for treating and preventing SSRI withdrawal symptoms. According to these researchers, the best way to stop an SSRI is with a very slow, very long medication taper. They recommend a taper lasting upwards of one month that continues well past the minimum therapeutic dose until the dose is zero.5
When you stop or reduce your dose of Lexapro, there is a risk that you may begin to feel suicidal. Large-scale research studies have found a clear association between the discontinuation of antidepressants and suicide attempts.6 It is important to keep this in mind during your withdrawal experience. If you begin noticing unusually strong symptoms of depression it imperative that you seek help immediately.
If you or someone you love shows any of the following signs or symptoms after stopping Lexapro, get help:7
- Planning how you would commit suicide if you were going to do it
- Talking or thinking about suicide more than normal, for example, “I wish I were dead”
- Gathering the means to commit suicide, such as bullets or pills
- Feeling hopeless or trapped
- Having intense mood swings
- Engaging in risky or self-destructive activities, such as driving drunk
- Becoming preoccupied with death, dying, or violence
- Getting affairs in order or giving away belongings
- Saying goodbye to people as if it were the last time
About 50 percent of people who recover from one episode of depression will have more depressive episodes in their lifetime.8
If Lexapro didn’t help or you had to stop taking it because of unwanted side effects, then you will need to develop a long-term plan to treat your depression or anxiety. This may include trying different antidepressants or combinations of antidepressants.
Talk therapy is also an evidence-based treatment for depression and anxiety. Not every therapist is going to be a good match for you, so take the time to find a therapist who you will enjoy working with. You may need to try out a few people before you find the right fit.
If you or someone you love is experiencing suicidal thoughts, call the National Suicide Prevention Lifeline (1-800-273-8255). You will be connected with staff or volunteers at a crisis center near you. The people on the other end of the line can help you calm down and figure out what to do next.
If your doctor isn’t helping, consider finding a new psychiatrist, psychologist, or therapist in your area. The Substance Abuse and Mental Health Services Administration (SAMHSA) has a searchable directory of qualified providers. You can also call them at 1-800-662-HELP (4357).
If you have health insurance, you can also search the company’s list of local providers who accept your insurance.
A Word From Verywell
Lexapro has helped millions of people like you and me get our lives back. But what happens next? Most people don’t want to be on antidepressants for the rest of their lives, but they are afraid of what will happen when they finally quit—relapse, withdrawal, etc. Your concerns are not unfounded, getting off antidepressants can be really hard, but with proper planning, it is possible to have a seamless transition. Talk to your doctor about a slow and lengthy taper. You’ll be down to 0mg before you know it.