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Tapering off Escitalopram (Lexapro)

Depression & Anxiety | Last Active: 1 day ago | Replies (8)

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@mmsm Here's the most recent study:

For someone who has taken Lexapro (escitalopram) 10 mg for 5 years, a taper of 5 mg for 7 days, then stop is often too fast and not considered best practice for many people.

Why this matters:

Lexapro is an SSRI with effects on brain serotonin receptors that adapt over time. After long-term use, stopping too quickly can trigger SSRI discontinuation syndrome, which is common, not rare.

Symptoms may include:

Anxiety, agitation, or panic.

Dizziness or “brain zaps”.

Palpitations.

Insomnia.

Flu-like symptoms.

Mood swings or depression relapse.

These symptoms can appear within days of stopping and are often mistaken for “anxiety returning” or heart issues.

Is 5 mg for 7 days → stop “standard”?

It is sometimes suggested by PCPs.

It is not the approach most psychiatrists or guidelines recommend after years of use.

It carries a higher risk of withdrawal, especially in sensitive individuals or those already experiencing palpitations.

What is generally considered safer:

Many experts recommend:

Slow, gradual tapering, often over weeks to months.

Reductions of 10–25% of the dose every 2–4 weeks.

Slowing further once below 5 mg, where withdrawal risk increases.

A common example (one of many possible approaches):

10 mg → 7.5 mg for several weeks.

7.5 mg → 5 mg for several weeks.

5 mg → 2.5 mg for several weeks.

Then stop.

(Some people go even slower.)

Important nuance in your case:

Since:

You’ve been on Lexapro 5 years>

You’re already experiencing palpitations.

A cardiologist advised stopping.

A slower taper is usually more, not less, heart-friendly because it avoids sudden nervous-system stress.

Key takeaways:

Withdrawal symptoms are real and well-documented*

Fast tapers increase the risk.

If symptoms appear, it does not mean you “need the drug again” — it may mean the taper was too quick.

A psychiatrist (or PCP comfortable with slow tapers) is often better suited to guide this.

Source's:

. Lexapro (escitalopram) FDA prescribing information (official label) — tapering recommended.
The FDA label for Lexapro says:

1. > “A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible.”
📄 Full PDF: https://www.fda.gov/media/135185/download

2. Harvard Health Publishing — Going off antidepressants:
Harvard Medical School explains that slow tapering over weeks to months helps minimize withdrawal symptoms.
It also notes rapid discontinuation (1–7 days) increases risk of relapse vs. gradual taper.
https://www.health.harvard.edu/diseases-and-conditions/going-off-antidepressants
3. Cleveland Clinic — Antidepressant Discontinuation Syndrome
Discusses common withdrawal symptoms and emphasizes that the best way to prevent them is to slowly taper under a provider’s guidance. https://my.clevelandclinic.org/health/diseases/25218-antidepressant-discontinuation-syndrome

Research & Clinical Practice Resources:

4. Clinical practice guideline review (PMC)
A systematic review found most major guidelines recommend gradual tapering for antidepressants, and withdrawal symptoms can be common after stopping long-term use.
https://pmc.ncbi.nlm.nih.gov/articles/PMC8841913/
5. SSRI tapering evidence (PubMed). Research shows tapering over months and reducing dose slowly (especially at low doses) leads to fewer withdrawal symptoms than abrupt stopping.
https://pubmed.ncbi.nlm.nih.gov/30850328/
Royal College of Psychiatrists — stopping antidepressants
The UK Royal College states if you get withdrawal symptoms, you should slow down the taper — not stop abruptly. https://www.rcpsych.ac.uk/mental-health/treatments-and-wellbeing/stopping-antidepressants

Additional Helpful Info:

7. Wikipedia (Escitalopram) — Withdrawal section
Summarizes evidence that abrupt stopping (especially after long-term use) is linked with withdrawal symptoms, and very slow tapering is recommended. https://en.wikipedia.org/wiki/Escitalopram

What these sources collectively show:

✔️ SSRIs like Lexapro can cause withdrawal symptoms if stopped too fast.
✔️ Slow tapering (weeks to months) is widely recommended by guidelines and experts.
✔️ Abrupt cessation or very rapid taper increases risk of symptoms.

For context, I want to share where my comments are coming from. I’ve spent more than 20 years independently investigating epidemiological data, scientific literature, and peer-reviewed medical research across a wide range of topics. My focus has always been on primary sources—original studies, systematic reviews, and consensus statements—rather than summaries, headlines, or anecdotal reports.

I make a point of cross-checking claims, understanding study design and limitations, and distinguishing between correlation, causation, and hypothesis. When evidence is incomplete or evolving, I try to say so clearly. When strong data exist, I rely on that rather than speculation or opinion.

I’m not here to persuade or argue, but to contribute information that is evidence-based, transparent, and open to correction if better data emerge. Thoughtful discussion grounded in reliable science benefits everyone, and that’s the spirit in which I participate here.

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Replies to "@mmsm Here's the most recent study: For someone who has taken Lexapro (escitalopram) 10 mg for..."

@tommy901 Hi Tommy, I really appreciate all of that wonderful information. I switched from 10 to 5 with (thank goodness) little to no withdrawal, just have a headache, but not too bad. Unfortunately however, my pcp won't prescribe me more pills and the pharmasist strongly suggested not cutting the 5mg in half. SO with that being said I am just hoping and praying I will be okay.