Tapering off Lexapro or Cipralex (Escitalopram)

Posted by aliali @aliali, Aug 14, 2020

Hi there,
1. Where can I access reliable information for Lexapro tapering off? The leaflet contains no information about that. People use this community to ask for help about this matter, but I feel great hesitation to accept advice from anyone, even my physician. Why?
In the past, I had stopped taking Cipralex 10 mg suddenly and without consulting my physician and a relapse occured. Last week, my physician asked me to take a 10 mg dose rather than a 20 mg dose. I am a little hesitant. Should I do it?! I am looking for some reliable source for tapering off. Should I reduce the dose immediately from 20 mg to 10 mg or take it like 20,10,20..mg per day? I really need your help

Interested in more discussions like this? Go to the Depression & Anxiety Support Group.

Hi @aliali, Here is a brief inventory of recent discussions where members are talking about escitalopram (Lexapro or Cipralex).

- Horrible Lexapro Side Effects Not Going Away. https://connect.mayoclinic.org/discussion/horrible-lexapro-side-effects-not-going-away/
- LEXAPRO https://connect.mayoclinic.org/discussion/lexapro-1/
- Lexapro withdrawals? https://connect.mayoclinic.org/discussion/lexapro-withdrawals/
- how to wean off lexapro 10 mg https://connect.mayoclinic.org/discussion/how-to-wean-off-lexapro-10-mg/
- Lexapro Withdrawal https://connect.mayoclinic.org/discussion/lexapro-withdrawal-1/

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@aliali

@helenfrances
Hi there,
Thanks for being responsive.
I appreciate your time in writing those valuable, supportive posts!
I am living in Saudi Arabia; I can hardly access a reputable physician! I should double-check whether his guidelines are recommended or not.
For example, I have finally accessed a reliable source of information about tapering steps:

https://www.health.harvard.edu/diseases-and-conditions/how-to-taper-off-your-antidepressant

Harvard medical school states that I should decrese my dose by 5 mg each stage: 20,15, 10, 5 mg then no taking anymore. This is clearly different from my physician’s proposal which seems to be unwise. As I am obsessed with the reliability of information I hear or read, it seems like I have to reduce my daily dose to 15 mg rather than 10 mg.

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Many years ago I was told by my excellent pharmacologist/psychiatrist that some people are exquisitely sensitive to certain medications, as I was to imipramine. From a top dose of 70 mg, he helped me go down by taking just 10 mg less on one day a week for a month, then on two days a week for a month etc. It took a long time for me to go down, but it was almost painless. If you have been on your med for a long time, there is no rush. Only you know how you feel. You may feel the difference for a day or two, but you know your own body. You will know whether you can tolerate going faster or not.

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My son has been on escitalopram (Lexapro) since he was 6. He's now 17. The last few years he's had more anxiety/depression/feeling numb and the psychiatry CRNP has increased and added other meds with no improvement. After a discussion about how much he's grown since he was first put on it and how higher dosage is not helping him this last year, we decided to wean him off and see how he does. We've been weaning him off even slower than his CRNP felt necessary to avoid withdrawal symptoms and it's just been rough. He's more anxious and depressed than ever and easily agitated. He just feels hopeless and broken. He was at 25 mg daily. On July 29th, I reduced to 22.5. Then ten days later, I reduced another 2.5. The CRNP said that was not necessary that I can reduce easily by 5 mg. I continued the 2.5 but reduced more frequently. He's down to 10 mg as of 9/14. I've been adding a stress relief supplement called Levium in hopes that it would help him wean off easier but he's really struggling. I wish there was something that could be taken to help buffer the process but not cause its own side effects or addiction. Any suggestions on what help others that have gone through this process before? Was anyone successful at staying off of it?

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@shannoleary

My son has been on escitalopram (Lexapro) since he was 6. He's now 17. The last few years he's had more anxiety/depression/feeling numb and the psychiatry CRNP has increased and added other meds with no improvement. After a discussion about how much he's grown since he was first put on it and how higher dosage is not helping him this last year, we decided to wean him off and see how he does. We've been weaning him off even slower than his CRNP felt necessary to avoid withdrawal symptoms and it's just been rough. He's more anxious and depressed than ever and easily agitated. He just feels hopeless and broken. He was at 25 mg daily. On July 29th, I reduced to 22.5. Then ten days later, I reduced another 2.5. The CRNP said that was not necessary that I can reduce easily by 5 mg. I continued the 2.5 but reduced more frequently. He's down to 10 mg as of 9/14. I've been adding a stress relief supplement called Levium in hopes that it would help him wean off easier but he's really struggling. I wish there was something that could be taken to help buffer the process but not cause its own side effects or addiction. Any suggestions on what help others that have gone through this process before? Was anyone successful at staying off of it?

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You might ask your doc about low dose Prozac as a bridge. I’ve heard it does work. I tried the Levium. It was very expensive and did nothing for me. I think if this was a good supplement more would be taking it and talking about it. We’ve all heard about Levium, it’s advertised all over the internet.

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@pankaj

@menzies: I am a bit puzzled at the manner in which your doctor has advised tapering of Escitalopram. To the best of my knowledge, it should be gradual, i.e, from 20 to 15 to 10 etc, over several weeks, as you have been taking this medication for more than 10 years. Taking it for a few more weeks will not cause severe liver damage, beyond what has already happened. But it will reduce the severity of your withdrawal symptoms. And please don't taper the benzo at the same time; taper one medication at a time, not two. Escitalopram has the best side effect profile, so gradual withdrawal should not be difficult. Also curious to know whether your doctor intends to replace it with another antidepressant, and if so which one. Please stay calm, everything will be OK. All good wishes for your successful recovery. Regards.

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So what happens if you've been on 5 mg for one month (higher prior, up to 20 which caused serotonin saturation, down to 10, now 5)? How does one stop that, 2.5 and then nothing?

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I would suggest you take your doctor’s advice and drop to 10 mg. During this time, be sure to using coping skills to help with the transition. You may experience flu-like symptoms for awhile. I advise counseling during this time (if you aren’t already doing this). Prayers & hugs, wish you the best. If you struggle too much, be sure to let the doctor know.

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@loriem

So what happens if you've been on 5 mg for one month (higher prior, up to 20 which caused serotonin saturation, down to 10, now 5)? How does one stop that, 2.5 and then nothing?

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The pharmacist told us to decrease by 10% every three to 4 weeks as long as you’re stable before decreasing again. Once my son was at 5 mg, the doctor prescribed the lexapro in liquid form, so that we could decrease by 10% since you can’t cut a pill in such small increments. We are still trying to taper down to zero. It’s no easy task. 🙏🏻💙

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What is the procedure to stop taking escitalopram(cipralex 10mg) after 3 years of usage.Especially interested this procedure to last 1 month.

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@constantinos

What is the procedure to stop taking escitalopram(cipralex 10mg) after 3 years of usage.Especially interested this procedure to last 1 month.

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Hello @constantinos and welcome to Mayo Connect. You are asking a good question. You must realize that when you stop taking a prescription like escitalopram, also known as Lexapro, it is important to taper off the medication slowly. The length of time to taper is undoubtedly different for each person.

Here is a Connect discussion on this topic which you might find helpful:
— Tapering off Lexapro or Cipralex (Escitalopram):
https://connect.mayoclinic.org/discussion/tapering-off-lexapro-or-cipralex-escitalopram/

I see that you want to end this process in one month. Is there a specific reason for this? Please know that might not be possible. Each person is different in their tolerance to this tapering off process.

Did your doctor or pharmacist suggest a tapering schedule to gradually reduce the dosage to make it easier?

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Dr. Tapering scdedule. It's been 30 days now: from 20 mg to 10 mg two weeks, 10 mg to 5 mg two weeks and now no more. I feel horrible. Was originally prescribed for vertigo and sleep disorder. Took for 3 years and want to stay off of it. How long do these weird feelings last?

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