How to Safely Discontinue Lexapro: Tips for Managing Withdrawal Symptoms

How to discontinue the use of Lamotrigine?

Due to gastrointestinal issues that could not be resolved, I was referred to a psychiatrist.
The psychiatrist diagnosed me with autonomic nervous system dysregulation and prescribed Lurasidone, which I took for over three months without improvement.
I then gradually reduced and stopped the medication on my own, experiencing no significant symptoms during the tapering process.
However, after stopping the medication, I developed insomnia, waking up frequently and sometimes only sleeping for 2 to 3 hours at a time, making it difficult to fall back asleep.
I feel very tired in the mornings and am unsure how long this will last.
During this period, I also visited other medical clinics and was prescribed an alternative medication, Sertraline, but I am still hesitant about taking it.
I want to discontinue Lurasidone and would like to know how to proceed.

Xiao Xuan, 30~39 year old female. Ask Date: 2021/09/04

Dr. Zhang Gengjia reply Psychiatry

Dear Sir/Madam,
From your letter, it is clear that you are experiencing discomfort and distress due to autonomic nervous system dysfunction and the pressure of insomnia.

1.
Facing an uncertain future, autonomic nervous system dysfunction is a common condition in modern society.
This is a chronic illness that requires long-term treatment for recovery.
2.
Regarding pharmacological treatment, each primary medication requires 4 to 6 weeks to assess its efficacy.
I recommend that if you experience any discomfort, you should note the duration and frequency of these symptoms.
For any physiological issues, please discuss them thoroughly with your physician during your follow-up visit, as some symptoms may be related to the original condition, while others could be side effects of the medication.
3.
Additionally, the pandemic may have contributed to mental and physical stress.
You can refer to the following news article: https://udn.com/news/story/7266/5715088.
Our clinic is open Monday to Friday, both in the morning and afternoon.
I suggest you consider visiting the clinic for a personal evaluation of your symptoms, so we can collaboratively determine the best course of action for you.
Wishing you good mental and physical health.
Sincerely,
Dr.
Chang Geng-Jia
Department of Psychiatry

Reply Date: 2021/09/04

More Info

Discontinuing Lexapro (escitalopram), a commonly prescribed selective serotonin reuptake inhibitor (SSRI) for depression and anxiety, requires careful consideration and a structured approach to minimize withdrawal symptoms and ensure a smooth transition. Here are some tips and insights on how to safely discontinue Lexapro, especially in light of your experience with insomnia and fatigue.

1. Consult Your Healthcare Provider
Before making any changes to your medication regimen, it is crucial to consult your healthcare provider. They can provide personalized advice based on your medical history, current symptoms, and overall health. Abruptly stopping Lexapro can lead to withdrawal symptoms, including mood swings, irritability, dizziness, and sleep disturbances.

2. Gradual Tapering
If you have been taking Lexapro for three months, a gradual tapering schedule is advisable. This means slowly reducing the dose over time rather than stopping suddenly. Your doctor can help create a tapering plan, which may involve reducing your dose by a small percentage every few weeks. This approach helps your body adjust to lower levels of the medication and can minimize withdrawal symptoms.

3. Monitor Withdrawal Symptoms
As you taper off Lexapro, keep track of any withdrawal symptoms you experience. Common symptoms can include insomnia, fatigue, anxiety, and flu-like symptoms. If you notice significant discomfort or if symptoms worsen, contact your healthcare provider. They may recommend adjusting your tapering schedule or suggest alternative medications to help manage withdrawal symptoms.

4. Consider Alternative Medications
You mentioned that you have been prescribed an alternative medication, such as Zoloft (sertraline). Discuss with your doctor whether starting this medication while tapering off Lexapro might help alleviate withdrawal symptoms. Sometimes, switching to another SSRI or a different class of antidepressants can provide a smoother transition.

5. Lifestyle Modifications
Incorporating lifestyle changes can also help manage withdrawal symptoms. Here are some strategies:
- Sleep Hygiene: Establish a regular sleep schedule, create a calming bedtime routine, and limit screen time before bed to improve sleep quality.

- Exercise: Regular physical activity can boost mood and improve sleep. Aim for at least 30 minutes of moderate exercise most days of the week.

- Nutrition: A balanced diet rich in fruits, vegetables, whole grains, and lean proteins can support overall health and well-being.

- Mindfulness and Relaxation Techniques: Practices such as yoga, meditation, and deep-breathing exercises can help reduce anxiety and improve sleep.

6. Stay Connected
Reach out to friends, family, or support groups during this transition. Sharing your experiences and feelings can provide emotional support and help you feel less isolated.

7. Be Patient
Withdrawal symptoms can vary in duration and intensity from person to person. While some individuals may experience symptoms for a few weeks, others might find that it takes longer for their body to adjust. It’s essential to be patient with yourself during this process and allow your body the time it needs to heal.

Conclusion
Discontinuing Lexapro should be approached with caution and under the guidance of a healthcare professional. Gradual tapering, monitoring for withdrawal symptoms, and considering alternative treatments can help ease the transition. Additionally, lifestyle modifications can support your mental and physical well-being during this time. Remember, you are not alone in this journey, and seeking support from healthcare providers and loved ones can make a significant difference.

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