Lexapro Withdrawal

Lexapro (escitalopram) is a commonly prescribed antidepressant medication. It belongs to a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). Lexapro works by increasing levels of serotonin, a neurotransmitter that regulates mood, in the brain. It is approved by the FDA for treating major depressive disorder and generalized anxiety disorder in adults.

Lexapro is one of the most widely used antidepressants. In 2021, over 14 million prescriptions were written for escitalopram in the United States alone. Though generally well-tolerated, Lexapro does have potential side effects and can cause withdrawal symptoms when discontinued abruptly. This article will provide an in-depth overview of Lexapro, including its uses, benefits, side effects, and withdrawal process.

How it Works

Lexapro enhances serotonin signaling in the brain by inhibiting the reuptake of serotonin. Here's a quick explanation of how it works [1]:

  • Serotonin is a neurotransmitter that sends chemical messages between brain cells. It plays a key role in regulating mood.
  • Normally, after serotonin is released into the synapse (space between nerve cells), it binds to receptors on the next nerve cell and then is reabsorbed into the original cell through a process called reuptake.
  • Lexapro blocks the reuptake of serotonin by binding to serotonin transporters on nerve cells. This leaves more serotonin available in the synapse to bind to receptors and prolongs its effects.
  • With more serotonin active in the brain, Lexapro lifts mood and provides antidepressant and anti-anxiety effects.
Whiskey Glass
Table of Contents
Primary Item (H2)

Call Today For Help Managing Your Lexapro Withdrawal Symptoms Call us today!

Benefits of Lexapro

  • Lexapro is FDA-approved to treat the following conditions [2]:

    • Major depressive disorder
    • Generalized anxiety disorder

    It has also shown efficacy in clinical trials for:

    • Social anxiety disorder
    • Panic disorder
    • Obsessive compulsive disorder

    The key benefits of Lexapro include:

    • Lifts mood and reduces symptoms of depression such as sadness, loss of interest, low energy, and suicidal thoughts.
    • Alleviates anxiety, worry, panic attacks, and fear.
    • Improves overall functioning and quality of life.
    • Safe, well-tolerated with mild side effects for most people.
    • Not as sedating as some other antidepressants.
    • Shown to be effective long-term.
Lexapro Addiction Treatment Program

Common Side-Effects

Lexapro is generally well tolerated, but some potential side effects, especially when first starting treatment, include [3]:


  • Nausea is one of the most frequently reported side effects of Lexapro, occurring in up to 20% of people.
  • It tends to be worst when first starting treatment or increasing the dosage. The nausea is usually mild to moderate and often goes away within 1-2 weeks as the body adjusts to the medication.
  • Taking Lexapro with food can help minimize feelings of nausea. If it persists, a doctor may recommend anti-nausea medication.


  • Up to 10% of individuals taking Lexapro experience insomnia or trouble sleeping.
  • The insomnia may involve difficulty falling asleep, frequent awakening through the night, and early morning wakening.
  • The activation effects of Lexapro that improve daytime energy can make it more difficult to fall asleep. Trouble sleeping often improves over time.
  • Taking Lexapro in the morning rather than evening can minimize insomnia for some people. Sleep hygiene tips like avoiding screens before bedtime, limiting caffeine intake, and relaxation techniques can also help combat Lexapro-induced insomnia.

Decreased Libido

  • Lexapro may cause decreased sex drive in up to 10% of users.
  • It is thought to occur because high serotonin levels inhibit dopamine, a neurotransmitter involved in sexual arousal and pleasure.
  • Both men and women can experience lowered libido, difficulty becoming aroused, and inability to reach orgasm while taking Lexapro.
  • Symptoms generally improve over time or with dosage adjustments. Discussing options with a doctor rather than abruptly quitting medication is advised. Some counteractive strategies include adding bupropion, drug holidays, or scheduling sexual activity for when medication levels are lowest.
schedule a call today
a man trying to help a loved one struggling with addiction


  • Up to 10% of people taking Lexapro experience drowsiness, especially when first starting treatment.
  • The drowsiness tends to improve within the first few weeks as the body adjusts to the medication. Taking Lexapro at bedtime can minimize daytime drowsiness.
  • If daytime drowsiness persists, discuss with your doctor. They may adjust timing/dosage or recommend stimulants like modafinil to counteract the sedating effects.


  • Headache is reported in up to 25% of individuals starting Lexapro treatment.
  • The headaches are generally mild and transient, often subsiding as the body acclimates to the medication in 1-2 weeks.
  • Staying hydrated, getting adequate rest, over-the-counter pain relievers, and relaxation techniques can help manage headaches until they resolve.

Increased Sweating

  • Up to 10% of people notice increased perspiration or night sweats after starting Lexapro.
  • The mechanism is unknown but seems related to shifts in serotonin levels. Sweating often improves on its own within a few weeks.
  • Using an antiperspirant and wearing breathable fabrics can help manage symptoms. Speak to your doctor if bothersome or embarrassing sweating persists.

Dry Mouth

  • Because Lexapro inhibits saliva production, up to 10% of users experience dry mouth or thirst.
  • Symptoms may include parched mouth, hoarse voice, cracked lips, mouth sores, and bad breath.
  • Drink plenty of water, chew sugar-free gum, use a humidifier, and practice good oral hygiene to alleviate dry mouth. Your doctor may also recommend medication to stimulate saliva flow.


  • Up to 10% of people taking Lexapro develop diarrhea, characterized by loose, watery stools.
  • It is likely caused by Lexapro's effects on serotonin levels in the gastrointestinal tract. Diarrhea often resolves on its own within a few weeks.
  • Staying hydrated, eating bland foods like bananas or rice, eliminating caffeine/alcohol, and over-the-counter anti-diarrheals can help manage symptoms. Seek medical advice if diarrhea is severe.


  • Some individuals experience tiredness, lethargy, or lack of energy while taking Lexapro. Fatigue impacts up to 10% of users.
  • The exact cause is unclear but may relate to changes in sleep patterns or metabolism. Fatigue typically improves with time as the body adjusts.
  • Getting enough sleep, eating a balanced diet, exercising regularly, and staying mentally stimulated can counteract Lexapro-related fatigue. Discuss with your doctor if fatigue interferes with daily activities.


  • Fine involuntary muscle tremors affect up to 5% of those taking Lexapro. Tremors typically occur in the hands but may also affect the arms, legs, head, mouth, or tongue.
  • The tremors tend to be mild and temporary, dissipating within the first 1-2 months of treatment. Reducing dosage often minimizes tremors.
  • If bothersome, your doctor may prescribe beta-blockers or anticonvulsants to counteract the tremors.

Our Lexapro Addiction Treatment Programs

Partial Hospitalization Program California - Crescent Moon Recovery LLC

Detox : 
Drugs &

The detoxification process takes place in one of our high end residential treatment centers with 24/7 medical supervision by state-certified addiction practitioners.
Partial Hospitalization Program California - Crescent Moon Recovery LLC


Participants stay within the same facility that they completed detox in, partaking in various therapeutic treatment modalities and have access to all amenities offered.
Partial Hospitalization Program California - Crescent Moon Recovery LLC


This is typically a 30 day stay within a beautiful residential center in Orange County, with access to a variety of therapies, case management, and psychiatry.
Partial Hospitalization Program California - Crescent Moon Recovery LLC


PHP offers 30 clinical hours over a 5 day week and can last for 4-8 weeks. Participants can commute from home or live in one of our gorgeous sober lives here in Orange County.

Some less common side-effects are:

Weight Changes

  • Lexapro may cause modest weight changes, both weight loss and weight gain, in some users. About 2% experience significant weight fluctuations.
  • The mechanism is unclear but may involve effects on metabolism, fluid retention, or changes in appetite/cravings.
  • Maintaining a healthy diet and exercise regimen can help minimize Lexapro-related weight changes. Notify your doctor if weight changes are bothersome.

Blurred Vision

  • A small percentage of individuals taking Lexapro report blurred vision or difficulty focusing their eyes.
  • It can be caused by pupils dilating or muscle/nerve issues resulting from Lexapro’s effects on serotonin. Symptoms are usually temporary.
  • If vision problems persist, speak to an optometrist to rule out other causes. Dose adjustments may be needed.


  • Some people experience lightheadedness, vertigo, or a swimming sensation when starting Lexapro. Dizziness typically resolves within a few weeks as the body adjusts.
  • Taking Lexapro before bed, moving slowly when changing positions, and keeping hydrated can help reduce symptoms. Report persistent or severe dizziness to your doctor.


Finally, some uncommon side-effects can present themselves:

Skin Rash

  • A small number of people may develop skin rashes, hives, or itching while taking Lexapro. These allergic reactions are not well understood but likely involve histamine release.
  • Rashes generally appear within the first 1-2 weeks and resolve quickly once the medication is stopped. Seek immediate medical attention if rash is accompanied by fever, swelling, or blisters.


  • There is a slight risk of mania or hypomania in a subset of individuals taking Lexapro, estimated at less than 1%.
  • Symptoms involve elevated energy and mood, impulsive behavior, racing thoughts, and reduced need for sleep.
  • Mania requires promptly discontinuing Lexapro and may signal underlying bipolar disorder. This serious side effect highlights the importance of carefully screening patients before prescribing Lexapro.
Therapy For Anxiety in Orange Count
Partial Hospitalization Program California - Crescent Moon Recovery LLC


MAT involves using FDA-approved medications, in combination with counseling and behavioral therapies, to help individuals overcome substance use disorders.
Partial Hospitalization Program California - Crescent Moon Recovery LLC


Half the clinical hours of PHP & more flexible schedule. As clients accrue sobriety time, hours are tapered down, while maintaining therapeutic support.
Partial Hospitalization Program California - Crescent Moon Recovery LLC


This program offers greater flexibility to continue your daily schedule during treatment. This program meets twice per week in the evenings.
Partial Hospitalization Program California - Crescent Moon Recovery LLC


Our sober living homes are residential facilities that provide a structured and supportive environment for individuals in addiction recovery.

Understanding Lexapro Withdrawal

Lexapro is not addictive but many long-term users do experience withdrawal symptoms when reducing dosage or stopping the medication. This occurs because the brain becomes dependent on the artificially elevated serotonin levels. When Lexapro is discontinued, serotonin drops and the brain must readjust. The resulting imbalance in neurotransmitters causes both physical and emotional withdrawal symptoms.

Causes of Lexapro Withdrawal

There are several situations that can precipitate Lexapro withdrawal:

Abrupt Discontinuation

Suddenly stopping Lexapro after extended use leads to a steep plunge in serotonin levels. This shock to the brain often triggers severe withdrawal. Doctors strongly advise gradually tapering dosage over a period of weeks or even months to avoid harsh side effects.

For example, someone taking 20mg/day for a year should gradually reduce by 5mg each week before fully stopping. This gradual decline in dosage gives the brain more time to rebalance neurotransmitters and adapt to functioning with less serotonin augmentation. Quitting Lexapro abruptly after long-term use almost always leads to difficult withdrawal.

Missing Doses

If someone inadvertently forgets to take their regular Lexapro dose, withdrawal can start within hours because of the drop in serotonin. Symptoms generally resolve quickly once dosage is resumed. But multiple missed doses in a row substantially increase withdrawal severity.

This is because Lexapro has a short half-life - its concentration in the body drops by 50% every 24 hours. Just a few missed doses can leave someone with minimal Lexapro left in their system. This sends serotonin levels plummeting and triggers escalating withdrawal symptoms.

Dose Reductions

Doctors may incrementally reduce someone's Lexapro dosage over weeks or months to help safely transition off the medication. Even with this gradual tapering schedule, each dose decrement causes mild withdrawal effects as the brain adjusts to slightly lower serotonin levels.

Symptoms tend to emerge towards the end of the dosage interval as the last dose wears off. These minor withdrawal episodes after each dose reduction compile to increase overall withdrawal discomfort during the taper. This is unavoidable but reinforces the importance of gradual Lexapro cessation.

Drug Interactions

Starting or stopping a medication that interacts with Lexapro can disrupt serotonin balance and cause pseudo-withdrawal. For example, drugs like tramadol, linezolid, and methylene blue prevent Lexapro from working properly. This leads to falling serotonin levels and withdrawal symptoms even if the Lexapro dosage remains constant. Checking for medication and supplement interactions is important before and during Lexapro treatment.

Physiological Factors

Elements like genetics, metabolism, age, and medical conditions influence how dependent someone's neurochemistry becomes on Lexapro for proper serotonin signaling. These innate and acquired factors affect the brain's sensitivity and adaptability to dosage changes.

For instance, a mutation in the CYP2C19 liver enzyme that metabolizes Lexapro could lead to much higher blood levels for a given dose. If this person stops suddenly, their withdrawal may be more extreme due to the exaggerated imbalance. Older individuals and those with conditions like hypothyroidism that slow metabolism are also prone to more intense withdrawal effects.

In general, the longer someone takes therapeutic doses of Lexapro, the more ingrained the serotonin imbalance becomes. As a result, intense withdrawal symptoms upon discontinuation become increasingly likely.

Physical and Emotional Symptoms

Lexapro withdrawal can produce an array of uncomfortable symptoms, both physical and psychological. These usually start within a few days after stopping Lexapro but can emerge after just missing one dose.

Withdrawal normally lasts for 2-4 weeks but symptoms may persist at lower intensity for months in some cases, especially after long-term treatment. The severity and duration of symptoms depend on individual factors like dosage, length of treatment, physiology, and rate of taper.

Physical Symptoms

  • Headache - From mild to migraine levels depending on withdrawal intensity
  • Nausea and vomiting - Particularly when first waking after missing doses
  • Dizziness - Sensations of the room spinning with balance difficulties
  • Fatigue - Feeling exhausted, lack of energy, and hypersomnia
  • Flu-like aches and chills - Joint pain, muscles aches, runny nose, and general malaise
  • Insomnia or vivid dreams - Trouble falling and staying asleep with intense dream activity
  • Tremors - Shakiness in hands, fingers, arms that is apparent at rest
  • Electric shock sensations - Also called brain zaps; brief but disturbing jolts
  • Changes in appetite and weight - Usually reduced appetite and weight loss
  • Diarrhea - Frequent loose stools characteristic of discontinuation
  • Sensory disturbances - Tingling, numbness, blurred vision, ringing ears

Emotional Symptoms

  • Depression and hopelessness - Feelings of sadness and despair
  • Irritability and anxiety - Increased temper, frustration, and apprehension
  • Mood swings - Rapid fluctuations in mood and emotional reactivity
  • Loss of interest and motivation - Apathy, lack of engagement in activities
  • Crying spells - Tearfulness over minor frustrations
  • Panic attacks - Episodes of acute fear, heart palpitations, dizziness
  • Thoughts of suicide or self-harm - Reemergence of disturbing suicidal ideations
  • Poor concentration and memory - Mental fogginess, difficulty focusing
  • Nightmares or intrusive thoughts - Disturbing dreams and repetitive thoughts

These unpleasant withdrawal effects underscore why it is critical to wean off Lexapro slowly under medical supervision. Abruptly stopping puts someone at risk of debilitating physical and psychological symptoms. Doctors may prescribe interim medications like Prozac to smoothen the crossover and minimize the impact of withdrawal.

Discontinuation vs. Relapse

Lexapro withdrawal symptoms can sometimes be confused with a return of the original anxiety or depression. However, there are ways to distinguish between discontinuation effects versus true psychiatric relapse:

Time Course

Relapse tends to occur gradually whereas discontinuation symptoms emerge within days of stopping Lexapro. Withdrawal starts quickly but improves steadily whereas relapse intensifies over time.

Medication Response

Restarting Lexapro will alleviate withdrawal but has little effect on returning psychiatric symptoms. Relapse often requires starting a different antidepressant medication.

Symptom Profile

While there is overlap, withdrawal is characterized more by physical symptoms like dizziness, headaches, and nausea, while relapse centers on sadness, suicidal thoughts, and lack of interest.


Withdrawal symptoms typically resolve within weeks whereas relapse persists indefinitely without treatment. Lingering symptoms beyond a month likely signify a genuine recurrence of anxiety or depression rather than mere withdrawal effects.

Distinguishing withdrawal from relapse ensures people get appropriate care. The discomfort of withdrawal wanes with time but recurring mental illness needs acute attention and modification of long-term treatment plans. Being attuned to the unique characteristics and trajectories of withdrawal versus relapse allows for optimal management when discontinuing Lexapro.

Managing Withdrawal Symptoms

Lexapro withdrawal can be challenging to endure, but there are ways to ease the transition and get through this period safely under medical supervision. Understanding the general timeline of withdrawal and utilizing coping strategies allows people to minimize discomfort until serotonin levels normalize.

Lexapro Withdrawal Timeline

While variable between individuals, Lexapro withdrawal often follows a rough timeline after completely stopping the medication:

In the first few days, usually days 1-4, the first signs of withdrawal appear. These early symptoms tend to be milder and include flu-like achiness, insomnia, nausea, and sensory disturbances like tingling or electric shock sensations. While unpleasant, these initial symptoms are usually manageable with over-the-counter remedies and lifestyle adjustments.

Withdrawal typically intensifies in the second week, around days 5-7. This period often represents the peak of withdrawal severity. Depression, anxiety, crying spells, vertigo, and brain zaps are common during this time, along with continued flu-like symptoms and sleep disruption. Support and coping aids become crucial to endure the peak symptoms.

In the third and fourth week after stopping Lexapro, most physical symptoms resolve but psychological symptoms persist. Depression, mood swings, and difficulty concentrating prevail during this time. Energy starts to return but motivation may remain low and crying spells still occur. Ongoing support and redirection of thoughts is important.

Finally, by weeks 5-6, most symptoms are improving steadily. Psychological symptoms continue to abate, energy increases, and normal sleep returns for most people. However, brain zaps may still strike periodically and low-grade headaches, fatigue, and emotional sensitivity could linger. Anxiety about coping without the medication diminishes.

With very gradual dosage tapering under medical supervision, the timeline is more attenuated and protracted. But the week 2-3 mark remains the peak of withdrawal intensity before symptoms begin improving. Understanding the usual ebb and flow of withdrawal makes it more tolerable.

Coping Strategies

There are many constructive techniques to manage withdrawal discomfort:

  • Continue stress-relieving habits like therapy, meditation, yoga, journaling, and social support.
  • Avoid major life changes or important decisions until withdrawal passes.
  • Stay busy and engaged in hobbies, especially mentally absorbing activities.
  • Get regular exercise to boost endorphins and manage anxiety.
  • Maintain a healthy diet and stay hydrated.
  • Seek counseling if suicidal thoughts reemerge.
  • Use OTC remedies for physical symptoms like headaches, nausea, and diarrhea.
  • Ask about short-term medications to manage insomnia, anxiety, or depression during withdrawal.

Having an arsenal of coping tools makes withdrawal more bearable, especially getting through the peak severity period.

Importance of Medical Supervision

It is vital to work closely with a doctor when discontinuing Lexapro to:

Gradually tapering dosage over weeks or months under medical supervision substantially reduces the risks, severity and duration of withdrawal. This approach eases the neurochemical adaptations needed as serotonin declines. Doctors can provide encouragement and adjust the taper schedule if symptoms flare and become unmanageable.

Doctors can also prescribe supportive medications to ease particular withdrawal symptoms like insomnia, anxiety, or depression that emerge despite gradual tapering. Monitoring mental health and distinguishing withdrawal effects from psychiatric relapse is another key role for physicians. They may alter medications or treatment plans if it appears an underlying condition is resurfacing.

Good medical oversight also involves conducting important health screening during withdrawal like monitoring weight, blood pressure, and suicidal ideation. Emotional support and expert guidance on what to expect reduces uncertainty and anxiety during this transition.

Withdrawing from any psychiatric drug without medical supervision is extremely risky. Having your doctor's assistance through the ups and downs of withdrawal facilitates safe discontinuation. Be transparent with them about all symptoms so they can provide optimal management and reassurance.

Alternatives Treatments

In addition to traditional medical management, there are some other medications and therapeutic techniques that may help ease Lexapro withdrawal effects. These alternatives should be discussed with a doctor to determine appropriate options on a case-by-case basis.

Medication Options

Prozac (fluoxetine)

Due to its exceptionally long half-life, Prozac remains active in the body much longer than shorter-acting SSRIs like Lexapro. Doctors may prescribe Prozac during withdrawal and slowly taper the dosage over months. This effectively bridges the gap, keeping serotonin levels more stable and avoiding steep drops during the crossover process. For maximum benefit, the switch to Prozac should occur while still taking Lexapro so their effects overlap. Typical dosage is 10-20mg daily for 4-6 months tapering.

Trintellix (vortioxetine)

This newer antidepressant modulates serotonin activity in a complex, nuanced manner rather than simply blocking reuptake. Switching to Trintellix avoids complete serotonin system depletion during Lexapro withdrawal. Trintellix is not an SSRI and has a lower incidence of discontinuation symptoms. Gradual cross-tapering Lexapro down as Trintellix is titrated up over several weeks can facilitate transitioning. The target dose is usually 10-20mg daily.


This non-habit forming anti-anxiety medication stimulates serotonin 1A receptors similarly to SSRIs, but without directly blocking serotonin reuptake. This may help manage anxiety, irritability, and insomnia during Lexapro withdrawal. Buspirone is typically dosed at 10-30mg divided into 2-3 daily doses. It takes about 2 weeks to take full effect.


Clonidine reduces adrenergic overdrive involved in withdrawal symptoms like agitation, panic attacks, and insomnia. It may be prescribed at low doses of 0.1-0.3 mg twice daily in the short-term to help alleviate these effects during peak withdrawal intensity.

Beta blockers

Beta blockers like propranolol curb the autonomic arousal behind symptoms such as heart palpitations and tremor. Beta blockers do not alter neurotransmitter systems long-term but can provide temporary relief of hyperadrenergic symptoms. Doses around 10-40mg twice daily may be used symptomatically during withdrawal.

Supplements and Herbal Remedies

Omega-3 fatty acids

Fish oil and other omega-3 supplements help replenish membranes that are depleted by long-term SSRI usage. This structural support aids withdrawal. High doses up to 2 grams of combined EPA/DHA daily may be helpful.


Magnesium supplementation can ease muscle cramps, tension, anxiety, insomnia and irritability - common Lexapro withdrawal complaints. Doses of 400-600 mg daily in divided doses, preferably as chelated formulations for better absorption, may provide relief.


This amino acid is the precursor for serotonin synthesis in the body and brain. L-tryptophan at doses of 500-2000 mg twice daily may soften the serotonin plunge during Lexapro withdrawal. It may also improve sleep.


Probiotic supplements support healthy gut microbiota which influence neurotransmitter balance through the gut-brain axis. This stabilizing effect could benefit Lexapro withdrawal. Doses around 20-50 billion CFUs from reputable brands taken daily may be helpful.

Call Crescent Moon Recovery's Lexapro Addiction Team For Help Today!

Frequently Asked Questions

With gradual tapering under medical supervision, withdrawal symptoms can be minimized or avoided completely. Abruptly stopping almost always leads to difficulties. The slower the taper, the easier the transition.
Lexapro does not cause addiction. Withdrawal upon discontinuation occurs due to temporary neurochemical imbalances as the brain readjusts, especially if stopped abruptly. This is not the same as an addictive substance dependence withdrawal.
Quitting Lexapro abruptly after long-term use is never advisable. It risks severe physical and psychological withdrawal effects. Tapering is always the safest method to discontinuing any antidepressant.
Yes, emotional symptoms like anxiety, depression, and irritability very commonly occur during withdrawal. These reflect neurochemical fluctuations as the brain adapts to lower serotonin levels. Psychological symptoms should improve with time.
Recurring depression or anxiety may indicate the underlying condition rather than mere withdrawal effects. However, distinguishing between the two and modifying long-term treatment should be overseen by a doctor. Lifelong Lexapro continuation is not always necessary.
Practicing good sleep hygiene, avoiding stimulating substances in the evening, natural remedies like magnesium or melatonin, and temporary use of approved sleep aids can all help manage insomnia during withdrawal.


Timeline of withdrawal:

Coping strategies:

Medical supervision:

Support groups:

Serving Southern California.

Wherever you are in Southern California, we have a local addiction treatment center near you.
"The Only Place To Be"


Evidenced based rehab and mental health treatment for men and women

© 2024 Crescent Moon Recovery: Alcohol & Drug Rehab Centers Orange County, LLC. All Rights Reserved. 

starchevron-down Skip to content