lexapro, lexapr, lexap, lexa, lex, le, l
September 9, 2010 9:12 AM   Subscribe

Advice on stopping Lexapro.

I have been taking 10mg/day of Lexapro for four months and would like to stop taking it due to two reasons: no health insurance, and better overall mental health than when I started taking it. I made several positive changes in my life to alleviate stress and make life better and am now hoping to leave behind the chemical help I needed during a crappy time in my life. However, I'm hearing about exciting withdrawal symptoms (ranging from dizziness, heart palpitations, insomnia, brain zaps, flu-like symptoms, to sadness and suicidal thoughts). Sometimes the internet makes you think that everyone has an awful experience with things because the people who are having the most difficulties tend to write about them. Is this the case with Lexapro withdrawal?

In addition, I am unemployed so going to a MD would be expensive. Should I suck up the cost and go to get advice on tapering or do it myself?
posted by anonymous to Health & Fitness (23 answers total) 3 users marked this as a favorite
You need to do this with a qualified physician. Adjusting doses of drugs that affect the brain is beyond the ability of a layperson and Google.
posted by Inspector.Gadget at 9:17 AM on September 9, 2010 [3 favorites]

I was on Lexapro for longer then you were (and at a higher dose, but it's been too long).

I started feeling better and unconsciously stopped taking it (aka, i often forgot to take them and when I remembered I shrugged and said "I'll take it tomorrow". After about two weeks of this I stopped it all together).

I experienced no withdrawal side effects. If I did.. they weren't noticeable and I functioned normally.

I did go back on Lexapro a few years later and promptly went off it for a host of side effects that was worse then the reasons I was taking it. I'm not sure if this was ever an aspect of just having taken it in the past.. or because i cut it off so abruptly.

Try going off of it for a few days and see how you feel. If you start feeling like a mess.. switch to taking it infrequently. Ask your pharmacist for only half a month's worth.

IANAD and this is pure anecdotal.
posted by royalsong at 9:25 AM on September 9, 2010

Only you know how you have been with this and other drugs. If you are generally healthy, know that just because a side effect is listed that it will not always happen, that maybe you can tell someone to watch out for you over the next 2 weeks and you can taper slowly then that would seem suitable. Can't see why a medic would say different. But I'm no doc. But I have been on this type of med.
posted by episodic at 9:28 AM on September 9, 2010

You really SHOULD see a doctor. And I am NOT a doctor.

That being said, people who've always had health insurance and/or money are very quick to scream "GO SEE A DOCTOR!" when it's not always a practical option. And tapering off of a pretty typical SSRI is NOT the same thing as pulling out a steel bar that's embedded in your skull or ignoring a lump in your breast. It's not ADVISABLE, but nor is it generally likely to be catastrophic.

And THAT being said... it appears as though your are on the lowest common dose of your SSRI. It appears as though the tablets can be cut without any issues. And Forest Labs, the drug's developer, has the full prescribing information available online. I would read that in its entirety as well as spending a lot of time on the Crazy Meds site before proceeding.
posted by julthumbscrew at 9:29 AM on September 9, 2010 [3 favorites]

Yes--for some people, the side effects of withdrawal can be worse than the initial reasons for taking the medication. Please consider doing this under the supervision of a qualified professional, even if it means spending an entire day in the waiting room of the free clinic in your area. No one here can tell you how it will affect you, your brain, or your body for sure, unfortunately.
posted by so_gracefully at 9:29 AM on September 9, 2010

Who prescribed it to you in the first place? Even if you're lacking medical insurance, they should at least be willing to tell you how to properly wean off of it.
posted by drstein at 9:29 AM on September 9, 2010 [1 favorite]

You don't necessarily need to see a doctor. You need to call a doctor. The one who prescribed it for you originally. They will tell you what to do. (They might feel that you need to come in and see them, and in that case I would do it despite the expense, but make sure they know you are broke and uninsured.)
posted by grouse at 9:35 AM on September 9, 2010 [4 favorites]

If you decide to go off under the supervision of a doctor/therapist, Benadryl is about the only thing that helps with the brain zaps.
posted by emilyd22222 at 9:41 AM on September 9, 2010

(part 2) The reason why it's dangerous to use psychoactive medications without the supervision of a doctor in the first place is that they are affecting your feeling and thinking and that's the point of these medications. There are plenty of ways that it could go badly that are serious enough not to just say "oh well, no biggie"--from suicidal ideation (or attempts or completion), to unexpected drowsiness/inattention that causes you to get fired from your job, or, far worse, get into a car accident and kill 12 people. Just because you think it doesn't seem "generally likely to be catastrophic" doesn't mean that it's advisable for you to make that call--a doctor needs to be at least involved to monitor symptoms and safety for the OP. These medications and their effects upon the body are to be taken seriously, and I strongly encourage you, OP, to consider that.

Best wishes--I know this is a tough position to be in.
posted by so_gracefully at 9:43 AM on September 9, 2010

again, grouse has it. call a doc, at least. I started cutting up my pills (10mg/day for a couple years) into smaller pieces every few weeks. My doctor's advice was, basically, "Cut up your pills into smaller pieces, every couple weeks." I supplemented that by, once the pills got to be 1/4 sized, stretching out the time between taking them...Every 27 hours for a couple weeks, then every 36 hours. But I wasn't that regimented about it, and, despite my doc's advice, I would just occasionally stop cold turkey during the quitting process for a few days to see if could just power through it. It doesn't, apparently, work that way. Please don't mistake what I just said for medical advice.

It was still difficult. It took a few months, I'm afraid, to feel like myself again. But it wasn't wall-to-wall withdrawal.

I resented how cavalier my doctor was when prescribing Lexapro, which I hadn't heard of and hadn't asked for, when he asked me about my sleep habits and depression. He said, "Lexapro is well-tolerated." But he failed to mention how difficult it was to stop. I had the 'brain-zaps' occasionally, sometimes felt like I'd had a few drinks, often felt foggy, and occasionally had the same feeling in my head I got back when I was a smoker and it had been too long without a Camel Light.

Good luck. If you're more methodical about it than I was you should have fewer problems.
posted by Buffaload at 10:09 AM on September 9, 2010

I was on the same dose as you, and I didn't taper off -- I just stopped cold one day. The brain zaps went on for a couple of weeks, as I recall -- like a little "FZZZZT" feeling in my head. They didn't bother me too much except when I was trying to get to sleep -- and as emilyd22222 says, something like Benadryl will knock you out for the night so you can ignore them.
posted by vickyverky at 10:09 AM on September 9, 2010

OK, I am not a doctor, nor do I play one on TV. However, AFAIK, lexapro is different than many other antidepressants because it does not require the kind of warm up and taper off time that they do. In pure anecdata, I have started and stopped Lexapro without any tapering of any kind so many times in the last ten years that I cannot count them. I have never had a bad side effect of any kind.

Just as more info, I was first prescribed Lexapro by my gynecologist for severe PMS. That prescription specified that I start taking it roughly ten days before each period and then stop on the first day of my period. That would seem to indicate that tapering on and off isn't that big of a deal, right? I did that for almost a year with no problems and yes, it helped tremendously with the PMS. I then started taking it later for depression and have often taken it for four or so months at a time and then stopped. So far all of the doctors I've spoken to about this haven't thought it was a big deal at all.
posted by mygothlaundry at 10:16 AM on September 9, 2010 [1 favorite]

You should listen to what grouse, and a couple of other people in here, have said. This is not something you should undertake with the help of a community of lay-people and/or Google. Stopping antidepressants can be nasty. I've done it twice, and while Lexapro was by far the less unpleasant of the two, it still had all sorts of weird physiological effects, which were somewhat negated by a regime from the doctor that had me titrating off of them slowly. That doesn't have to be as fancy as the name implies--I cut my pills in half, and then into quarters, over the course of a few weeks. But, let me stress, this was done under a physician's supervision. And, as grouse noted, this can be done with a phone call. Whichever physician started you on this will be happy to spend five minutes talking with you about how to safely stop taking them.
posted by Mayor West at 10:16 AM on September 9, 2010

I'm going to respectfully disagree with Mygothlaundry and adamantly state that any doctor with experience with SSRIs will tell you that Lexapro does require tapering down in dosage. Many people do not have side effects and there are many that do. If you have a sudden withdrawal, it can be a huge shock to the brain. I always work with my client's doctors to make the transition as painless as possible. For some it's overly cautious, but it's not worth the risk of those terrible side effects.
posted by WhiteWhale at 11:09 AM on September 9, 2010

My experience, for what it's worth: I took Lexapro 20mg for about a year, then switched to Citalopram 20s because it was cheaper. Felt better after six months, started halving the tabs and taking 10 mgs daily with doc's concurrence. And then quit cold. Felt a bit sad and emotionally sensitive for a week or two, and had unhappy dreams, but then it all went away and I was fine. Or as fine as I can be, I guess, without taking an SSRI. Tolerably fine.

Nice to know it's out there if you need it again.
posted by fivesavagepalms at 11:12 AM on September 9, 2010

I withdrew from 20mg over time, and I spent about a month in various states of dizzy. (I'm extraordinarily sensitive to drugs.) For me it was worth it to suffer through because I felt so exhausted all the time, it was impinging on me enjoying my life. Of course it's always best to do this kind of thing under the supervision of a doctor. But knowing what you know about the weaning process, have a plan for what you will do if you experience unbearable side effects.
posted by Hildegarde at 11:54 AM on September 9, 2010

I tapered off Lexapro earlier this year. I was taking 10mg as well. She had me take 5mg for 10 days and the 5mg every other day for 10 days.

My side effects mostly consisted of sharper feelings of anxiety and sadness. Not anything drastic, but I *defintely* feel my emotions more.
posted by megancita at 12:26 PM on September 9, 2010

My wife and twp co-workers have gone through the Lexapro cycle with different results; my wife, at her doctors suggestion, went with smaller and smaller doses over the course of a couple of weeks. She didn't have much in the way of problems, She was a bit grouchy, but nothing earthshaking.

The co-workers both went cold turkey, one reported getting what he called "brain flashes" or "brain shocks" which he hated. (based on what he was calling them, I don't blame him...) eventually he went back on and went to his doctor who I believe gave him something else.

Other coworker just quit, and didn't seem to have any effects (he may have also tapered his dosage, and not mentioned it.)

I'd say that your best choice is to consult with your doctor, and at the very least, reduce your dosage over time instead of any kind of cold-turkey approach. Brain shocks, whatever they may be, sound icky.
posted by quin at 1:33 PM on September 9, 2010

I am also not a doctor, but I was on 10 mg of lexapro for about eighteen months before quitting cold turkey. I would not recommend that method. I had dizziness almost all the time and instances where it felt like my brain was operating several seconds behind my body and would then fast forward to catch up. It was unpleasant, almost like when you drink a lot and then turn your head rapidly. My emotions went up and down as well til it totally worked its way out of my system. I knew to expect all this, though, because if I missed a dose even by a few hours the symptoms set in. You may be able to experiment a little to find out what your experience will be like.

I'd also recommend consulting a doctor about it if you're able. Four months seems to me like a short time to find antidepressants have fully outlived their usefulness.
posted by lilac girl at 2:43 PM on September 9, 2010

I was on Lexapro for four years (also 10mg) and it has been almost two years now since I have been off of it. I tapered gradually. For me, it was definitely the right decision. I wish you the best of luck!

The most prominent things that happened were vertigo/dizziness, exhaustion, and a spike in anxiety that eventually went down. Just generally feeling a little weird and out of sorts.

Remember to be gentle with yourself, while you're going through this. That might seem obvious, but it's easy to forget.
posted by Pochemuchka at 2:45 PM on September 9, 2010

My recent cold-turkey withdrawal (which was an accident: my pharmacy closed for a period of time and I hadn't planned for it) involved very serious, horrible dizziness and a whooooole bunch of general sadness despite the fact that I have not a thing to be sad about. It was a very, very unpleasant time. I spent most of it lying down because I was too dizzy to stand and talking to my dog because I was too depressed to talk even to my boyfriend.
posted by pineappleheart at 5:03 PM on September 9, 2010

I went off lexapro without tapering because I was experiencing really unpleasant side effects and the school shrink I was seeing refused to let me try different meds, so I took matters into my own hands. I think I got a bit of insomnia, but it was the end of the semester so I was up writing papers anyway. I do remember getting some of the brain zaps people talk about for about a week or two, which was incredibly strange but not unmanageable. I would recommend at least trying to taper off if you can, as it would probably lessen the severity of any symptoms you may get.
posted by you zombitch at 6:28 PM on September 9, 2010

Ideally you'll do this under medical supervision, or at least with medical advice.

I suggest you approach this with care. Monitor your mental state for a little while first to get a baseline. Then titrate down slowly, still monitoring yourself. (Monitoring yourself might include counting up any concrete symptoms of anxiety/depression, and rating your feelings of anxiety/depression on a scale of 1-10.)

I'd been taking 20s, and was told to drop to 10 and then stop. I had some pretty severe physical withdrawal symptoms lasting about a month when I stopped altogether.
posted by moira at 9:34 PM on September 10, 2010

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