Can Lexapro withdrawal kill you? (+2 withdrawal symptoms)

In this article, we will discuss the question, “Can Lexapro withdrawal kill you?” We will also explore the symptoms of Lexapro withdrawal, why Lexapro causes withdrawal symptoms, how to discontinue Lexapro safely, and measures to manage Lexapro withdrawal symptoms.

Can Lexapro withdrawal kill you?

No, Lexapro withdrawal does not kill you. However, abruptly discontinuing Lexapro can lead to antidepressant discontinuation syndrome (ADS) (1).

Lexapro is a second-generation selective serotonin reuptake inhibitor (SSRI) antidepressant prescribed for the treatment of major depressive disorder and generalized anxiety disorder (2).

Research shows that 14 out of 25 patients taking Lexapro experienced antidepressant discontinuation syndrome (ADS) upon discontinuation (1).

About 20% of the patients who have been on antidepressants like Lexapro for more than six weeks often experience withdrawal symptoms when they discontinue the medication (3).

Therefore, it is highly recommended not to discontinue Lexapro or any other antidepressant without consulting your healthcare provider, especially if you have been using it for an extended period.

What are the symptoms of Lexapro withdrawal?

The symptoms that typically occur after discontinuing Lexapro include the following (1,2):

• Dizziness.
• Nausea.
• Muscle tension.
• Chills.
• Confusion.
• Amnesia.
• Lethargy.

These symptoms are usually moderate and may last for 1-2 weeks. However, in some individuals, the symptoms can also be severe and may last up to several months or more. The symptoms of Lexapro withdrawal are often relieved after the reinitiation of the medication (3,4). 

If you experience any of these symptoms after discontinuing Lexapro, it is advisable to consult your healthcare provider immediately.

Why does Lexapro cause withdrawal symptoms?

Selective serotonin reuptake inhibitors such as Lexapro, when taken for an extended period, increase the synaptic level of serotonin by inhibiting serotonin reuptake, leading to the downregulation of post-synaptic receptors (3).

Discontinuing SSRIs like Lexapro abruptly can lead to a reduction in the synaptic serotonin levels. This deficiency worsens as the down-regulated post-synaptic receptors persist in their hypoactive state for days or even weeks (3).

The downregulation of receptors ultimately leads to the development of antidepressant withdrawal syndrome (ADS). 

Due to its high selectivity, potency, and dose-dependent inhibition of the serotonin transport system, patients who have been taking Lexapro at a high dose are at a higher risk of developing withdrawal symptoms upon discontinuation (3).

What does research suggest?

Research has indicated that patients who had been taking Lexapro for conditions like major depressive disorder without a previous history of bipolar disorder developed mania after its discontinuation (5).

One case involved a 34-year-old woman who had been prescribed Lexapro by her psychiatrist for major depression at a dose of 20 mg/day. The women continued the treatment for eight months. However, after eight months, she suddenly stopped taking Lexapro as she felt no symptoms of depression (5).

Within two days of discontinuing Lexapro, she developed insomnia and increased psychomotor activity. After one week of discontinuation, the symptoms became worse. Based on the Young Mania Rating Scale (YMRS) score, which was 37 (very high), she was diagnosed with mania (5).

The mania was believed to be associated with Lexapro withdrawal, so the medication was reintroduced at a dose of 20 mg/day. After ten days, the woman’s symptoms were resolved, and her YMRS score was reduced to 6 (5).

How to safely withdraw Lexapro?

It is recommended to gradually taper off the antidepressant dose over weeks or months to reduce the risk associated with antidepressant withdrawal. However, when it comes to SSRIs such as Lexapro, discontinuing can be challenging (6).

Hyperbolic dose reduction method:

Studies suggest that a new method called hyperbolic dose reduction can be used to safely discontinue antidepressants rather than using the conventional dose tapering method (6).

There is limited data available for using this method in Lexapro withdrawal. However, a case involving a 25-year-old male who was taking Lexapro for generalized anxiety disorder and major depressive disorder has been reported (6).

The patient had a history of withdrawal syndrome associated with discontinuing escitalopram, mirtazapine, and fluoxetine. To minimize the risk of further withdrawal symptoms, the patient’s Lexapro dose was gradually reduced using the hyperbolic dose reduction method (6).

The tapering schedule involved reducing the dose of Lexapro weekly from 10mg to 5mg, 3mg, 1.5mg, 1mg, 0.5mg, and 0.25mg before cessation. At each step, there was a 10% reduction in the serotonin transporter occupancy (6).

Withdrawal symptoms went from minimal to mild and eventually improved. The patient’s anxiety and depression symptoms remained low during the dose reduction period and even after discontinuation of the drug (6).

The patient became completely free of antidepressants without experiencing withdrawal symptoms for three months. To manage his anxiety, he was also using Clonazepam, which was also reduced from 0.25mg twice daily to 0.125mg twice daily (6).

How to manage Lexapro withdrawal symptoms?

The following measures are recommended to manage the withdrawal symptoms associated with discontinuing Lexapro (7,8):

• Your healthcare provider should educate you about the possible withdrawal symptoms that might appear upon abruptly discontinuing Lexapro.
• It is important to note that the withdrawal symptoms are not life-threatening and do not indicate addiction. Your healthcare provider should assure you that these symptoms are reversible and will eventually resolve.
• If you experience withdrawal symptoms during tapering, the simple and most effective way to reverse them is by reinitiating the medication at the previous dose and then tapering the dose more slowly.
• Symptomatic treatment is recommended to manage withdrawal symptoms. For example, headaches can be managed using acetaminophen or benzodiazepines to manage insomnia.
• It is also advisable to consult a nutritionist while withdrawing from Lexapro or any other antidepressant. A nutritionist will provide dietary guidance about the foods and supplements that can help you during antidepressant withdrawal.
• Lifestyle support options like yoga, acupuncture, and tai chi are also recommended for managing Lexapro withdrawal symptoms.

Conclusion

In conclusion, abruptly discontinuing Lexapro does not kill you, but it can lead to severe withdrawal symptoms. We have explored a case study involving a woman who experienced mania after suddenly stopping Lexapro.

Additionally, we have discussed a safe withdrawal approach using the hyperbolic dose reduction method and the measures that will help in managing the withdrawal symptoms.

References