Coming off Lexapro: why the last milligrams are the hardest

Escitalopram (Lexapro) comes down in steps that are supposed to get smaller as the dose gets lower, not stay the same size the whole way. This episode walks through what that looks like in practice: a step-down such as 20, 15, 10, 7.5, 5, 2.5, then 0, waiting at each dose until symptoms calm down before the next reduction, and going back up to the last comfortable dose and reducing more slowly when a step is too hard.

We also cover why the timing feels fast. Escitalopram's half-life is about 27 to 32 hours and there is no long-acting leftover in the body, so symptoms often start within a few days of a cut and sometimes within hours. Common effects follow the FINISH pattern: flu-like feelings, insomnia, nausea, imbalance, sensory changes such as brain zaps, and hyperarousal. Mild cases often ease over one to two weeks. About 1 in 5 people who stop an antidepressant abruptly after taking it for at least six weeks get noticeable symptoms, and after long-term use a taper can run three months or longer.

Read the full guide: How to Safely Come Off Escitalopram (Lexapro). To find a provider trained in deprescribing, see the MyDeprescriber.com directory.

The hosts of this episode are AI-generated from the written guide.

Educational only, not medical advice. Never stop a medication without your provider. If you are in crisis in the US, call or text 988.