Lexapro (Escitalopram) ® Abrupt Discontinuation
After 8 weeks of treatment with citalopram, abrupt discontinuation of treatment caused a higher incidence of anxiety, emotional indifference, impaired concentration, headache, migraine, paresthesia, and tremor than was seen in patients who continued on citalopram. These symptoms are not indicative of addiction.

Although it is not known whether gradual discontinuation will prevent the discontinuation symptoms, it is recommended that the dosage of citalopram should be tapered off over 1 to 2 weeks

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Pakage insert- Discontinuation of Treatment with Lexapro


During marketing of Lexapro and other SSRIs and SNRIs (serotonin and
norepinephrine reuptake inhibitors), there have been spontaneous reports
of adverse events occurring upon discontinuation of these drugs, particularly
when abrupt, including the following: dysphoric mood, irritability, agitation,
dizziness, sensory disturbances (e.g., paresthesias such as electric
shock sensations), anxiety, confusion, headache, lethargy, emotional lability,
insomnia, and hypomania. While these events are generally self-limiting,
there have been reports of serious discontinuation symptoms.
Patients should be monitored for these symptoms when discontinuing
treatment with Lexapro.

A gradual reduction in the dose rather than abrupt
cessation is recommended whenever possible. If intolerable symptoms
occur following a decrease in the dose or upon discontinuation of treatment,
then resuming the previously prescribed dose may be considered.
Subsequently, the physician may continue decreasing the dose but at a
Clinical Worsening and Suicide Risk: Patients, their families, and their
caregivers should be encouraged to be alert to the emergence of anxiety,
agitation, panic attacks, insomnia, irritability, hostility, aggressiveness,
impulsivity, akathisia (psychomotor restlessness), hypomania, mania,
other unusual changes in behavior, worsening of depression, and suicidal
ideation, especially early during antidepressant treatment and when the
dose is adjusted up or down.

Families and caregivers of patients should
be advised to observe for the emergence of such symptoms on a day-today
basis, since changes may be abrupt. Such symptoms should be
reported to the patient’s prescriber or health professional, especially if
they are severe, abrupt in onset, or were not part of the patient’s presenting
symptoms. Symptoms such as these may be associated with an
increased risk for suicidal thinking and behavior and indicate a need for
very close monitoring and possibly changes in the medication.

If you have any questions, discuss them with your doctor or healthcare professional. For additional information about Lexapro, call the Forest Professional Affairs Department toll-free at 800-678-1605, extension 66297.