Restarting Lexapro (Is it okay to do so?)

In this blog post, we are going to talk about restarting lexapro. Lexapro is an antidepressant which is used to treat mild to severe episodes of depression and generalised anxiety disorder (GAD). 

Sometimes, the treatment with this antidepressant is discontinued, but later it is restarted. This blog is all about that. We will discuss everything you need to know before restarting your antidepressant. 

Is it okay to restart lexapro? 

It is absolutely okay to restart your treatment with lexapro if you suffer from a relapse of the mental health condition for which you started using this antidepressant in the first place. 

Studies have suggested that most of the population taking lexapro might need to restart it if the drug is stopped at any point of the treatment. However, this is not the case if you can’t tolerate lexapro. 

If the med didn’t help relieve your symptoms previously, there’s no point of restarting it as nothing much will change this time and you will still experience little to no therapeutic results. 

Some studies suggest that restarting lexapro may require dose escalation as there’s a chance that your antidepressant may not work on lower doses. 

So, this treatment is started with a moderate dose, which is increased if your doctor deems fit. Make sure you take your doctor’s approval before restarting your med as this is not something you should do on your own. 

What to expect when you start taking lexapro again?

There are a few common things you need to understand before restarting lexapro. These include:

Your drug will not start working overnight 

When your healthcare provider recommends you to restart using lexapro, don’t think that it will provide immediate relief from your systems. Just because you used to take it, it doesn’t mean the drug will start working readily. 

It will still take a few weeks to kick in, just like it did the first time. Make sure you give your body enough time to adjust to the medication and it is strongly prohibited to stop using abruptly. 

If you accidentally miss a dose and you’re way past the usual time at which you take your med, do not take it. It will cause you to overdose when you take your next dose, which is not too far away. It’s better to skip the missed dose and take the next one. 

If you remember your missed dose earlier, it’s safe for you to take it. In case of overdose, immediately go to the hospital. Make sure you properly guide them about how much drug you have taken and when.

You may still experience some side effects 

There’s a chance that you will again suffer from side effects but hang in there. These side effects will begin to subside within 2 to 3 weeks of treatment. 

Restarting lexapro should only be an option when you gained benefits from it prior to stopping it. 

If the reason behind your discontinuation was lexapro intolerance, it should not be restarted as it will again cause intolerability and will do you no good. Common side effects of lexapro include:

• Loss of appetite 
• Constipation or diarrhoea
• Sexual issues
• Difficulty in falling asleep
• Vertigo 
• Decreased salivation or dry mouth
• Sweating
• Anxiety 
• Infections caused by decreased immunity
• Nausea
• Shaking
• Weakness
• Sleepiness and fatigue
• Weight gain 

Some serious and rare side effects include:

• Allergic reaction associated with symptoms like redness of skin, itching, burning sensation, blisters, blue-purple patches, tightness of chest, wheezing, difficulty in breathing, hoarseness etc. 
• Angle-closure glaucoma causes symptoms like eye pain, vision changes, or swelling or redness in your eyes.
• It could cause low sodium levels which can result in psychological symptoms like confusion, agitation, inability to understand surroundings, memory loss etc.
• It can cause elongation of QT interval, causing increased heartbeat or arrhythmia
• Teeth grinding
• Convulsions 

You may need dose escalation or a dose higher than your previous dose

Experts suggest that lexapro may not work that well if it is restarted from the dose you commonly used to take. 

Your brain has already responded to that dose before and it might not provide enough relief from your depression or anxiety symptoms. 

Taking an increased dose means you have to give your body enough time to adjust to the new dose and you may also suffer from side effects. Make sure you don’t stop your treatment halfway. 

Why is restarting lexapro common after abrupt withdrawal?

Abrupt withdrawal of lexapro leads to discontinuation syndrome which has disturbing symptoms including chills, fever, diarrhoea, vomiting, nausea, headaches, excess sweating/night sweats, insomnia, dizziness, brain zaps, mood swings, anxiety or depression relapse etc. 

These symptoms are hard to manage and the treatment is restarted in order to help relieve them. This is exactly why dose tapering is considered crucial in order to stop using lexapro safely. 

In usual practice, your doctor gradually decreases the dose over the period of a few weeks, to ensure safe and effective withdrawal of lexapro and other SSRIs. 

Sudden withdrawal causes deficiency and your receptors end up craving the excess amount of serotonin. So, if you abruptly stop taking it, your receptors which are dependent on it will start to have a major impact of serotonin deficiency.

This is exactly why dose tapering is considered extremely important with antidepressants. It is a safe and effective method to withdraw SSRIs. Your healthcare provider simply just reduces the dose of your antidepressant. 

It enables you to start taking medicine in lesser quantities without completely depriving your receptors of serotonin. Half of the dose keeps

decreasing gradually over the period of 7 to 8 days. 

After spending a week or two, the med is on its lowest possible dose and now it is considered safe for you to stop using it.

How to ensure the proper use of lexapro? 

• Make sure lexapro is the right choice of antidepressant for you. Stick to your doctor’s recommended dose. Do not take more or less than that. 

• Ask your doctor before taking lexapro if you’re pregnant, trying to conceive or if you’re a breastfeeding mother. 

• If you fail to understand how to use the drug properly or have any other question, ask your doctor or pharmacist.

• Report any problems with bleeding or bruising to your doctor. If you see any unexplained blisters or rashes on your body, or experience any problems with urination, or if you feel changes in your vision, immediately report to your healthcare provider.

• Keep the bottle away from children and pets. In case of overdose, immediately take them to the hospital. 

• Do not suggest medications, unless you are a healthcare professional yourself. Do not share medications. You might think your conditions match but oftentimes they don’t. It’s actually pretty dangerous.

• Lexapro tends to induce suicidal behavior in users younger than 24 years of age. If you have someone who shows suicidal behavior or you see hopelessness in them, make sure you keep an eye on them and get medical attention as soon as you can. 

Conclusion 

In this blog, we have discussed restarting lexapro. Lexapro is an antidepressant which is used to treat mild to severe episodes of depression and generalised anxiety disorder (GAD). 

Several studies suggest that it is okay to restart your treatment with lexapro if you suffer from a relapse of the mental health condition for which you started using this antidepressant in the first place. 

If the med didn’t help relieve your symptoms previously, there’s no point of restarting it as nothing much will change this time and you will still experience little to no therapeutic results. 

When you start taking lexapro again, just remember that your drug will not start working overnight and it will still cause side effects. Experts also suggest that lexapro may not work that well if it is restarted from the dose you commonly used to take. 

Just make sure you do exactly what your healthcare provider recommends and do not deviate from the prescribed dose. Take it as directed by your doctor and do not stop the treatment halfway. 

FAQs: restarting lexapro

What happens if you stop and start Lexapro? 

Stopping lexapro can make you go through withdrawal symptoms, including chills, fever, diarrhoea, vomiting, nausea, headaches, excess sweating/night sweats, insomnia, dizziness, brain zaps, mood swings, anxiety or depression relapse etc. This often results in restarting the treatment to help relieve these symptoms. 

How long does it take for Lexapro to start working?

Lexapro usually takes up to 4 weeks to start producing noticeable therapeutic results. However, this time duration can vary from person to person. Some people start noticing effects earlier than the others. 

What is the success rate of Lexapro?

Lexapro has a success rate of around 70-80% in the treatment of depression. People taking it have complained of some side effects, but they begin to fade away on their own when the body is adjusted to the medication. 

Doctors usually start from the lowest effective dose of lexapro, that is 10 mg, and then the dose is gradually increased if needed.

What is a good alternative to Lexapro?

Other selective serotonin reuptake inhibitors are good alternatives to lexapro (escitalopram). These include Zoloft (Sertraline), Paxil (Paroxetine), Prozac (Fluoxetine) and Celexa (Citalopram). 

If, for some reason, the SSRIs don’t work out for you, there are several other classes of antidepressants including Serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs) and Monoaminoxidase inhibitors (MAOIs).

Is 5 mg of Lexapro enough?

It depends how a person responds to it. For some people 5 mg is a low dose and does not produce adequate therapeutic response, while others can feel significant reduction in their symptoms after taking 5 mg lexapro for a few weeks. 

How do you know if Lexapro is working?

You will know your lexapro is working when your symptoms start to subside. Depression and anxiety are commonly associated with psychological symptoms including feelings of sadness, tearfulness, emptiness or hopelessness, irritability or frustration, even over small matters. 

You simply feel relieved from above mentioned symptoms. When you feel happy and satisfied, when you feel like engaging in your favourite activities and when you start feeling like being a part of your social gatherings again, you know your medicine is working. 

References 

• P Haddad – The SSRI discontinuation syndrome https://pubmed.ncbi.nlm.nih.gov/10958258/
• Norio Yasui-Furukori et al. Clin Neuropharmacol. (2016) – Characteristics of Escitalopram Discontinuation Syndrome: A Preliminary Study https://pubmed.ncbi.nlm.nih.gov/27171568/
• Escitalopram (Oral Route) https://www.mayoclinic.org/drugs-supplements/escitalopram-oral-route/side-effects/drg-20063707
• James M. Ferguson, M.D. – SSRI Antidepressant Medications: Adverse Effects and Tolerability https://www.ncbi.nlm.nih.gov/pmc/articles/PMC181155/
• Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review https://www.karger.com/Article/FullText/370338
• Matthew Gabriel and Verinder Sharma – Antidepressant discontinuation syndrome https://www.cmaj.ca/content/189/21/E747