Is Lexapro Addictive? All You Need To Know
Many people ask if Lexapro is addictive.
The answer is no, but stopping it can still be challenging.
About 20% of people may experience withdrawal symptoms when stopping SSRIs like Lexapro, known as 'antidepressant discontinuation syndrome.'
These symptoms are due to dependence, not addiction.
Dr. Giordano can provide guidance through personalized sessions, helping you express your concerns in a private environment.
Understanding the difference between dependence and addiction is crucial.
This article delves deep into this distinction, highlighting the importance of safe deprescribing practices for those on psychiatric medications.
What is Lexapro?
Lexapro (Escitalopram): A prescription medication.
Classification: Selective Serotonin Reuptake Inhibitor (SSRI).
Common Uses:
Treating depression
Addressing anxiety disorders
Managing panic disorder
Treating obsessive-compulsive disorder (OCD)
Generalized Anxiety Disorder (GAD)
Social Anxiety Disorder (SAD)
Lexapro is a common prescription drug intended to treat mental disorders.
Like most antidepressants, it falls under the class of selective serotonin reuptake inhibitors (SSRIs).
It works through its impact on serotonin, a neurotransmitter that plays a significant role in determining one’s mood, emotions, and even sleep.
It is prescribed for cases of depression, generalized anxiety disorder, and other anxiety-related disorders.
How Does Lexapro Work?
Mechanism of Action
Lexapro (escitalopram) changes serotonin activity in the brain.
Serotonin is a chemical that affects mood, emotions, and mental health.
Lexapro is an SSRI used to treat depression and anxiety.
Serotonin Reuptake Inhibition:
Inhibition of Serotonin Transporter (SERT):
It settles in the serotonin transporter on the presynaptic neuron and reduces the reuptake process.
This action prevents serotonin from being reabsorbed reuptake back into the presynaptic neuron.
Increased Serotonin Availability:
Since reuptake is blocked, serotonin cannot be reabsorbed back into the pre-synaptic neuron, causing a buildup of serotonin in the synaptic cleft.
This increases the level of serotonin in the brain, resulting in increased nervous transmission and elevated mood.
The Latest Research
While the serotonin theory of depression was widely popular for years, upon systematic evaluation of the scientific evidence in a metanalysis published in 2023, it was found there is "no convincing evidence that depression is associated with, or caused by lower serotonin concentrations or activity."
This questions Lexapro's relevance in the use of treating depression entirely.
Lexapro Dependence and Discontinuation Challenges
Lexapro is not addictive like opioids or stimulants, but some people may develop a dependence over time.
This dependence means that when they stop taking Lexapro, they may experience withdrawal symptoms.
This is why following a knowledgeable provider's guidance when stopping is important.
This physiological dependence is linked to Lexapro's role in altering serotonin levels in the brain (and throughout the body).
It is important to note that dependence is different from addiction.
Lexapro dependence is not about misuse or craving, but rather the body's adaptation to the medication.
If you have been using Lexapro for a prolonged period, it is crucial to consult a specialist for guidance on gradually reducing the dosage to minimize withdrawal effects.
Physical and Mental Signs of Lexapro Dependence
Lexapro can lead to physiological dependence over time, which may include both physical and psychological symptoms.
Let's break down the signs.
Physical Signs:
Withdrawal Symptoms: Withdrawal symptoms can occur when Lexapro use is reduced or discontinued abruptly. Common symptoms include dizziness, headaches, nausea, fatigue, and irritability. Occasionally, people may experience “brain zaps,” which are brief, shock-like sensations in the head.
Tolerance: Over time, the body may develop a tolerance to Lexapro, meaning a higher dose is needed to achieve the same therapeutic effect. It is important to work closely with a healthcare provider when managing the dosage.
Psychological Signs:
Feeling Dependent on Lexapro: Some individuals may feel psychologically dependent on Lexapro to manage daily tasks, maintain mood stability, or maintain interpersonal relationships. This dependence can impact their overall well-being, as they feel reliant on the medication to face life’s challenges.
Adverse Effects of Lexapro
Short-term Side Effects
When individuals begin taking Lexapro, they may experience a series of initial side effects:
Nausea: In most cases, it occurs soon after the start of the medication and usually lasts for several days to weeks. It can vary from mild to severe, resulting in quite a lot of discomfort in some instances and even reduced feed intake.
Headaches: These may persist but eventually fade away as the body adjusts to the drug. These symptoms can be mild and, at other times, severe and may, at times, be associated with a kind of pressure or build-up of tension at the head.
Sleep disturbances: These are common side effects such as insomnia, which affects the individual's ability to fall sleep or stay asleep. It creates unusual dreams that may be vivid or disturbing and thus affect a user’s ability to have quality sleep at night. Sleep disorders can also impact daytime performance and result in the efficiency of work at the workplace.
Long-term Side Effects
With prolonged use, Lexapro can lead to more persistent adverse effects:
Weight gain: An area of major concern for many resulting in low self-esteem and possible development of diseases such as obesity, diabetes, and cardiovascular diseases, among others. This may be due to appetite increase or metabolic changes that occurred due to the medication.
Sexual dysfunction: Reduced sex drive, increased time to achieve sexual climax, or the failure of a person to experience any sexual climax at all is a troublesome side effects for many. These problems can cause remarkable impairments of interpersonal relationships and psychological health, causing frustrations and diminished quality of life. Although often not mentioned at all, it is a side effect that is potentially life-changing.
Withdrawal Symptoms
Stopping Lexapro, particularly abruptly, can trigger withdrawal symptoms that are often uncomfortable and distressing:
Brain zaps: Brief sensations that may feel like a slight jolt or shock (in the brain). They are peculiar and unpleasant withdrawal symptoms that can elicit anxiety.
Dizziness: These symptoms can impair one's daily functionality and makes it impossible to perform regular activities . This can also be accompanied by problems balancing.
Irritability: The instability of emotions and can cause fluctuation in mood and increased stress. This can put a lot of pressure on relationships and general well-being during the withdrawal phase.
Other withdrawal effects include flu-like symptoms including body aches and general malaise. Some other sensory changes include the sensation of insects crawling over the skin.
Does Lexapro Cause Weight Gain?
This is one of the most common side effects of Lexapro, and it is quite frequent among its users.
There are numerous reports of users gaining weight or having trouble losing weight while on this medicine.
Many researchers have reported that weight increase is among the side effects of Lexapro and other drugs in the SSRI class.
It is not clearly known how the drug works and alters serotonin in the body, but it has been proposed that the medication affects the appetite and metabolism as well as influences fat storage.
Some people have claimed that they have actually gained a lot of weight, including 20 pounds or more, after taking Lexapro.
This weight gain can be distressing, and lead to low self-esteem or body image problems.
For avoiding excess weigh gain, it is advised to have a healthy diet and also incorporate physical activities into daily schedule when on Lexapro.
An increase in appetite can be dealt with effectively through the use of portion control and mindful eating Moderate exercises such as walking or cycling and drinking water play a role in weight loss as well.
Can Lexapro Trigger Brain Zaps?
A brain zap, also called a brain shock or brain shiver, is a peculiar sensation common when coming off specific antidepressants such as Lexapro or when users miss doses.
These electrical-like sensations might be felt as a lightning-like, sharp shock or as a flickering feeling occurring in the brain for a short time.
Most longtime Lexapro users have complained that they experienced brain zaps, particularly when they were discontinuing the use of Lexapro.
Although these episodes are clinically not serious, they are inconvenient and can interfere with normal functioning in day-to-day activities.
Coping strategies for managing brain zaps include:
Gradual tapering: There are many ways to prevent brain zaps but one of them is tapering off Lexapro gradually with doctor’s advice.
Stay hydrated: Lack of fluids may worsen the condition of the brain zaps. Therefore, one should be certain to drink enough water.
Get enough rest: The symptoms of brain zaps tend to be aggravated by fatigue and insufficient sleep; therefore, the recommendation is to get enough sleep.
Practice relaxation techniques: Simple practices such as deep breathing, meditating, or even practicing yoga will help reduce the discomfort that is generally experienced in the course of brain zaps.
Seek support: People connecting to online forums or discussing with a withdrawal expert/coach can get so many tips on how to cope during withdrawals.
If such brain zaps are frequent, or if they are severe, it is important that you seek medical advice concerning your treatment.
Does Lexapro Cause Insomnia?
Insomnia is one prominent side effect associated with Lexapro.
Some people have problems going to sleep, staying asleep, or waking up with a sense of not being refreshed.
Here’s what you need to know:
Study findings: Sleep disturbances are reported in approximately one-fifth of patients, with some degree of insomnia being quite severe.
Patient experiences: Patient reports and forums further validate the occurrence of insomnia as a side effect of Lexapro. Many individuals share their experiences of struggling with sleep issues, ranging from mild to severe, after starting the medication.
Tips to Manage Lexapro-Related Insomnia:
Practice good sleep hygiene: Regular bedtime, no screens, and having (a cool, dark) the best sleeping environment.
Try relaxation techniques: Doing some breathing exercises such as deep breathing or muscle relaxation or using mindfulness meditation.
Explore alternative therapies: Yoga, Acupuncture or use of supplements, especially under (the guidance of a holistic provider can be of help in sleeping.
Gastrointestinal Side Effects From Lexapro
Some of the side effects that many people using Lexapro experience include nausea and other gastrointestinal side effects that may include diarrhea and constipation.
These side effects can be mild or severe depending on the individual.
Diarrhea
Common in the initial weeks of treatment.
Can cause multiple loose or watery bowel movements.
May lead to dehydration and disrupt daily activities.
Constipation
Causes hard stools, straining, and infrequent bowel movements.
More common in individuals with a history of gastrointestinal issues.
Managing Side Effects
Stay hydrated.
Increase fiber intake (fruits, vegetables, whole grains).
Engage in regular physical activity.
Use over-the-counter or natural remedies consult a healthcare practitioner first.
Avoid symptom-triggering foods (e.g., dairy, spicy foods).
Can Lexapro Cause Depression and Anxiety?
It should be noted that in some cases, Lexapro is required for treating depression and anxiety, yet in some instances, its use leads to an aggravation of these conditions.
Here's what you should know:
Paradoxical reaction: A negative side effect that occurs when Lexapro makes the symptoms of depression or anxiety worse after starting the medication.
Symptoms: Worsening depressive symptoms, feelings of hopelessness, increased irritability or anxiety, usually in the first weeks of therapy.
Possible cause: Like other SSRIs, Lexapro may cause fluctuations in the neurotransmitter levels in the brain that can (produce severe discomfort especially in the first six to eights weeks of exposure).
What to Do:
Consult (a healthcare professional who is knowledgeable about the risks and benefits of Lexapro if the symptoms persist or become severe.
How to Resolve Lexapro Dependence
Here are the recommended steps to safely discontinue Lexapro:
Consult with a healthcare provider who understands: Make sure you speak with your doctor or psychiatrist before you stop using Lexapro as there can be severe consequences.
It is best if you can find a healthcare provider who is informed of the safe methods for reducing Lexapro using hyperbolic tapering.
Gradual dose reduction: The dose of Lexapro should be gradually tapered under the guidance of (a healthcare professional using a hyperbolic taper.
This can mean making reductions as small as 2-10% at a time and holding doses for a month or longer.
Depending on how long you were on the medication, a taper can take years to complete.
It's best to listen to your body every step of the way as you determine a pace at which you can safely taper without significant withdrawal symptoms.
Follow the tapering schedule: It is recommended that patients stick to the tapering schedule of this medication as advised by their healthcare provider .
Lexapro should not be stopped, or its dosage should not be changed without consulting a healthcare professional.
Seek medical supervision: It is highly advisable to consult with your provider on a regular basis when undergoing tapering.
She/he can observe your physical and mental state and help guide the pace of tapering
Consider therapy and support systems: Seeing a therapist or counselor can assist those who are tapering off medication to help develop coping techniques and receive support.
Practice self-care: Adopt a daily exercise regime, and a proper diet, manage stress and ensure you take sufficient rest. The following activities can help you maintain good health while you are in the process of tapering.
Seek support from those you trust: It can be highly supportive during difficult times (to seek support from people you trust and who understand what you are going through.
Be patient and persistent: Coming off Lexapro takes time. Find a doctor who understands the tapering terrain and can safely guide you through the psychiatric medication tapering journey.
Your Journey To Recovery!
Dr. Giordano provides a safe, personalized approach where you can openly discuss your concerns about coming off psychiatric medications.
She can guide you through a holistic process uniquely tailored to you to help you safely reduce or taper off Lexapro without being overwhelmed by withdrawal.
Dr. Giordano ensures that each step is carefully managed and that you are supported at every point in the process.
Her approach is designed to guide you through the deprescribing journey in a way that prioritizes your well-being and mental health. Book an appointment now!
FAQs
What is serotonin syndrome and how can it occur with Lexapro?
Serotonin syndrome is a serious condition caused by excess serotonin. It can happen from Lexapro alone or more commonly when it is prescribed with other serotonin-increasing medications. (Symptoms include: Tremor, dilated pupils hyperreflexia increased reflexes, sweating, agitation, restlessness, muscle rigidity, fever, seizures, confusion, anxiety, lethargy, and coma. It is a medical emergency and needs immediate medical attention.
What are common Lexapro withdrawal symptoms?
Common Lexapro withdrawal symptoms include insomnia, GI upset, anxiety, flu-like symptoms, muscle aches,) dizziness, nausea, fatigue, and irritability. Consult a healthcare provider if you feel you are experiencing Lexapro withdrawal
