Can a person stop taking anxiety medication if they no longer have symptoms?

Question

Hi doctor,

Last year, I used to feel sudden chest pain (like cramps) for a few seconds, and it happened a few times. Also, I felt shortness of breath twice. After all the tests, the family doctor said that I had acute anxiety disorder and gave Pexep Plus. I took it for three days and stopped it as I had minor side effects. Then, after a few days, I took it for two days and consulted a psychiatrist who gave me Paro CR 25 mg. I took Paro CR25 and had severe side effects the next day (nausea, numbness in the left neck, tingling of hands, etc).

I stopped taking all the medicines. After four to five days, I started having intense pain at the top of my head, and sometimes, it spread to other parts of the head. Most of the time, the feeling was needle-pointing on the head. For one month, I did not take any medicine. I started having acute anxiety attacks. I even had a brain MRI without contrast, and the results were normal.

Then, I took the advice of a family doctor and started taking Rexipra 5 mg. I took 5 mg at night and 5 mg at day (a total 10 mg per day). I also started doing yoga, pranayam, and counseling. I did not have any anxiety attacks while taking this, but I did have a persistent headache, which increased at the end of the day, especially if I used a mobile or computer. In between, I stopped Rexipra for a few days as I had to take antibiotics for a cold and cough. I did not have anxiety, but after four days, I felt a little shortness of breath, and I was getting angry quickly.

After a few months, Rexipra doses started lessening as per consultation with the doctor. For two weeks, it was 5 mg at day and 0.25 mg at night. Next three weeks, 5 mg per day. Now, I am taking 2.5 mg daily. My headache increases if I check my computer or mobile too much; otherwise, it is a stable condition touchwood with a little bit of sensation at night.

So, my queries are:

Since I am taking 2.5 mg daily, can I wean it off by taking it on alternate days?
Initially, I felt pain even if I touched my forehead and cheeks. Now, I do not feel that. But I feel as if nerves are tight around my face, and they are getting relaxed sometimes. A few times, involuntary trembling of the skin around the eyes and lips has happened. Is it anxiety? How can it go?

Please help me.

Thanks.

Answer 1

Hi,

Welcome to icliniq.com.

I can understand your concern.

First of all, do not wean off too fast, as you are having tension headaches, and still, symptoms of stress and tension are present. As you mentioned, when you stopped Rexipra (Escitalopram) for only four days, even though shortness of breath and anger came back. So, it suggests that neurochemical imbalances persist. Continue taking Rexipra (Escitalopram) for at least three months. After that, you can stop gradually, like 5 mg half for 15 days, then alternate days and stop it. But when you start quitting, start physical exercise daily.

Yes, the trembling sensation around the eyes and lips is due to anxiety only. It will go with Rexipra (Escitalopram) only. If it does not improve, then you can add Amitriptyline 10 mg at night. You need to limit mobile and laptop exposure. Also, avoid fasting and sleep deprivation. Sleep is very important. Start physical exercise daily and avoid smoking and drinking, if any.

I hope this information helps you.

Thank you.