How to taper Escitalopram dosage?

Question

Hello doctor,

I was on the following combination of prescribed medications for one year.

Escitalopram 20 mg, Flupenthixol 5 mg, Dosulepin 50 mg

This combination was tapered as follows:

Phase 1 For 30 Days (Escitalopram 20 mg, Flupenthixol 0.5 MG on alternate days, Dosulepin 50 mg)

Phase 2 for 30 days (Escitalopram 10 mg, Dosulepin 50 mg)

Phase 3 for 30 days (Escitalopram 10 mg, Dosulepin 25 mg)

Phase 4 for 10 days (Escitalopram 10 mg)

Phase 5 for 10 days (Escitalopram 5 mg)

During phase 5, I had issues with having adequate sleep. Usually, I sleep for eight to nine hours, but from phase 5 onwards it became six to seven hours with a mild unrefreshed feeling.

After phase 5, Escitalopram was completely stopped.

After phase 5, during the daytime, I had a little headache and cloudy feeling along with a turn-off feeling inside my head. We waited for 10 days and there was no improvement. Again I started Escitalopram 5 mg daily after 15 days. The problem of a little headache and cloudy feeling along with a turn-off feeling inside has subsided, and now I have completed 30 days on 5 mg Escitalopram. The plan is to stay on 5 mg Escitalopram on alternate days for the next 30 days and stop it.

What is your recommendation for stopping 5 mg Escitalopram? Do you think I should have stayed on 10 mg Escitalopram for 30 days and then 5 mg for 30 days and then stopped it? Kindly suggest.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

You have gradually tapered off your all above medications, I expect you have done it under the observation of your doctor. I need more details about the duration and severity of your illness.

Why were you on all the above medications?
Do you have a relapse of your illness after tapering your medication?

I suggest you follow the below-mentioned instructions:

You may need to take medication for a longer period.
You should continue your tablet Escitalopram 5 mg daily(I would suggest you do it from your current details).
I can not comment (or guide) about stopping your medication without getting enough details of your illness.

Please let me know about your illness details so I can guide you in a better way.

I hope this information will help you.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

I can understand your concern.

You should continue your tablet Escitalopram 5 mg alternate day for four to six weeks and then stop it. But you need to watch for relapse. There is no specific guideline for it.

I would suggest you follow the below lifestyle to deal with your anxiety. It is a non-pharmacological management of anxiety. It will help you and you may not need to take medication for anxiety.

You should do exercises daily for 30 to 45 minutes like at least going for a walk.
You should do meditation for 20 minutes daily, just sit in one place in a comfortable position, and try to concentrate on your normal breathing, do not stop or force yourself to stop your thoughts, just let it be. It will relax and reduce anxiety.
You should eat healthy home-cooked foods, and avoid junk foods.
You must drink enough water.
You should spend quality time with friends and family daily or do video calls if you are living away from your family.
You should spend time on creative hobbies like reading good books, writing journals, painting, drawing, and learning new skills or language or musical instruments.
You should get enough seven to eight hours of sleep daily.
You must avoid tobacco alcohol or any substance abuse.
Be bold and confident.
Stop overthinking.
Take enough sun exposure and fresh air.
Express gratitude daily before going to sleep.
You must do the following investigation as if they are abnormal then it may precipitate your anxiety.
1. CBC (Complete blood count).
2. Thyroid profile.
3. Vitamin B12.
4. Vitamin D3.
5. RBS (Random blood sugar)

I hope this information will help you.

Thank you.

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