Hi doctors team, I have been taking nexito 20 mg (ecslitopram) from nearly 1 year for ocd (harm & repetitive thoughts). Now since I am well versed in mindfulness, meditation yoga, 7 chakra balancing, pulling back, awareness, self compassion, being in the moment. My kundalini energies is way too balanced and I find myself very deep content and peaceful person. Present scenario:- because of escitalopram and heavy dose my digestive system has weaken and nearly from month and two I am getting heavy mouth ulcers. I have tried everything since I am a video person (effects on gut) like taking papaya, non oily food, fibres, warm water, still this issue is persisting of digestion & constipation. I came to the conclusion that its because of lexapro - nexito. Now my question is since I am finding myself very much calm, controlled, stable with 100% fine and easily noticing and letting go thoughts. How should I taper of lexapro since I have read to taper 25% and its half life is also 27 hr?

Dr. Saranya DevanathanPsychiatrist51yrs exp

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Dear Veer, Lexapro (escitalopram) can be tapered by 5 mg every 2-3 weeks, if you continue to letting go thoughts. You digestive problems sounds like obsessive traits in your personality. However, see to that it does not interfere with your quality of life. 

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Dr. Vel Prashanth VPsychiatrist7yrs exp

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If ure in remission, we can definitely consider tapering off. But the thing with ocd is, some percentage have population will show full remission, some can have relapse after stopping ssri, so we need to observe through a period of slow tapering. Do get a direct consult to discuss how to go about this process of tapering and observations. Take care.  

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Dr. Rashmi NavelkarPsychiatrist11yrs exp

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The mouth ulcers may be due to b-complex deficiency. Please take a multivitamin tablet for atleast 15 days and see if that improves. If you have been maintaining well on nexito for almost 6 months atleast, then you can taper it slowly over every few weeks. Depending on whether your ocd symptoms recur or not you can reduce the dose. However due to the waxing and waning nature of ocd I would advise you to continue on a minimum effective dose. For now you can reduce nexito to 15 mg daily. Continue the same for atleast 2-3 weeks. Then if you are still maintaining well with any ocd symptoms, then you can further reduce to 10 mg. And continue that for another 3 weeks. Pls consult a psychiatrist before you decide to stop medications.  

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