Stopping Antidepressants: Withdrawal Symptoms And Detox

Last Updated: June 10, 2020

Authored by Sharon Levy, MD, MPH

The decision to stop taking antidepressants should be made only with the support of a specialist to avoid risking a recurrence of depression. Once the patient decides to stop antidepressants, the physician will create a personalized plan to minimize or prevent the withdrawal symptoms that can occur if the treatment is stopped too quickly.

Stopping Antidepressants

Stopping Antidepressants Cold Turkey

Antidepressants work by affecting the brain chemical serotonin. When the treatment is suddenly stopped, there is an increased chance that the body will respond with emotional and physical withdrawal symptoms due to the lack of serotonin. That is why people under a depression treatment should not stop cold turkey.

Abruptly stopping antidepressants might put the brain into an imbalance. The patient might be diagnosed with discontinuation syndrome if symptoms appear days after stopping the treatment, and if the side effects go away when the depression treatment is started again. Depending on the types of antidepressant medications the patient is on, the symptoms vary in intensity and duration.

Tapering Off Antidepressants

The best way to stop the treatment is by tapering off depression drugs. This means that the dose is gradually decreased. A doctor will educate the patient on how to taper off antidepressants. The individual will be offered a personalized plan depending on the type of antidepressant, antidepressants mechanism of action, current dose, how long the patient has been taking it, and any side effects the patient might have had during previous medication changes.

This way, the severe withdrawal symptoms will be avoided, as the brain gradually adapts to the lower dose and the subsequent chemical changes.  Some doctors also advise patients to have mood calendars while stopping antidepressants to record their mood every day and write any side effects they might experience.

Stopping taking antidepressants should not be done without a doctor’s supervision. Sometimes the patient might also need other medicines to address insomnia or nausea, for example, or the treatment could be switched from a short-acting drug to a long-acting one.

woman feels it hard to stop antidepressants she is taking

Coming Off Antidepressants: Which Are Harder To Stop?

Although all depression medication comes with the risk of discontinuation symptoms, some drugs are considered harder to stop. These drugs have a short half-life, which means they break down and leave the system quickly. On the other hand, drugs with a long-release leave the body slowly, causing fewer problems when stopping the treatment.

Some of the drugs that are harder to stop are:

At the same time, withdrawal passes less severely with drugs that take a longer time to leave the body, such as Trintellix (vortioxetine) and Prozac (fluoxetine).

What Does Cause Antidepressants Withdrawal?

Antidepressants withdrawal, also known as antidepressant discontinuation syndrome, is defined by the side effects experienced by some patients who suddenly stop the treatment for depression. Studies show that almost 20% of patients will develop the syndrome after abruptly stopping the treatment.

The withdrawal symptoms can appear a few days after the treatment is stopped. No one can predict if the patient will experience withdrawal from antidepressants, and scientists cannot tell exactly why some people experience them while others do not.

Antidepressants Withdrawal Symptoms

The symptoms of withdrawal from antidepressants differ from person to person and depend on the type of drug and the duration of the treatment. The most common withdrawal side effects are similar to those of flu:

  • muscle pain
  • chills
  • nausea
  • excessive sweating
  • headache
  • insomnia
  • electric shock sensations
  • agitation
  • irritability

Some people might also experience what is called brain zaps, a sensation similar to an electric shock in the brain, making people, especially teenagers, prone to suicidal thoughts and actions.

Other possible antidepressants withdrawal symptoms include:

  • Blood vessel control – flush, finding hot weather difficult to tolerate
  • Mental – anxiety, mood swings, confusion, depression, paranoia, suicidal thoughts
  • Balance – dizziness, feeling lightheaded
  • Sleep – nightmares, unusual dreams
  • Movement – uneven gait, restless legs, tremors, difficulty coordinating chewing and speech
  • Digestive – diarrhea, loss of appetite, cramps, vomiting
  • Strange sensations – hypersensitivity to sound, numbness or pain, brain zaps, sense a ringing in the ears

man while withdrawal process

Antidepressant Withdrawal Timeline

Each person has a different withdrawal timeline when going off antidepressants, which depends on the severity of the discontinuation syndrome, the antidepressant used, the period of the treatment if the antidepressant was combined with other drugs, the patient’s psychiatric and medical history and other factors. However, the common withdrawal timeline is as follows:

Days 1–3 The patient starts to experience the first withdrawal symptoms. The attempt to taper the use of the drugs might still cause strong withdrawal.
Days 4–5 Patients typically experience dizziness, nausea, fever, and flu-like symptoms during this stage.
Weeks 1–3 Usually, the symptoms last for up to three weeks; therefore, the patient might see the symptoms starting to subside.
After 4 weeks At this point, the severity of the symptoms depends on the individual and the length of the treatment.

How To Manage Withdrawal Safely

The first step in managing withdrawal safely is acknowledging the possibility of such side effects. A doctor can properly inform the patient on how to get off antidepressants to minimize the chance of experiencing them. This way, the patient can prepare for them and even take time off for a couple of days if the withdrawal symptoms are severe. Side effects, such as disrupted sleep, tiredness, and irritation, can make everyday activities more difficult.

For some people, it proves efficient to eat well, get enough rest, and do physical exercises. A few quiet days can help to reduce the level of stress when stopping antidepressants. Drinking lots of fluids and staying warm also helps.

woman successfully managing antidepressants withdrawal

Another important thing is to find the right time for weaning off antidepressants. For example, the individual might be at a higher risk of depression relapse in periods of emotional difficulty and stress.

Some withdrawal symptoms can be eliminated with flu medicine or pain relievers. Some patients might also find useful the natural antidepressants available OTC, to ease the side effects of the withdrawal syndrome. Both options should be done only under close medical supervision.

There Is Always A Way Out

Not knowing how to wean off antidepressants can make this process more challenging than expected. That is why getting professional help during withdrawal is of utmost importance. In some cases, patients need the help of drug rehab centers to come off the drugs safely and to cope with the emotional, mental, and physical imbalance caused by this change.

Page Sources

  1. Gabriel M, Sharma V. Antidepressant discontinuation syndrome. Canadian Medical Association Journal. 2017; 189(21): E747. doi:10.1503/cmaj.160991.
  2. Papp A, Onton JA. Brain Zaps: An Underappreciated Symptom of Antidepressant Discontinuation. The Primary Care Companion for CNS Disorder. 2018; 20(6). pii: 18m02311. doi: 10.4088/PCC.18m02311.

Published on: October 15th, 2019

Updated on: June 10th, 2020

About Author

Sharon Levy, MD, MPH

After successful graduation from Boston University, MA, Sharon gained a Master’s degree in Public Health. Since then, Sharon devoted herself entirely to the medical niche. Sharon Levy is also a certified addiction recovery coach.


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