Available information indicates that out of every 10 Americans age 12 and over, one is on antidepressant drugs. However, it doesn’t end there. The same findings show that 60% of people taking these drugs have done so for at least 2 years with 14% using these drugs for about 10 years. These medications can cause dependence and lead to antidepressant overdose and addiction which, in turn, can cause antidepressant withdrawal symptoms. These symptoms can be deadly which is why many of the users are getting off antidepressants. However, antidepressant withdrawal is associated with health problems (including depression) if not done properly. Thus, the decision to stop taking these drugs should be made only with the support of a specialist to avoid risking a recurrence. Once the patient decides to stop, the physician will create a personalized plan to minimize or prevent the withdrawal symptoms that can occur if the treatment is stopped too quickly.
This article will discuss what happens to the body during antidepressant withdrawal and how to go about safely getting off antidepressants.
What Happens To Your Body When You’re Stopping Antidepressants?
Antidepressant 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. Though its exact cause is still being studied, scientists believe that antidepressant discontinuation syndrome is caused when the levels of antidepressants in the brain reduces. When the serotonin levels in the brain drop, it takes time for the body to adjust and this can lead to withdrawal symptoms.
The withdrawal symptoms can appear a few days after the treatment is stopped. No one can predict if the patient will experience withdrawal signs, and scientists cannot tell exactly why some people experience them while others do not.
Antidepressant Withdrawal Symptoms
Antidepressant withdrawal symptoms differ from person to person and depend on the type of drug and the duration of the treatment. The withdrawal symptoms from these drugs are both mental and physical, and they usually appear within three to five days after stopping the treatment and can last for up to six weeks.
The Most Common Withdrawal Side Effects Are Similar to Those of Flu:
- muscle pain
- excessive sweating
- electric shock sensations
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. If the symptoms are severe, the doctor might decide to reintroduce another antidepressant and reduce it more slowly to better manage the symptoms.
Other Possible Antidepressant 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
Other serious symptoms are catatonia and psychosis which requires prompt psychiatric attention. Patients should avoid stopping antidepressants on their own; neither should they attempt treating the antidepressant withdrawal symptoms. Rather a doctor’s help should be enlisted to avoid health complications. Since the antidepressants withdrawal symptoms differ depending on the patient, the health professional will prescribe an individualized treatment plan.
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:
- Zoloft (sertraline)
- Paxil (paroxetine)
- Lexapro (escitalopram)
- Celexa (citalopram)
- Venlafaxine (Effexor)
The symptoms of antidepressant withdrawal are present in all types of these medications. This includes MAOIs drugs and some types of tricyclic antidepressants. 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). People who have taken older types of antidepressant medications such as SSRI drugs or SNRI types, and atypical antidepressant medications have shown signs of withdrawal as well. Since getting off antidepressants is not child’s play, it is recommended that patients seek medical help whenever they are depressed or face anxiety. Doing so would help the health professionals to map out a perfect strategy should there be the need to quit the medications.
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.|
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. That is why anyone deciding on stopping the depression treatment should address a doctor who will know how to do this process safely or contact a rehab facility and apply for a treatment program.
Ways Of Stopping Antidepressants
There are two ways of stopping antidepressants each with its advantages and disadvantages. Stopping cold turkey is when one quits taking the medication abruptly which can lead to severe health implications. Tapering off, on the other hand, aims to avoid or minimize the effects of getting off antidepressants by gradually lowering the dose to ultimately quit taking the drugs. However, the best method recommended by health professionals is the tapering off routine.
- Stopping Antidepressants Cold Turkey (not recommended)– Antidepressant drugs work by affecting the brain’s 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. Stopping antidepressants cold turkey might put the brain into an imbalance.
- 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.
When tapering off these drugs, 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 use mood calendars while stopping antidepressants to record their mood every day and write any side effects they might experience.
Also, patients should avoid alcohol while quitting the medications since mixing antidepressants and alcohol is dangerous. 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. Patients must strictly obey the tapering off plan if they want to enjoy the benefits of getting off antidepressants.
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.
- 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 natural antidepressants available OTC, to ease the side effects of the withdrawal syndrome. Both options should be done only under close medical supervision.
Sometimes, it is difficult to distinguish relapse from discontinuation symptoms, that is why it is crucial to seek medical help before deciding on weaning off antidepressants.
Quitting antidepressants should not be done without a doctor’s supervision.
How Long After Stopping Antidepressants Before You Feel Normal Again
Feeling better after stopping antidepressants may take a while, so patience and discipline are essential. Also, feeling better after stopping antidepressants depends on several factors including the type of medication, body metabolism, etc. The information available from a 2019 study indicates that it may take from weeks to months. According to some research, 40% of the people who took antidepressant medication took up to six weeks to recover. Also, it took 25% of people 12 weeks or more to feel normal again. The most important thing is to adhere to the withdrawal timetable which would indicate when a patient is expected to be feeling better after stopping antidepressants.
Going Back on Antidepressants After Stopping
Going back on antidepressants after stopping is possible when symptoms of depression and anxiety rear their heads months or years after treatment and recovery. According to available information, this happens to around 20% of people who have recovered.
Signs of Going Back on Antidepressants After Stopping Include:
- Seclusion from social gathering/activities
- Depressed mood
- Taking longer to complete simple tasks
- Difficulty concentrating or remembering
- Feeling worthless and unloved
- Feeling restless
- Changes in appetite
Some of these side effects may also be present when medications are switched. Symptoms may differ from one person to the other and may even lead to suicide attempts. Thus, people need to note what triggers the depressive episodes and take steps to avoid them. Also, patients are advised to stick to treatment plans to avoid going back on antidepressants after stopping. Patients can share information on their health with their doctors to help doctors track the signs of anxiety and depression and take appropriate steps.
Always Consult With Your Doctor Before Stopping
There are lots of benefits of getting off antidepressants like antidepressant weight reduction and getting rid of antidepressants adverse effects. However, not knowing how to wean off antidepressants can make this process more challenging than expected. This is because weaning off the regular use of an antidepressant medication could result in symptoms like nausea, diarrhea, chills, headaches, strange sensations, etc. That is why getting professional help during withdrawal is of utmost importance. The doctor may prescribe a tapering off method which may take like weeks or months, depending on the severity of the symptoms. Patients can also try natural antidepressants like Omega 3 Fatty foods, saffron, and folate.
Patients are reminded to stick to the use of the treatment plan if they are to enjoy the benefits of getting off antidepressants. 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.
Hope Without Commitment
Find the best treatment options. Call our free and confidential helpline
Most private insurances acceptedMarketing fee may apply
- C. Warner, W. Bobo, C. Warner, S. Reid, J. Rachal. (2006). Antidepressant Discontinuation Syndrome. American Family Physician. https://www.aafp.org/afp/2006/0801/p449.html
- M. Gabriel, V. Sharma. (2017). Antidepressant Discontinuation Syndrome. Canadian Medical Association Journal.
- Harvard Health Publishing: Harvard Medical School. (2020). Going Off Antidepressants. Harvard Health Publishing: Harvard Medical School. https://www.health.harvard.edu/diseases-and-conditions/going-off-antidepressants
- M. Horowitz, D. Taylor. (2019). Tapering Off SSRI Treatment To Mitigate Withdrawal Symptoms. The Lancet Psychiatry.
- J. Davies, J. Reid. (2019). A Systematic Review into the Incident, Severity, and Duration of Antidepressant Withdrawal Effects: Are Guidelines Evidence-Based? Science Direct.
- B. McHugh, R. Krishnadas. (2011). Guide to Safely Withdrawing Antidepressants in Primary Care. Wiley Clinical Healthcare Hub. University of Michigan Health. (n.d). Antidepressant Withdrawal. University of Michigan Health. https://www.uofmhealth.org/health-library/abq4245
- J. Rosenbaum, M. Fava, S. Hoog, R. Ashcroft, W. Krebs. (1998). Selective Serotonin Reuptake Inhibitor Discontinuation Syndrome: A Randomized Clinical Trial. Biological Psychiatry.