When people stop taking antidepressants, they may experience withdrawal symptoms or a relapse.

According to one study, about 20% of people who suddenly stop taking antidepressants will experience symptoms, which doctors refer to as antidepressant discontinuation syndrome. The National Alliance on Mental Illness say that the number may be as high as 80%.

For this reason, experts recommend consulting a doctor before stopping the use of antidepressants. Antidepressants are not habit forming, so stopping them does not cause withdrawal. However, it can cause symptoms, which a doctor can help the person manage.

In this article, we look at why it can be hard to stop taking antidepressants. We also discuss the symptoms that can occur, how to relieve them, and tips for stopping these medications safely.

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Antidepressants cannot cure depression, but they can help reduce anxiety, low mood, and suicidal thoughts. They work by changing how the brain uses chemicals to balance mood or deal with stress.

When people start taking antidepressants, the drugs can take several weeks or longer to be effective. Antidepressants can also have side effects. Both of these factors can make a person want to stop taking them.

People might also wish to stop taking antidepressants because:

  • the medication is too costly
  • they feel as though they have recovered sufficiently
  • a medical professional has advised them to stop
  • they are pregnant or plan to become pregnant

It can be hard to stop taking antidepressants after taking them for a long time.

People should seek a doctor’s advice and support when planning to stop using these medications. The doctor will help make a plan that may involve reducing the dosage gradually or switching to another drug.

Although they do not lead to physical dependence, medications for depression change the chemicals in a person’s brain. The body adjusts to these changes, so stopping suddenly can cause a reaction.

Stopping antidepressants can have a mental and physical impact. A person may also worry that symptoms of depression will return.

Six types of symptoms can occur when stopping antidepressants.

They are:

  • Flu-like symptoms: Fatigue, headaches, pain, and sweating.
  • Insomnia: Difficulty sleeping and vivid dreams.
  • Nausea: There may also be vomiting.
  • Imbalance: Dizziness, vertigo, and lightheadedness.
  • Sensory disturbances: Tingling, burning, and shock-like sensations.
  • Hyperarousal: Agitation, irritability, anxiety, aggression, mania, and jerkiness.

Stopping different antidepressants will result in different symptoms, depending, to some extent, on the half-life.

Antidepressants with a short half-life can cause more side effects and be harder to stop taking. However, people may still experience symptoms when they stop taking a drug with a longer half-life.

The half-life is the amount of time that it takes for the level of the substance in the body to reduce by half. The half-life varies among drugs, and it can also vary among individuals.

Antidepressants with a short half-life include venlafaxine (Effexor) and trazodone (Desyrel). Fluoxetine (Prozac) and citalopram (Celexa) have a long half-life.

Below, we look at some types of antidepressants and the different adverse effects that can occur on stopping them.

Selective serotonin reuptake inhibitors (SSRIs)

SSRIs include medications such as citalopram and fluoxetine. Discontinuation symptoms include:

  • stomach pain and cramps
  • flu-like symptoms
  • headaches
  • lethargy
  • dizziness
  • appetite changes
  • insomnia and nightmares
  • vertigo
  • ataxia, or loss of muscle coordination
  • blurred vision
  • numbness and tingling
  • “electric shock” sensations
  • tremor
  • difficulty with movement
  • agitation, anxiety, aggression, and low mood

Monoamine oxidase inhibitors (MAOIs)

MAOIs include medications such as phenelzine (Nardil) and isocarboxazid (Marplan). Discontinuation symptoms include:

  • headaches
  • insomnia and nightmares
  • feeling agitated or irritable
  • jerky movements or muscle twitches
  • agitation
  • low mood
  • hallucinations and delusions
  • delirium
  • catatonia, which is when a person is unable to move

Tricyclic antidepressants (TCAs)

TCA medications include amitriptyline (Elavil) and doxepin (Silenor). Discontinuation symptoms include:

  • flu-like symptoms
  • headaches
  • lethargy
  • abdominal and gastrointestinal disturbances, such as nausea, vomiting, cramping, and diarrhea
  • insomnia and nightmares
  • dizziness, lightheadedness, and vertigo
  • problems with coordination and movement
  • tremor
  • feeling agitated or anxious
  • low mood

Atypical antidepressants

These include venlafaxine (Effexor) and duloxetine (Cymbalta). Symptoms that can occur following discontinuation include:

  • flu-like symptoms
  • headaches
  • lethargy
  • appetite changes
  • nausea and vomiting
  • insomnia and nightmares
  • dizziness and vertigo
  • “electric shock” sensations and tingling
  • anxiety
  • low mood

Symptoms usually appear within a few days of stopping an antidepressant. Knowing which symptoms to expect can help a person prepare.

In some cases, severe symptoms may make it necessary to take time off work.

Choosing a suitable time to stop taking antidepressants can help with the process. A person may be more at risk of a relapse of depression during periods of stress or emotional difficulty.

Flu-like symptoms

Some people experience flu-like symptoms. A doctor may recommend treating these by:

  • drinking plenty of fluids
  • getting rest
  • staying warm

Taking pain relievers to ease any discomfort is usually safe, but it is best to check with a doctor first.

Fatigue and sleep problems

The symptoms of tiredness, disrupted sleep, and irritation can make everyday activities more difficult.

Planning a quieter few days while stopping antidepressants can reduce stress.

Is it a relapse?

Sometimes, discontinuation symptoms can resemble a relapse. However, while discontinuation symptoms usually start within a few days, signs of a relapse take longer — typically 2–3 weeks — to appear.

If a person has concerns that depression is returning, they might wish to seek medical advice. In some cases, a doctor may prescribe medication to help with discontinuation symptoms.

How long do symptoms last?

Discontinuation symptoms usually start within a few days. Research from 2017 says that they tend to last for 1–2 weeks, but it can be longer in some cases. Some newer research has shown that, although it is uncommon, discontinuation symptoms can last up to 79 weeks.

According to the American Psychological Association, a person can expect the symptoms to last “at least several weeks.”

Having a good support network in place or someone understanding to talk to during this time can be beneficial.

Getting sufficient rest, eating well, and exercising regularly can reduce symptoms for some people.

Stopping antidepressants is a serious decision that can affect a person’s health. A doctor will be able to offer information and advice.

Know your drug

Being involved with the decision-making and planning at each stage of the treatment can help reduce the risk of an unpleasant experience.

For instance, a person can talk to the doctor about:

  • the drug and how to stop using it, even before they start
  • reasons for stopping and a plan for stopping, for when they feel ready to do so
  • which effects to expect, how long they are likely to last, and how to distinguish between adverse effects and a relapse

It may also help if the person keeps a chart to track their progress. They can share this with their doctor.

Stop gradually

A doctor will often advise an individual to stop taking antidepressants gradually, which is known as tapering. A person slowly reduces the dosage of medication over time until they are no longer taking it.

The time that it takes to taper off antidepressants will depend on the drug and how long a person has been taking it. A doctor can advise on this process and the best way to approach it.

Switching drugs

In some cases, a doctor may recommend switching to another medication as a step toward discontinuing the drug.

They may suggest switching to a drug with a longer half-life and then gradually lowering the dosage.

Seek support

Family and friends can support a person while they stop taking antidepressants. Supportive psychotherapy may also help.

Deciding to discontinue antidepressant use needs serious consideration. With appropriate support, many people stop safely, although they may experience uncomfortable adverse effects.

A person should always seek a doctor’s advice before stopping and follow the plan they suggest.

Withdrawal symptoms from certain medications can lead to suicidal thoughts. If this happens, it is vital to seek urgent support.

People can contact the National Suicide Prevention Lifeline in the United States on 1-800-273-8255 or visit their website for support and information.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours per day at 800-273-8255. During a crisis, people who are hard of hearing can call 800-799-4889.

Click here for more links and local resources.