You might be taking medicine to help with stress, depression, or anxiety. There may come a time when you feel better and want to stop taking your medicine. However, stopping these medicines abruptly can lead to some very uncomfortable physical and emotional feelings.
It is important to understand what happens to your body and mind when you stop antidepressant medicine. This guide will walk you through everything you need to know about antidepressant discontinuation syndrome. You will learn the symptoms, why they happen, and how to work with your doctor to stop your medicine safely.
Key Takeaways.
- Stopping antidepressants suddenly can cause physical and emotional withdrawal symptoms known as discontinuation syndrome.
- Common signs include dizziness, nausea, fatigue, headache, and mood changes like anxiety or irritability.
- Medicines that leave your body quickly have a higher risk of causing these discontinuation symptoms.
- You can prevent most symptoms by slowly reducing your dose over time with your doctor's guidance.
- Never stop taking your medicine without talking to your doctor first to keep your mental health stable.
Check if you have depression with the internationally recognized PHQ-9 method
What is Antidepressant Discontinuation Syndrome?
Simply put, if you have taken antidepressant medicines every day for at least six weeks and stop them suddenly, you might experience discontinuation syndrome. Some people call this withdrawal symptoms from stopping medicine. In the medical world, doctors call this antidepressant discontinuation syndrome or ADS.
When you have ADS, your body reacts to the sudden absence of the medicine. You might feel dizzy, have trouble sleeping, feel sick to your stomach, or feel very tired. Do not panic, because these symptoms usually fade away within two months. This condition does not cause permanent physical damage, but it can feel very uncomfortable and distressing.
Keep in mind that when you stop taking antidepressants, the original mental health condition you treated, such as depression or anxiety, can also return. Therefore, if you are thinking about stopping your medicine, you must talk to your doctor first. Your doctor can help you avoid ADS and manage your health safely.
How Common is Antidepressant Discontinuation Syndrome?
Research shows that between 27 percent and 86 percent of people experience ADS when they try to stop taking antidepressants. This can happen whether you stop on your own or try to taper down. As you can see, this condition is quite common and affects many people who stop their treatment.
Symptoms of Antidepressant Discontinuation Syndrome.
These withdrawal symptoms usually start within two to four days after you stop taking your antidepressant. Here are the main signs and symptoms you might notice:
- Flu-like symptoms: You may feel extreme fatigue, get a headache, experience body aches, and sweat more than usual. Some people also experience unusual or frightening dreams.
- Nausea: You might feel sick to your stomach and sometimes experience vomiting.
- Dizziness: You may feel light-headed or unsteady on your feet.
- Strange physical sensations: You might feel a burning sensation, numbness, or zapping feelings like mild electric shocks in your body. This can feel like a very strange experience.
- Mood changes: You may feel anxious, irritable, restless, or even unusually aggressive.
If you notice these symptoms, you should talk to your doctor right away. The severity of these symptoms varies from person to person, but most people find them manageable. One study found that among people who experienced discontinuation symptoms:
- 7 percent still had symptoms after two months.
- 6 percent still had symptoms after one year.
- 2 percent had symptoms lasting longer than three years.
As you can see, for some people, these symptoms can last longer than expected.
Causes of Antidepressant Discontinuation Syndrome.
Researchers still do not know the exact cause of discontinuation syndrome. However, they believe it relates to changes in a brain chemical called serotonin. Medicines like selective serotonin reuptake inhibitors, or SSRIs, and serotonin and norepinephrine reuptake inhibitors, or SNRIs, affect your serotonin levels.
When you stop taking these medicines suddenly, your brain experiences a sharp drop in serotonin. Your body reacts to this sudden drop by producing various physical and emotional withdrawal symptoms as it tries to adjust to the new chemical balance.
Risk Factors for Antidepressant Discontinuation Syndrome.
Your chance of having ADS increases under certain conditions when you stop your antidepressant medicine:
- If you stop taking the medicine completely right away without tapering.
- If you have taken the medicine for a long time, such as several years.
- If you take a high dose of the antidepressant medicine.
- If you have experienced withdrawal symptoms in the past when a dose was missed, even if taking the medicine again made it better.
The specific type of antidepressant you take also affects your risk of ADS. This depends largely on how long the medicine stays in your body. Medicines that leave your body quickly, meaning they metabolize fast, tend to cause ADS more often than medicines that stay in your system longer.
Let us look at different medicine types and their risk levels:
SSRI Medicine Risk Levels.
- High risk for ADS: Paroxetine and fluvoxamine.
- Moderate risk for ADS: Citalopram, escitalopram, and sertraline.
- Low risk for ADS: Fluoxetine.
SNRI Medicine Risk Levels.
- High risk for ADS: Venlafaxine and desvenlafaxine.
- Moderate risk for ADS: Duloxetine.
- Low risk for ADS: Milnacipran and levomilnacipran.
In addition to these, monoamine oxidase inhibitors, tricyclic antidepressants, and tetracyclic antidepressants are also considered to carry a relatively high risk for ADS. Knowing which medicine you take helps you understand your risk.
Complications of Antidepressant Discontinuation Syndrome.
In some cases, stopping antidepressants can lead to serious risks and dangerous complications. Here are the main concerns:
- Suicidal ideation.
- Suicide.
- Mania.
Emergency Warning.
If you or your child have thoughts of suicide or experience dangerous behavior changes, please call emergency services right away (911 in the US/Canada, 999 in the UK) or go to the nearest Emergency Department. Support is available around the clock. You do not have to struggle with these feelings alone.
How is Antidepressant Discontinuation Syndrome Diagnosed?
There are no special medical tests to diagnose antidepressant discontinuation syndrome. Instead, your doctor will ask you questions about your symptoms and your medical history. They will also ask when you stopped taking your antidepressant medicine.
The symptoms of ADS can look very similar to the symptoms of depression and anxiety. Therefore, sharing as much detail as possible about your symptoms and when they started helps your doctor make an accurate assessment.
Treatments for Antidepressant Discontinuation Syndrome.
The most effective treatment for ADS is to start taking the antidepressant medicine again at your previous dose. This usually makes your symptoms go away within 24 hours. If you still want to stop taking the medicine, your doctor can give you specific instructions on how to lower your dose very slowly over time.
Depending on how severe your symptoms are and how long they last, your doctor may suggest other medicines to help manage them. For example:
- Pain relievers like ibuprofen or acetaminophen for headaches.
- Anti-nausea medicines like ondansetron for stomach upset.
- Other medicines like hydroxyzine or benzodiazepines for anxiety and trouble sleeping.
| Symptom Type. | Common Relief Options. / Doctor Guidance Needed. |
|---|---|
| Headaches & Body Aches. | Common Relief Options.: Over-the-counter pain relievers. Doctor Guidance Needed.: Yes, to check correct dosages. |
| Nausea & Stomach Discomfort. | Common Relief Options.: Anti-nausea medicines. Doctor Guidance Needed.: Always consult your doctor. |
| Severe Anxiety & Insomnia. | Common Relief Options.: Prescription calming medicines. Doctor Guidance Needed.: Strictly under medical supervision. |
Outlook for Antidepressant Discontinuation Syndrome.
The outlook for ADS varies for each person. Most cases are not severe and do not last longer than eight weeks. However, some cases can be severe, and symptoms may last for a year or even longer. This is why professional medical guidance is essential.
How to Prevent Antidepressant Discontinuation Syndrome.
Unfortunately, you cannot always prevent antidepressant discontinuation syndrome completely. However, the best way to prevent severe symptoms is to talk with your doctor before you stop taking your medicine. Stopping antidepressants safely is a slow process that requires gradually reducing your dose over time.
Every antidepressant medicine is different. Therefore, the best person to help you stop your medicine safely is your doctor. Your doctor will create a personalized schedule to show you how to lower your dose correctly and safely.
💡 Take-Home Message.
In summary, antidepressant discontinuation syndrome can be an unpleasant experience. The best way to prevent it is by tapering your medicine slowly under your doctor's guidance.
Remember that if you have any questions or concerns about your medicine, you should talk to your doctor. They are there to help you stay healthy.
Medicines are very helpful when used correctly. Knowing how to use them and how to stop them safely is very important. If you have any questions, feel free to ask your doctor.
Sources & References:
- Cleveland Clinic. Antidepressant Withdrawal: Symptoms & Discontinuation Syndrome. Available online.
- Mayo Clinic. Antidepressants: Safe ways to safely stop taking antidepressants. Available online.
- National Health Service (NHS). Stopping or coming off antidepressants. Available online.
- Centers for Disease Control and Prevention (CDC). Mental Health Resources and Guidance. Available online.
- National Institutes of Health (NIH) / PubMed Central. Antidepressant Discontinuation Syndrome Review. Available online.
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