What Happens When You Stop Taking Antidepressants

When you’re living with depression, taking antidepressants can be life-changing. But as you start to feel better, and your doctor gives the OK, you may consider getting off the medicine.

You may wonder, “how will this affect my body and mind?”

While they aren’t addictive, people who stop antidepressants can feel withdrawal symptoms — sometimes called antidepressant discontinuation syndrome.

In fact, more than half of people who stop antidepressants report withdrawal effects, according to an October 2019 systematic review in ‌Addictive Behaviors‌‌.‌

“It is the norm, not the exception,” says Jodie Skillicorn, DO, a holistic psychiatrist in Ohio. “Yet few people are told by their doctors that this is not just a possible side effect of the drugs, but a likely one,” she says.

Don’t get us wrong: There is no shame in taking a medicine that can help you live a better life. But if you’re considering tapering off, here’s what to expect, and tips to manage side effects.

The way antidepressants work is closely related to the reason why you feel withdrawal effects.

The two most common types of antidepressants — selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) — change the levels of neurotransmitters in your brain responsible for sending signals throughout your body, per Harvard Health Publishing.

More specifically, SSRIs and SNRIs increase the amount of serotonin in your brain — a neurotransmitter responsible for mood, sleep and pain, per the American Psychological Association (APA).

Over time, your body gets used to this new increased amount of serotonin. When you stop taking antidepressants, though, your serotonin levels shift again.

This shift causes a neurochemical imbalance in your body, Dr. Skillicorn says. In other words: Your body has to work hard to rebalance its natural serotonin levels, per the APA.

Because these neurotransmitters affect your whole body, a change in their levels can cause a range of mental ‌and‌ physical side effects.

Antidepressant withdrawal effects can be summarized with the acronym FINISH, per the Canadian Medical Association Journal, which include the following:

• ‌F‌lu-like symptoms (lethargy,
  fatigue, headache, achiness and sweating)
• ‌I‌nsomnia (with vivid dreams or
  nightmares)
• ‌N‌ausea (and sometimes vomiting,
  diarrhea and loss of appetite)
• ‌I‌mbalance (dizziness, vertigo and light-headedness)
• ‌S‌ensory disturbances (“burning,”
  “tingling,” “electric-like” or “shock-like” sensations and ringing in the ears)
• ‌H‌yperarousal (anxiety,
  irritability, agitation, restlessness, aggression, mania and jerkiness)

Feeling depressed is also a withdrawal symptom, along with “cognitive issues like slowed thinking (or, feeling like you have “cobwebs on your brain”), difficulty focusing and trouble concentrating,” Dr. Skillicorn says.

Other potential side effects can include, per Dr. Skillicorn:

• Problems with speech or
  speaking clearly
• Unusual sense of taste or smells
• Feeling unreal or detached (also called “dissociation” or “derealization”)

Many of the mental and emotional symptoms of withdrawal are the same as depression itself, including low mood, tearfulness, irritability and anxiety.

Sometimes it’s so tricky to tell the difference, that even doctors mistake withdrawal for a depression relapse, “especially if they don’t know much about antidepressant withdrawal,” Dr. Skillicorn says.

Unfortunately, “many doctors assume that withdrawal symptoms are actually a relapse of the original depression or anxiety, and “treat” symptoms by putting patients back on antidepressants,” Dr. Skillicorn says.

But the idea of re-prescribing a drug when it may not be medically necessary can feel “deeply distressing and unfair to patients,” she adds.

The best way to advocate for yourself at the doctor is knowing the signs of antidepressant discontinuation versus depression itself.

Here are a few key differences between withdrawal and depression to keep in mind, per Harvard Health Publishing:

• Discontinuation symptoms usually start within days to weeks of stopping your medication or lowering your dose, whereas relapse symptoms develop later and more gradually.
• Discontinuation symptoms often include
  physical complaints that aren’t commonly found in depression, like dizziness, flu-like symptoms and abnormal sensations.
• Discontinuation symptoms disappear
  quickly if you take a dose of the antidepressant, while drug treatment of
  depression itself takes weeks to work.
• Discontinuation symptoms resolve as your body readjusts, while a depression relapse often continues and may get worse over time.

Try writing your symptoms down in a journal or on your phone to help you keep track while tapering off an antidepressant, per the APA. That way, if you notice a trend in certain symptoms, you can bring them up to your doctor.

It’s possible to predict how severe withdrawal symptoms will be by knowing an antidepressant’s half-life. That is, how long the drug takes to break down and leave your body, Dr. Skillicorn says.

“The medications with the shortest half-lives are often the most difficult to taper,” she adds. This includes SSRIs and SNRIs like Paxil, Effexor and Cymbalta, Dr. Skillicorn says. With these, you may start to feel withdrawal symptoms within just one day of stopping or tapering.

On the other hand, antidepressants with a ‌longer‌ half-life (like Prozac) are less likely to cause severe withdrawal side effects, per Harvard Health Publishing.

Medications that affect your dopamine and norepinephrine levels (NDRIs) like Wellbutrin can also cause withdrawal effects.

While you and your doctor shouldn’t necessarily choose which antidepressant is right for you from its half-life alone (you’ll want to stick with the drug that helps you the most, and causes the least side effects), knowing half-lives of certain medications can be helpful.

Here’s a breakdown of the half-life of the most common antidepressants:

According to the APA, withdrawal symptoms should go away within days or weeks, but newer evidence has shown it can take much longer, per the ‌Addictive Behaviors‌ review.

In fact, for some people, withdrawal can last months. But “the symptoms that show up, and how long it takes to taper, will drastically vary from person to person,” Dr. Skillicorn says.

For example, if you’ve been on antidepressants for years, withdrawal side effects may be more noticeable than if you’ve only been taking them for a few months, she adds.

Plus getting off antidepressants ‌too quickly‌ can make withdrawal side effects worse. Yet some doctors prescribe “tapering for only a few weeks, or taking a dose every other day, like you would with some thyroid medications,” Dr. Skillicorn says.

“This can lead to a lot of disruption, and send your body on a roller coaster of ups and downs,” she adds.

Another issue with determining how long withdrawal lasts? Most available research has been funded by pharmaceutical companies, per the APA. These studies usually include people who’ve only been on antidepressants for a short period of time and have mild side effects.

The bottom line: More unbiased studies are needed to explore the effects of antidepressant withdrawal in people who’ve been on them for a long time.

It may be impossible to avoid withdrawal effects completely, but there are some things you can do to make the tapering process feel easier.

“I find many symptoms can be eased by calming and soothing your nervous system,” Dr. Skillicorn says.

Not only can these strategies offer relief, but they could also help you “learn skills to bring greater balance and resilience to your everyday life,” Dr. Skillicorn says.

If your doctor or therapist doesn’t know much about the effects of stopping antidepressants, they might not be able to properly guide you through the tapering process.

“The truth is that [many] doctors are simply not taught about the existence of withdrawal symptoms, let alone how to manage them,” Dr. Skillicorn says.

Ideally, it’s best to partner with a provider who’s up to date on current research about these drugs. They can support you and address any concerns that come up in the weeks or months after stopping your medication.

Lowering your dose gradually can help minimize (and possibly prevent) withdrawal symptoms and give your body time to adjust.

Your doctor can help you make a tapering schedule, which will depend on factors like the following, per Harvard Health Publishing:

• Which medicine you’re on
• How long you’ve been on it
• Your current dose
• Any side effects you’ve had with previous medication changes

Always listen to your body while tapering, to make sure you’re going at a good pace, Dr. Skillicorn says. There’s nothing wrong with slowing down if symptoms show up, or staying at your current dose for a while until you feel better, she adds.

And remember: Never stop taking antidepressants suddenly or without guidance from your doctor. Quitting “cold turkey” on your own can increase your risk of severe side effects, or a depression relapse.

“Tending to your body as symptoms arise is essential and will help tremendously,” Dr. Skillicorn says.

She recommends the following practices that nurture the mind-body connection, to not only get your body moving, but your mind calm:

“Learning and practicing these before starting to taper can make the process feel much easier,” she adds.

“Acupuncture can be very helpful during this process, too,” Dr. Skillicorn says.

The Chinese medicine practice — which involves sticking small needles on certain pressure points of your body — helps calm your nervous system and possibly prevent side effects of withdrawal, like insomnia, she adds.

“When your body is stressed, it requires more nutrients,” Dr. Skillicorn says.

Along with eating nutritious foods, taking a good quality multivitamin can support your body through the withdrawal process, she adds.

Other specific supplements that could help your nervous system include the following, per Dr. Skillicorn:

• ‌Inositol: ‌frequently called vitamin B8, but it’s a simple sugar naturally found in your body that helps soothe your nervous system
• ‌S-adenosyl-L-methionine (SAMe):‌ helps produce the building
  blocks needed to make neurotransmitters, so your body has the resources it needs
  to reestablish balance

Always talk to your doctor before trying new supplements, though, as some may negatively interact with other medications, Dr. Skillicorn says.

Getting consistent exercise has been shown to help reduce stress and calm your body’s sympathetic (i.e., fight or flight) nervous system, Dr. Skillicorn says.

Working out can also help make serotonin more available to the neurons in your brain, which could help offset changes that happen during the tapering process, per Harvard Health Publishing.

Even just working out three times a week can reduce your risk of a depression relapse over time, per Harvard Health Publishing. You can start slow, by taking walks or bike rides, and work your way up to more moderate-intensity activity.

Getting enough sleep is crucial to your overall health — whether you’re tapering off antidepressants or not.

In this case, a lack of sleep is associated with depression, and can worsen other withdrawal symptoms. In fact, sleep-deprived people are ten times more likely to develop depression, according to Johns Hopkins Medicine.

While acupuncture can help relieve insomnia, practicing good sleep hygiene is also important, Dr. Skillicorn says.

Try these healthy sleep habits for better quality shut-eye, per the Centers for Disease Control and Prevention (CDC):

• Go to bed at the same time
  every night and wake up at the same time each morning, including on the weekends
• Make sure your bedroom is
  quiet, dark, relaxing and at a comfortable temperature
• Remove electronic devices,
  such as TVs, computers and smart phones, from your bedroom
• Avoid large meals,
  caffeine and alcohol before bedtime
• Get some
  exercise (being physically active during the day can help you fall asleep more
  easily at night)

The antidepressant withdrawal journey can be challenging. It’s “easy to get lost in fear,” Dr. Skillicorn says. That’s why having a healthy support system is essential.

This is the time to lean on your loved ones, or join support groups to find others who relate to what you’re going through.

Ultimately, though, these interactions should leave you feeling brave and supported, not fearful or unsettled, so choose support wisely, Dr. Skillicorn adds.

Support from a good therapist can help you stay strong through the withdrawal process, by helping your develop coping skills to manage your side effects.

Talk therapy can also help lower the chances of your depression coming back. In fact, people in counseling while tapering off antidepressants have a lower risk of relapse, per Harvard Health Publishing.

“Nature helps turn on your parasympathetic (i.e., your rest, digest and heal) nervous system,” Dr. Skillicorn says. In other words, it puts you at ease.

Indeed, spending time outdoors can improve your mood, mental health and emotional wellbeing, per the APA.

Try taking a stroll through the park, going on a nearby hike or taking a bike ride. You could even tend to a garden, or eat a meal outdoors.

And if you’re unable to get outside, even watching a nature video or virtual reality nature experience can have similar positive effects on your mood, per the APA.

It’s natural to feel some fear about getting off your antidepressants. The risk of withdrawal symptoms are real, but they aren’t impossible to work through.

By gradually tapering your dose, working with well-versed professionals and practicing self-care, you can minimize (and possibly prevent) symptoms, and reduce the risk of your depression coming back.

“The important thing to remember is that it will get better and the side effects will end,” Dr. Skillicorn says.

And ultimately, there’s no shame in staying on antidepressants for the time being. Be patient with yourself, and do what’s best for you and your mental health.