Discontinuation symptoms are typically mild and short-lived. However, for some people, symptoms can be severe enough to impact their day-to-day lives. By working with your doctor to gradually lower your dose over time (a process known as “tapering”), you may be able to minimize or even prevent many of these uncomfortable symptoms.
Antidepressant Discontinuation Syndrome
Antidepressant discontinuation syndrome is a set of symptoms that can occur after abruptly stopping or even or greatly reducing the dose of an antidepressant medication that you’ve been continuously taking for an extended period of time, generally greater than one month. Some estimates suggest that at least one in five people who stop taking an antidepressant abruptly experience these symptoms. These symptoms, which are often referred to as withdrawal symptoms, usually begin within two to four days and can last for as long as one to two weeks. Discontinuation symptoms can be grouped into six categories:
Flu-like symptoms: Fatigue, nausea, headache, light-headedness, chills, and body achesGastrointestinal: Nausea, vomiting, cramps, and diarrheaHyperarousal: Anxiety, irritability, and agitationImbalance: Dizziness, vertigo, and light-headinessSleep disturbances: Insomnia, nightmares, and vivid dreamsSensory disturbances: Burning, tingling, electric-like or shock-like sensations
The severity of these symptoms can vary significantly. Some people have few or no symptoms when they stop their antidepressant medication, whereas others may find these symptoms extremely uncomfortable.
Discontinuation Syndrome vs. Relapse
Discontinuation symptoms can be very similar to the anxiety or depression symptoms that prompted you to take the medication in the first place. Some people are frightened that their depression or anxiety is returning full force upon stopping their medication, when actually what they are experiencing is a discontinuation syndrome that will resolve by itself in time. Timing can help you tell the difference between the two. If depression or anxiety recurs after stopping an antidepressant, it is often a gradual process that slowly worsens over time. In contrast, symptoms related to antidepressant withdrawal tend to occur quickly (days rather than weeks) and slowly improve over time.
Guidelines for Tapering
The best way to avoid or reduce these withdrawal-like symptoms is to not stop antidepressants abruptly. Specifically, the American Psychiatric Association recommends tapering antidepressants over the course of “at least several weeks.” Because there are no drug-specific tapering recommendations, your doctor will use their clinical judgment to determine your individual tapering schedule. They will consider several factors including the antidepressant you are taking (specifically, its half-life), your current dose, and how long you have been taking it. Antidepressants with relatively short half-lives, such as Effexor (venlafaxine), Paxil (paroxetine), and Zoloft (sertraline), should be tapered over a longer period than drugs with long half-lives like Prozac (fluoxetine).
What If I Have Symptoms While Tapering?
Remember that everyone is different when it comes to weaning off antidepressants. Some people can taper off an antidepressant—even one with a short half-life—in a matter of weeks without any significant symptoms. Others may have bothersome symptoms and require that the drug be tapered over a period of months. If you experience discontinuation symptoms during a particular dose reduction (or shortly after discontinuation), your doctor may restart you at your original dose and then taper you off more slowly. If this doesn’t work, your doctor may switch you over to a drug with a longer half-life such as Prozac.
A Word From Verywell
There are many reasons you may decide to stop taking antidepressants. Maybe you’re having side effects. Or maybe your condition has improved and you no longer need medication. Regardless of your reasons, if you’re thinking about stopping your antidepressant medication, you should always talk to your doctor first. Your doctor will put you on a tapering schedule, prescribe the appropriate dosage, and support you during the transition. Working closely with them will help make your decision to quit taking antidepressants as safe and comfortable as possible.
