Nobody wants to admit they have a problem, especially when it comes to something like depression. Unfortunately, the stigma attached to the condition continues to affect how people who have it feel. It’s challenging to open up to others about it because you might be met with toxic positivity. For example, people might ridicule you for feeling bad. “Your life isn’t that bad. Imagine how bad it is for other people.” Or you encounter those who simply tell you to get over it because it’ll pass soon.
However, in many cases, your depression will pass. Unfortunately, it’s extremely common to endure feeling depressed. Maybe you had a dog your entire life, and they suddenly ran away, or the college you worked tirelessly through high school to get into rejected you. Maybe your significant other broke up with you abruptly or the job you’ve been with for years suddenly let you go. These are all legitimate reasons to feel depressed, although once you go through the stages of grief, your depression will soon wane.
That’s not the case for someone who’s clinically depressed or suffering from a major depressive disorder. A chemical imbalance in their brain causes them to lose interest in activities they once found joy in, makes it hard to get out of bed, and it may seem like that person just “checked out” of life. Even worse, once they become reclusive and seemingly check out, they don’t feel like they can talk to anyone about it because, as we mentioned above, it’ll get swept under the rug. Would you want to speak with someone who dismisses your feelings? Doubtful. If someone says they’re depressed, listen to them.
At this stage, it’s likely a person with major depressive disorder (MDD) has exhausted all other resources, such as alternatives to treating depression, and began a medication regimen; they’re not alone. According to the U.S. Centers for Disease Control and Prevention (CDC), between 2015 and 2018, 13.2 percent of Americans over age 18 had used an antidepressant medication in the past 30 days. The same report found that antidepressant use was much higher in women than men, and nearly 25 percent of women over age 60 took the medication.
At a certain point, once you feel your life has been rebuilt with the assistance of medication, you might stop and think to yourself, “I want to stop my antidepressants.” Amazingly, you’ve reached that level of balance in your life that you feel ready to move away from the chemical relief medication provides, but there is a lot you should know before stopping. As you’d expect from any drug, cessation of antidepressants can cause withdrawal symptoms. They can be pretty severe in some cases, so you must speak with the prescribing physician to determine a tapering regimen. It could take several months before you stop altogether.
When you’ve hit a rough patch in your life that you can’t overcome with natural alternatives and it keeps nagging at you, antidepressants can seem like a godsend. Unfortunately, depression has the potential to rob our lives of joy and makes it difficult to muster up the energy to complete simple tasks. Even something like walking up the stairs can become a chore. However, antidepressants can give that all back, but you might ask yourself, “How long should I take these pills?”
Well, for some, antidepressants might be something their doctor recommends they stay on for life, especially if they’re not dealing with many side effects. For example, a person might be willing to put up with some of the sexual side effects, such as a decreased desire or inability to orgasm, insomnia, headaches, or vivid dreaming. Still, over time it may be time to give up the prescription and move on. If you’re tired of these side effects and feel like you can live without the pills, it’s time to stop.
This decision to stop your medication must be made with careful consideration and the support of your prescribing physician. They want to make sure you’re not stopping prematurely and putting yourself at risk of relapsing from your depression. However, once you decide to quit, your doctor will help you take steps to minimize the withdrawal symptoms that will occur.
Antidepressant discontinuation syndrome can also be considered antidepressant withdrawal. This occurs because the drug alters the levels of neurotransmitters in our bodies and influences the activity. Neurons will adapt to the current level of neurotransmitters, causing symptoms to be anywhere from mild to severe, which typically occurs when you stop all at once. Although they aren’t medically dangerous like alcohol or benzodiazepines, which also affect neurotransmitters in our brain, they’re extremely uncomfortable.
Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are linked to various withdrawal symptoms, known as antidepressant or SSRI discontinuation syndrome. Stopping antidepressant drugs such as Wellbutrin that don’t affect serotonin systems, dopamine, and norepinephrine reuptake inhibitors seem to cause fewer symptoms. However, patients report developing severe cases of irritability.
It’s vital to note that because you experience discontinuation symptoms, it doesn’t mean you’re addicted to the medication. Addiction is when a person craves the drug, uses it in higher doses than prescribed, and will continue using despite the adverse effects caused by obtaining the drug. Although it does occur, it’s extremely uncommon for a person who uses antidepressants to become addicted to crave more or take higher doses than prescribed. However, sometimes a phenomenon known as “Prozac poop-out” will necessitate increasing the amount or adding another drug.
All antidepressants will cause some discontinuation symptoms, but some are much worse than others. The same goes for antidepressants as any drug you stop using. The factors that influence what you experience will be the size of your last dose, the size of the dose you were prescribed, your age, and your sex.
Antidepressant labels will warn you that abrupt cessation will equate to bothersome symptoms. With that said, discontinuation symptoms occur more often with antidepressants that remain in your body for a shorter period of time, especially those affecting norepinephrine and serotonin. These include the following drugs:
- Sertraline (Zoloft)
- Escitalopram (Lexapro)
- Paroxetine (Paxil)
- Citalopram (Celexa)
- Duloxetine (Cymbalta)
- Venlafaxine (Effexor)
People who stop using older types of antidepressant medications that include monoamine oxidase inhibitors (MAOIs) and tricyclics have also reported discontinuation symptoms. Although it may lead you to wonder if you’re ready to stop using the medication, you may wonder what the symptoms of antidepressant discontinuation are?
The most common symptoms you will experience from antidepressant discontinuation are solely dependent on the type of medication you’ve been taking and the dose. However, we’ll include a generalized list of symptoms below.
The symptoms most often occur within three days after you stop using the antidepressant, and there will be differences in how someone reacts when suddenly stopping the medicine. Some people report mild to moderate symptoms, while others endure severe symptoms that last several weeks. These symptoms include:
- Depression and severe mood swings
- Intense anxiety
- Electric shock sensation sometimes referred to as “brain zaps”
- Balance and dizziness problems, potentially vertigo
- Flu-like symptoms
- Fatigue
- Loss of coordination
- Headache
- Nausea
- Muscle spasms
- Tremors
- Nightmares
- Vomiting
- Trouble sleeping (insomnia)
In some cases, antidepressant withdrawal can elicit mania, which is more common with older antidepressants like MAOIs. Withdrawal can lead to confusion and psychotic symptoms that require immediate medical attention. Reach out to your physician or head to the emergency room immediately if you experience severe symptoms.
If you’ve been considering a change in your life and you’re ready to stop using antidepressant drugs, you should speak to your doctor and let them know how they feel. They’ll likely discuss the risks and rewards of stopping your treatment now. Is it the right time to stop? Are there any upcoming events that can trigger your depression? These are things you must consider before stopping. However, if you’re ready, talk to your doctor about a tapering regimen. Keep in mind; you should never stop cold turkey.
The best way to stop antidepressant use is to cut down slowly until you stop altogether. Your doctor will help you with this process, known as tapering, which helps your brain adjust to the chemical changes and mitigate some of the more severe symptoms you could face. Your doctor will help you and provide a schedule. Again, you should never do this alone because you could face horrible symptoms, and there would be no one to help you with them.
The benefit of doing this with your doctor is they can prescribe medications to ease your symptoms, such as insomnia or nausea. They can also provide you with a long-acting antidepressant to ease the transition off the medication for depression. Generally speaking, discontinuation symptoms will dissipate in a few weeks. Still, if you have extremely severe withdrawal symptoms, your doctor may prolong the taper over a few months or recommend other medications for relief.
