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    Stopping Antidepressants: Is it Withdrawal?

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    Hardest-to-Stop Antidepressants

    All depression drugs can potentially lead to discontinuation symptoms, but some are much more likely to do so than others. In fact, antidepressant labels often warn that stopping the medication too quickly may lead to bothersome symptoms. However, discontinuation symptoms are more likely with antidepressants that stay in your body for a shorter period of time, especially those that affect both serotonin and norepinephrine, such as Effexor (venlafaxine) and Cymbalta (duloxetine). Other short-acting medications that affect mainly serotonin include:

    Withdrawal is less common with medications that take longer for the body to clear, such as Prozac (fluoxetine) or Brintellix (vortioxetine). However, longer-acting antidepressants can still sometimes cause discontinuation symptoms.

    Discontinuation symptoms have also been reported in people who stop taking older types of antidepressant medications, including tricyclics and monoamine oxidase inhibitors (MAOIs).

     

    Symptoms of Antidepressant Discontinuation

    Symptoms of antidepressant withdrawal depend on the specific medication you have been taking. The longer you take an antidepressant, the more likely you are to develop withdrawal symptoms when you quit, especially if you have been using a short-acting one.

    Symptoms most often occur within three days of stopping the antidepressant. They are usually mild and go away within about two weeks. Symptoms can include:

    • Anxiety
    • Depression and mood swings
    • Dizziness and balance problems
    • Electric shock sensations
    • Fatigue
    • Flu-like symptoms
    • Headache
    • Loss of coordination
    • Muscle spasms
    • Nausea
    • Nightmares
    • Tremors
    • Trouble sleeping
    • Vomiting

     

    In rare cases, antidepressant withdrawal may cause mania. Certain, older types of antidepressants called MAOIs can lead to confusion and psychotic symptoms.

    How to Stop Antidepressants Safely

    If you are thinking about stopping your antidepressant therapy, talk to your doctor to discuss the risks and benefits of discontinuing treatment. Never stop "cold turkey." In many cases, the best way to stop taking an antidepressant is to slowly cut back your dose under the guidance of your doctor. This is called tapering. Tapering helps your brain adjust to the chemical changes and can help prevent discontinuation symptoms. Your doctor will tell you how to lower your dose over a couple of days. Never try to do this on your own.

    Sometimes, doctors can prescribe medicines to help with discontinuation symptoms such as nausea or insomnia. They also may advise switching from a short- to a long-acting antidepressant to ease the transition off of a medicine for depression.

    Discontinuation symptoms usually go away within a few weeks. But if you have extremely severe withdrawal symptoms, your doctor may recommend other medicines to relieve them.

     

    WebMD Medical Reference

    Reviewed by Joseph Goldberg, MD on February 22, 2015
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