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Antidepressant Withdrawal

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Hardest-to-Quit Antidepressants

All depression drugs can potentially lead to withdrawal symptoms. In fact, antidepressant labels often warn that stopping the medication too quickly may lead to bothersome symptoms. However, withdrawal 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). However, longer-acting antidepressants may still cause withdrawal symptoms.

Withdrawal symptoms have also been reported in people trying to quit older types of antidepressant medications, including tricyclics and monoamine oxidase inhibitors (MAOIs).

 

Symptoms of Antidepressant Withdrawal

Symptoms of antidepressant withdrawal depend on the specific medication you have been taking. Studies have not revealed factors that predict the chances of developing antidepressant discontinuation symptoms – including how long someone has been taking an antidepressant – although some research has found that discontinuation symptoms may be more likely in people who have had a more complete initial response to their antidepressant. 

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
  • Irritability
  • Depression and mood swings
  • Light-headedness
  • 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, in people who have bipolar disorder, antidepressant withdrawal has been known to trigger mania. Withdrawal from certain, older types of antidepressants called MAOIs has also (though rarely) been reported to cause confusion and psychotic symptoms.

 

How to Quit Antidepressants Safely

If you are thinking about stopping your antidepressant therapy, talk to your doctor. Never stop "cold turkey." In many cases, the best and safest way to quit 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 severe withdrawal symptoms. Your doctor will tell you how to cut back 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. 

Withdrawal 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 March 26, 2013
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