If you start to feel better while taking antidepressants, you may wonder how long you should take this medication or whether you can stop.
Expert guidelines about antidepressants can be confusing. They depend on a variety of factors, including:
- The type of prescription you take
- Your dosage
- The number of depressive episodes you’ve had
- Your risk of relapse
Whether it’s a good idea to stop depends on you.
“We know that taking antidepressants for too short a time might pose real risks for some people, but for others, taking them for longer could be more than you need,” says David Baron, a psychiatrist and provost of the Western University of Health Sciences in California.
“This decision needs to be made with a professional, just as a patient who takes insulin or chemotherapy would have specific discussions with their specialist,” he says. “Antidepressants can and do work, but they should be used like any other medication.”
If you and your doctor decide it’s time to stop, you’ll need to know the best way to do it and how to avoid possible side effects.
When to Stop
Under American Psychiatric Association guidelines, if you are taking an antidepressant for your first depressive episode, you should stay on it for at least 4 or 5 months after your symptoms of depression stop. Keep in mind that you may need to try several different antidepressants to find the right option for you, and even then, it can take 2 or 3 weeks to see an initial improvement. After that, it can take 3 to 6 months for symptoms to improve to the point that you are no longer depressed. Altogether, this could mean taking a prescription for about a year to get the full benefits.
If you have ongoing major depressive disorder, or you have had three or more depressive episodes, the APA recommends treatment for at least a few years. Doctors may also recommend longer treatment when the risk of relapse is high.
This can depend on a few factors including your:
- Family history of mental illness
- Other long-term medical or mental health problems
- Ongoing symptoms while you’re on medication
- Ongoing stressors, such as trouble sleeping or work or relationship problems
“Decide with your doctor what you expect to gain and improve from taking medication,” Baron says. “Poor sleep, low energy and low self-esteem symptoms might respond to medication, but antidepressants don’t take care of relationship problems.”
How to Stop
If you decide to stop taking antidepressants, don’t quit taking them on your own. And don’t stop all at once. A major drop in medication levels can trigger a relapse or other harmful symptoms, such as suicidal thoughts.
Work with your doctor to create a plan to gradually reduce your medication dose over time. Every antidepressant enters and exits the body at a different speed. It may take several weeks to decrease medication levels safely. During this process, you should schedule regular follow-ups so your doctor can closely monitor you for any side effects or signs of relapse.
You may also want to schedule sessions with a therapist to deal with other life issues, such as grief, low self-esteem, or negative thinking that may control your mood.
“Cognitive therapy can help people reexamine the accuracy of their negative beliefs, which can relieve their distress,” says Steven Hollon, a professor of psychiatry who researches the prevention and treatment of depression at Vanderbilt University in Nashville.
Consider your daily routine, too. Healthy lifestyle habits, such as proper sleep, good nutrition, regular physical activity, and stress reduction techniques, can help your body adjust to the changing medication levels.
What to Expect
Some people report side effects or noticeable changes when they lower their antidepressant dose. Common complaints include:
Keep track of any symptoms you have and discuss them with your doctor. They may be able to further tweak your dose to reduce the discomfort or prescribe something else to relieve the symptoms.
If you quit taking antidepressants suddenly, you may get “antidepressant discontinuation syndrome,” especially if you’ve been taking medication for more than a month or two. Symptoms can include:
It’s important to talk to your doctor about these symptoms to avoid a relapse and to find the right solution to ease symptoms as your body adjusts.