Things You Should Understand Before Stopping Antidepressants [Updated]

Antidepressants can be highly effective for many people, even lifesaving in some cases. However, because your body becomes accustomed to them, both starting and stopping these medications isn’t straightforward. If you’ve started a prescription, you know it can take weeks to see results. And if you and your doctor agree that it’s time to stop taking them, discontinuing antidepressants can be challenging.

Following a recent article in The New Yorker about one woman’s difficulties in switching and stopping psychiatric drugs, I started receiving messages from individuals who believed that quitting antidepressants was nearly impossible and feared that doctors weren’t equipped to help manage the process. Thankfully, this is not the case: mental health professionals are aware of these concerns, and while the process requires caution, it is absolutely possible to discontinue the medication with the right guidance.

Not only is it essential to work closely with a professional, but you should also consider whether you should even stop your medication. Feeling good doesn’t necessarily mean it’s the right time to change or stop your prescription. Similarly, if you’re worried about potential side effects or the medication’s risks, it’s crucial to discuss with your doctor whether the benefits of staying on the medication outweigh those concerns for you personally.

The challenge of discontinuing antidepressants lies in how it affects the body and mind. Ceasing these medications abruptly can lead to uncomfortable withdrawal effects, known as 'discontinuation symptoms'.

If you suddenly stop taking your antidepressants or even reduce the dosage rapidly, you might experience various symptoms like fatigue, dizziness, headache, and nausea. Other possible reactions could include agitation, anxiety, chills, tremors, and rare sensations like sudden electrical 'zaps' in your brain.

Jenny Chen, writing for Elemental, describes the difficulties of discontinuing antidepressants, emphasizing the unpredictable nature of the process. The experience varies greatly, influenced by the specific drug and the individual.

Paroxetine, known for its rapid metabolism, is particularly difficult to discontinue. This is because when you stop taking it, your brain has to adjust to its sudden absence. Fluoxetine, however, remains in the system longer and allows for a smoother tapering process.

Your doctor may recommend a careful tapering strategy when you decide to stop your medication, gradually reducing the dosage to minimize withdrawal effects.

If you’ve only been using medication for a short period, it’s generally easier to stop; however, if you've been on it for years, the process may prove more challenging. The typical duration for discontinuing an antidepressant ranges from two to four weeks, or possibly longer. To get a better sense of what this might involve, this chart displays common tapering schedules for several frequently prescribed drugs. Some psychiatric experts suggest a much slower approach, recommending tapering over months or even years.

However, avoid reducing your dose on your own. It’s essential to navigate this process with your doctor, not independently. Some withdrawal symptoms may closely resemble the return of depression, and you’ll need professional guidance to determine whether you should increase or decrease your medication.

UptoDate advises that if a patient has mild discontinuation symptoms, their doctor should offer reassurance but continue with the tapering plan. For more moderate symptoms, you may need to taper more gradually. For severe symptoms, it’s often best to revert to the previous dose where symptoms were absent and then reduce more slowly from there.

Another option could be switching to a medication that's easier to discontinue, such as fluoxetine. In summary, while the process is nuanced and complex, it is manageable—assuming you are confident that you no longer need the medication to manage your depression. This makes it even more crucial to undertake this process under the guidance of a trusted professional.

Updated 4/24/2019 to address concerns that some readers may interpret this article as recommending self-directed medication changes. The original title of the article was “How to Quit Your Antidepressants,” and it has since been revised to provide more context and clarify that we do not endorse changing your medication independently.