Weaning/tapering off Antidepressants


Between 2015 and 2018, 13.2% of adults in the United States used an antidepressant within the past month. This percentage includes more women than men. As a matter of fact, 17.7% of this population is female, and men only comprise 8.4% of the population. To top it all off, 7.2% of adults stated in 2018 that they had experienced a major depressive episode in the past year.

Does Your Brain Go Back to Normal after Antidepressants?

Selective serotonin reuptake inhibitors or SSRIs have shown that they work very well to reduce the symptoms of depression. Examples are Prozac, Lexapro and Celexa. When you take these medications, they help your brain increase its production of serotonin. Serotonin is the neurotransmitter that regulates your mood. It also regulates your sleep cycles and several other bodily functions. When you took one of the SSRIs listed above, you may have noticed that your depressive symptoms began to disappear. The symptoms that these drugs improve include the following:

  • Weight loss or weight gain that you were not striving to achieve
  • Low levels of energy
  • Extreme sadness
  • Feeling hopeless or worthless
  • Anxiety
  • Insomnia
  • Changes in your appetite
  • Lack of pleasure or anhedonia
  • Irritability

What Happens to the Brain after You Stop Taking Antidepressants?

If you are taking SSRIs, the medication has been affecting your brain’s serotonin receptors. If you stop taking the SSRI, you may experience something called “SSRI discontinuation syndrome.”

When you are experiencing SSRI discontinuation syndrome, it reduces your brain’s levels of serotonin and causes you to experience flu-like symptoms. These include body aches, chills, light-headedness, headache and fatigue. Sensory disturbances also appear, such as shock-like sensations, tingling or burning. You may also experience vertigo or dizziness. You may have high levels of agitation, irritability or anxiety. Lastly, gastrointestinal symptoms may appear, such as diarrhea, cramps, vomiting or nausea.

These effects only last a short period of time. In general, these symptoms may last for six to eight weeks, but after that, the symptoms will dissipate, and you will feel like your normal self again.

The Difference between Withdrawal and Addiction

The symptoms of SSRI discontinuation syndrome appear to be the withdrawal symptoms that you would experience after you stop ingesting your SSRI. Because of this, some people are concerned that they are addicted to antidepressants because they believe that withdrawal is a symptom of addiction. However, the withdrawal symptoms listed above do not indicate an addiction to your SSRI drug.

As was mentioned earlier, your brain readjusts itself after you stop ingesting your antidepressant. While your brain is readjusting itself, it sends out the withdrawal symptoms, so these symptoms are not related to addiction. Paxil, Zoloft and Lexapro are highly likely to cause withdrawal symptoms after you stop taking them.

The Difference between Discontinuation Syndrome and Relapse

As you may notice from the list above, discontinuation syndrome causes the same symptoms that antidepressants were created to relieve. After you stop taking your medication, you may notice that your depressive and anxiety symptoms are returning and that they are particularly strong. This does not mean that your depressive symptoms are relapsing; it is only the process that your brain has to go through for a short period of time until the symptoms begin to fade.

If your depressive symptoms return after you stopped taking your medication, they will do so in a slow, deliberate manner. As time goes by, these symptoms will get worse. In contrast, if your symptoms return right after you stop taking your antidepressant and slowly go away, you are likely experiencing withdrawal symptoms. The symptoms may come back within days if this is the case.

How Do You Wean Yourself Off of Antidepressants?

You do not want to stop taking an SSRI altogether. Instead, you must slowly reduce your dosage until you can go without taking the antidepressant without withdrawal symptoms. According to the American Psychiatric Association, you must follow a tapering schedule that lasts for several weeks to accomplish this.

The amount of time that you need to devote to this process will depend on the type of antidepressant you were taking and the amount of time that you were taking it. The dosage must also be considered when figuring out how long the tapering process will last. The amount of time that you have been taking the medication is very important because medications build up inside your body as you take them over a longer period of time. In most cases, withdrawal symptoms begin after the body metabolizes approximately 90% of the medication.

The medical community does not recommend that you taper off of your medication on your own. When you place yourself in the care of professionals, they will determine a tapering schedule for you based on the medication you were taking, the dose at which you were taking it, the length of time you were taking it and your personal characteristics.

What If I Have Withdrawal Symptoms While I Am Tapering Off?

The schedule for tapering off of antidepressants will be different for everyone. In some cases, a person can easily taper off of an antidepressant in a couple of weeks without experiencing any difficulties. If you experience several symptoms, it will be better for you to have a tapering schedule that lasts for a period of months.

For instance, you may have some withdrawal symptoms right after reducing your medication, or you may have them right after you taper off of the drug completely. If that is the case, you will need to return to taking your original dose of the medication and then begin the tapering process again. This time, the tapering schedule will need to be longer. In the event that this doesn’t allow you to stop taking the medication without experiencing withdrawal symptoms, your physician may prescribe a SSRI that has a longer half-life. Prozac is one example of this.

Tips for Experiencing a Successful Taper

Allow Your Antidepressant Time to Work.

Before you decide that you want to stop taking an antidepressant, allow it to work for at least six to nine months. Then, you can determine whether or not you like what the medication has done for you. It will be good for you to begin tapering off of the medication after you begin to feel better. This will mean that the medication worked for you and that it is now time to move on to other types of therapy.

Be Aware of the Things that Affect the Tapering Process.

The length of the tapering process depends upon the following:

  • Whether or not previous tapering schedules caused withdrawal symptoms. If so, you may need a longer tapering schedule for your SSRI.
  • Whether you are taking a high dose or a low dose of your medication. Higher dosages will require that you endure a longer tapering schedule.
  • The type of antidepressant you are taking. Some SSRIs require a longer period of time to be metabolized from your body.

Accept the Fact that Your Tapering Schedule Requires Your Patience.

Don’t be concerned if it seems like your tapering schedule is a lot longer than your peers. Remember that the tapering process may be short for some people but that it can take longer for others.

Take Advantage of a Mood Calendar.

A mood calendar allows you to document your moods over time. When you know exactly how your current dose of medication makes you feel every day, you can have the most meaningful conversations with your physician. You will have a place to list your withdrawal symptoms, and your physician can determine whether or not your depressive symptoms are returning.

Start Keeping Healthy Habits.

Healthy habits include eating a nutritious diet, maintaining a regular exercise schedule and finding ways to reduce stress. These three steps help reduce the possibility of withdrawal symptoms. They also help prevent you from experiencing depressive symptoms into the future.

Ask Friends and Family to Be Your Support System.

You need your friends and family members around you when you are tapering off of medications. The tapering process can cause changes in your moods that may be unsettling for you, so it is a good idea to have supportive people around you.

Make a Commitment to Complete the Tapering Process.

If you are going to start the tapering process, it is important that you finish it. You must visit your physician on a regular basis so that you can report your symptoms. Your physician may need to make adjustments during the process, and you will need to be assessed for the return of your depressive symptoms.

Obtaining Treatment for Depression

Even after you are finished with the tapering off process, you need to obtain further therapy so that you can prevent your depression from relapsing. At Long Island Treatment Center, you can enter our medication-assisted treatment program so that you do not have to worry about experiencing any withdrawal symptoms or cravings for your medication during the tapering off process, but this is only the first part.

After you are free from antidepressants, you may require further treatment. For example, you have been diagnosed with depression, but we may diagnose you with a substance use disorder. If this is the case, you have co-occurring disorders, but Long Island Treatment Center has a dual diagnosis program that can treat your depression and your substance use disorder. If you are prepared to get help for your depression and the troubles you are having with your antidepressant, contact us at Long Island Treatment Center today.

Reviewed for Medical & Clinical Accuracy by Long Island Treatment Center

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