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Originally Posted On: https://www.alternativetomeds.com/blog/discontinuing-antidepressants/

The Dangers of Abruptly Stopping Antidepressants

Not only is abruptly stopping antidepressant medications dangerous, it can often result in a medical or psychiatric misdiagnosis. In other words, the side effects caused by antidepressants may mistakenly be attributed to conditions that aren’t present. 5 A misdiagnosis can lead to a delay in treatment, worsening symptoms due to incorrect treatment, or even additional medications that are prescribed unnecessarily.

These side effects from abruptly stopping antidepressants can include:

• Nausea, along with vomiting, diarrhea, and abdominal cramping (which may be misconstrued as gastrointestinal illnesses or influenza) 10
• Disturbing thoughts or images leading to suicidal ideation (which may be misdiagnosed as another mental illness) 11
• Headaches (sometimes mistaken as migraines) 12
• Bodily or neuropathic pain (which can be mistaken as a symptom of a vast array of conditions) 13

• Insomnia (a symptom of a wide variety of conditions) 10
• Fatigue (another common symptom) 14
• Anxiety and mood swings (typically misdiagnosed as generalized anxiety disorder, or mood disorders) 15
• Disorientation and memory issues (often attributed to age or neurological disorders) 16
• Other psychological symptoms, like mania, anger, violent behavior, and even psychosis (which may be misdiagnosed as severe psychological disorders) 17,18

Learn more about the symptoms caused by abruptly discontinuing antidepressants, as well as the dangers they may cause.

About Antidepressants

Antidepressant medications were created to help those who are experiencing mental health symptoms that make it difficult to function. Many people seek medications as a balm to the overwhelming symptoms of depression, both to help improve mood and enable them to carry out daily tasks. Unfortunately, however, these medications often don’t work as they are theorized to do, and many times, they create unwanted side effects that can worsen mental health instead of improving it.

According to the Centers for Disease Control and Prevention, about 13.2% of adults take antidepressants, a rate that is even higher among women at 17.7%. 1 Undoubtedly, these people who began taking the medications to ward off symptoms of severe depression can continually suffer emotional highs and lows, but we’ve had many people report to us that the physical and mental side effects far outweighed any positive benefits of the antidepressant. Even without these side effects, people often mention how they just don’t feel like themselves while on prescription antidepressants.

When negative side effects or unwanted feelings occur, it can be tempting to cease using antidepressants immediately in an attempt to return to the relative normalcy they felt before the medication. However, it is important to speak with an antidepressant expert like a physician, psychiatrist, or recovery specialist first, as abruptly stopping antidepressants can have serious effects. It is almost never safe to suddenly stop using an antidepressant – they can cause dependency and should be tapered away from like any other drug or psychiatric medication.

Which Antidepressants Can Cause Negative Mental Health Symptoms?

Over the years, multiple antidepressant drugs have been created by the pharmaceutical industry with the intent of relieving symptoms of depression, anxiety, PTSD, OCD, and others 21Taking an antidepressant can cause drastic changes in the brain, especially once you have been taking the medication for four to six weeks. Antidepressants were developed to create artificially elevated levels of the neurotransmitters that may improve mood, like serotonin and norepinephrine, even though the nearly 50-year-old hypothesis that depression is directly related to serotonin deficiencies has never been proven. Citation #2]

The two major classes of modern antidepressants were both designed to artificially modulate the body’s levels of serotonin and norepinephrine. Selective serotonin reuptake inhibitors (SSRIs) are meant to prevent cells from absorbing serotonin (reuptake) before it can be used by the brain. Serotonin and norepinephrine reuptake inhibitors (SNRIs) prevent the reuptake of both these critical neurotransmitters. While this theoretically increases the serotonin available to the brain, evidence suggests that medications designed to boost serotonin levels may actually make any existing deficiency even worse. 3

This may be because the body and brain have become accustomed to artificially elevated neurotransmitter levels, reducing natural production and presenting issues when the medication ceases. In fact, any antidepressant can result in withdrawal symptoms if an individual suddenly stops taking the medication.

SSRIs that can cause negative symptoms when ceased abruptly include:

• fluvoxamine (Luvox)
• citalopram (Celexa)
• fluoxetine (Prozac)
• escitalopram (Lexapro)
• sertraline (Zoloft)
• Paroxetine (Paxil)

SNRIs may include:

• Duloxetine (Cymbalta)
• Venlafaxine (Effexor)
• Milnacipran (Savella)
• Levomilnacipran (Fetzima)

Antidepressant Discontinuation Syndrome

If you suddenly stop using antidepressant medication, you will likely begin to experience physical symptoms, as mentioned above. These symptoms, when coupled with the “brain zaps” many people describe when discontinuing antidepressants, are hallmarks of a condition known as antidepressant discontinuation syndrome. 4

The fact that this condition has a name leaves many people wondering, is there such a thing as antidepressant withdrawal? Yes, antidepressant discontinuation syndrome is another way of describing antidepressant withdrawal, and if you are experiencing these symptoms after abruptly stopping your antidepressant, it is a sign that you are in withdrawal. These symptoms can be experienced for several weeks after stopping an antidepressant.

Along with the dangerous side effects can come the temptation to resume using antidepressants to stave off withdrawal symptoms. This is similar to the way people with substance use disorders experience a strong desire to keep using a substance to avoid experiencing withdrawal. While antidepressants do not affect the brain in the same way as an illicit street drug, the brain can grow dependent on the artificially elevated neurotransmitter levels they provide. That means that removing them abruptly can cause serious side effects.

Psychological Dangers of Abruptly Stopping Antidepressants

Abruptly ceasing a medication that modulates mood swings and depression can cause several dangerous psychological symptoms in addition to physical symptoms.

In general, depression and other original symptoms can quickly return after abruptly ceasing antidepressant use. The risk of mania may mean you’ll experience more extreme highs and lows than you did before taking antidepressants, which can serve to reduce your stamina and affect the amount of activity you are able to do in a day.

Heightened anger and irritability may or may not result in physical violence, and disorientation and memory loss can dramatically affect your ability to accomplish daily tasks. One of the most serious side effects is psychosis, where you are unaware of what is happening in reality.

Most significant, however, is the increased danger of developing suicidal thoughts, which has triggered the requirement for a black box warning on all antidepressant medications. If you are having suicidal thoughts, take action right away.

Contact the National Suicide Prevention Lifeline at 988.

Can You Avoid the Dangers of Stopping Antidepressants Cold Turkey?

Antidepressant discontinuation syndrome, or antidepressant withdrawal, is a significant risk if you stop taking your antidepressant cold turkey. According to research, over 20% of patients experience this syndrome after an abrupt change in use. 5 Suddenly stopping your medication can create physical symptoms that can contribute to worsening mental health. It can also lead to psychological issues that may cause a setback in your treatment plan. Just as taking antidepressants may have caused side effects that were worse than the depression and other symptoms you felt before your prescription, abruptly stopping your medication can cause even more severe issues.

Simply put, while it may seem like an obvious solution to stop taking the medication that is causing unwanted side effects as quickly as possible, it is crucial to stop gradually, under the guidance of a medical professional.

Weaning off the medication with help from a professional, a process known as a medical taper, means that you will take gradually smaller doses over time as recommended by a physician. This process continues until you are no longer taking any antidepressants. Over this time, your brain can readjust to normal conditions, and you can begin focusing on what may really be at the root of your depression.

A Harvard Medical School study demonstrates the importance of slowly decreasing antidepressant dosage. In this study, 400 people were examined for a year after stopping their usage of antidepressants. Those in the study who quickly stopped taking antidepressants were more likely to slip back into their original symptoms than those who took a longer, tapered route to ceasing antidepressants. 6

Preventing and Addressing Antidepressant Withdrawal Symptoms

Before stopping your antidepressants, it is crucial to put a plan into place to address the effects of antidepressant withdrawal. There are ways you can prevent withdrawal and mitigate the symptoms as you taper away from your medication.

Consult with a Professional Throughout the Process

A medical professional can not only help you establish a safe taper that can be accomplished under supervision but can also help you monitor your progress as you reduce your dose. It is essential to keep track of all of the symptoms that you are experiencing. If they become more severe, you may need to slow down the process of weaning yourself off the medication. Keep your doctor aware of all medications you are taking so that they know how they will interact with each other. With a doctor’s assistance, you can follow an approved medical plan to safely taper away from the antidepressant.

Consider Therapy

Consider if you are in a good space in your life physically and emotionally. If you are undergoing major life changes or difficult circumstances, the importance of seeking professional help with discontinuing your medication is crucial to prevent withdrawal symptoms from exacerbating your troubles. In this way, therapy is a crucial component of a safe taper. If you are struggling with managing your emotions, anxiety, and depression, consulting with a licensed therapist who can help you walk through your feelings and thought processes is essential. Strategies like cognitive behavioral therapy can help you reduce your use of antidepressants, deal with the fear of withdrawal, and address depressive and other symptoms if they recur. 7

Address Your Activity Levels

People who stay active and exercise for up to three times a week are usually less likely to have their feelings of depression come back. Exercise can boost your mood and has shown results better than antidepressants for addressing depression. 8 Also, the healthier that you are, the easier it will be for your body to adjust to no longer taking the medication.

Manage Your Nutrition

The wisest step to managing your antidepressant withdrawal symptoms is to take care of yourself. Make sure that you stay well-hydrated and eat a well-balanced diet. Taking care of your health is especially important as your body is undergoing changes in medication. Just as eating the wrong foods full of neurotoxins can contribute to depression, eating the right foods rich in amino acids, vitamins, and other nutrients can help you combat depression and other undesirable conditions, and mitigate feelings of withdrawal. 9

Consider Holistic Therapies

Here at Alternative to Meds Center, we recognize a full range of therapies that can help combat depression and antidepressant withdrawal alike. For example, IV and NAD therapies and nebulized glutathione treatments can help you address nutrient deficiencies and make essential biological compounds more accessible to the tissues that so desperately need them. Things like colon hydrotherapy, massage, and acupuncture can help you detoxify the body and brain from months or even years of pharmaceutical buildup.

Other adjunctive supports like equine-assisted therapy, art therapy, coaching, and group or peer support can help you adjust your mind to life after antidepressants. Even practicing yoga and Qi Gong can ensure you remain in a state of focused mindfulness necessary to avoid returning to antidepressant use.

Can You Stay Off Antidepressants Forever?

With careful attention to your symptoms and remaining vigilant about addressing withdrawal as it occurs, you can successfully and safely cease using antidepressants. If depression makes a reappearance, you can use the same tactics listed above to address mental health symptoms as they return.

There are far safer and more effective alternatives to taking antidepressants.

As we recently concluded, the top ten include:

1. Changing your diet
2. Participating in yoga and mindful breathing
3. Custom vitamin therapy
4. Establishing an exercise routine
5. Participating in massage therapy
6. Acupuncture to restore energy and blood flow
7. Talking to friends, family, and other loved ones
8. Professional counseling and adjunctive therapies
9. Mindfulness and meditation
10. Helping others on their journey to wellness

Participating in a few or all of these strategies can help you combat depression naturally, without the use of pharmaceutical medications.

Antidepressant Withdrawal FAQs

The following are some of the most frequently asked questions about antidepressant withdrawal.

What Is Antidepressant Discontinuation Syndrome?

Antidepressant discontinuation syndrome occurs when an individual suddenly stops taking their antidepressant medication and experiences several negative side effects as a result. Some of the symptoms that may be associated with this syndrome are tiredness, irritability, headaches, trouble sleeping, flu-like symptoms, and nausea.

What Happens When You Stop SSRIs Abruptly?

If you abruptly stop taking a selective serotonin reuptake inhibitor antidepressant or SSRI, you can experience symptoms such as dizziness, nausea, stomach pain, vertigo, vomiting, and diarrhea. You may also have blurred vision or feel something like electrical shocks going through your body. Your mood may change frequently and you may have difficulty sleeping. These symptoms may be caused by a severe disruption in the neurotransmitters in your brain but can be mitigated by gently tapering use with the help of a medical professional.

What Are the Benefits of Coming Off Antidepressants?

Using antidepressants can cause certain negative side effects, such as dry mouth, sweating, dizziness, headaches, stomach pain, and constipation or diarrhea. Additionally, using antidepressants for a long time can result in an increase in weight, changes in sexual satisfaction, and even dependence on the medication itself. If you stop using antidepressants safely, you can reduce these unwanted side effects.

How Long After Stopping Antidepressants Do You Get Withdrawal?

Typically, it does not take long to start experiencing withdrawal symptoms after stopping antidepressants abruptly. Withdrawal symptoms are generally predicated according to the half-life of the medication, and each medication has a distinct timeline for this phenomenon. For example, Prozac has a relatively long half-life of between 2 and 4 days, and the drug continues to be active in the body for some weeks after discontinuation. <sup19 Paxil has a half-life of just 21 hours. 20 Every person has a unique genetic profile and medical history as well as other factors which may slow or advance the emergence of withdrawal symptoms.  Consult with a medical professional about slowly tapering your use to reduce these withdrawal symptoms.

Learn More About Safe Tapering at Alternative to Meds Center

At the Alternative to Meds Center, we focus on guiding you to healthier habits for a happier and healthier lifestyle, free from pharmaceutical and illicit drugs and other neurotoxic substances. We do so by assessing each individual who crosses our threshold and developing a personalized, holistic plan to cease antidepressant use, eliminate the root cause of symptoms, and build your natural stamina to combat depression, anxiety, PTSD, OCD, eating disorders, and other unwanted symptoms naturally. 21 For more information about the dangers of abruptly stopping antidepressants and the many alternatives we offer, please contact Alternative to Meds Center.

References:

1. Brody DJ & Gu Q. Products – Data Briefs – Number 377 – September 2020. CDC. 2020. [Cited 2024, September 11]
2. Cowen PJ & Browning M. What has serotonin to do with depression?. World psychiatry : official journal of the World Psychiatric Association (WPA), 14(2), 158–160. 2015. [Cited 2024, September 11]
3. Siesser WB, Sachs BD, Ramsey AJ, Sotnikova TD, Beaulieu JM, Zhang X, Caron MG & Gainetdinov RR. Chronic SSRI treatment exacerbates serotonin deficiency in humanized Tph2 mutant mice. ACS chemical neuroscience, 4(1), 84–88. 2013. [Cited 2024, September 11]
4. Rizkalla M, Kowalkowski B & Prozialeck W. Antidepressant Discontinuation Syndrome: A Common but Underappreciated Clinical Problem. Journal of Osteopathic Medicine, 120(3), 174-178. 2020. [Cited 2024, September 11]
5. Gabriel M & Sharma V. Antidepressant discontinuation syndrome. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne, 189(21), E747. 2017. [Cited 2024, September 11]
6. Horowitz MA, Framer A, Hengartner MP, Sørensen A & Taylor D. (2023). Estimating Risk of Antidepressant Withdrawal from a Review of Published Data. CNS drugs, 37(2), 143–157. 2023. [Cited 2024, September 11]
7. Gautam M, Tripathi A, Deshmukh D, Gaur M. Cognitive Behavioral Therapy for Depression. Indian Journal of Psychiatry 62(Suppl 2):p S223-S229, 2020. [Cited 2024, September 11]
8. Weir, K. The exercise effect. Monitor on Psychology, 42(11). 2011. [Cited 2024, September 11]
9. Rao TS, Asha MR, Ramesh BN & Rao KS. Understanding nutrition, depression and mental illnesses. Indian journal of psychiatry, 50(2), 77–82. 2008. [Cited 2024, September 11]
10. Henssler J, Heinz A, Brandt L, Bschor T. Antidepressant withdrawal and rebound phenomena. Dtsch Arztebl Int; 116(20):355–361. doi:10.3238/arztebl.2019.0355. 2019. [Cited 2024, September 11]
11. Tint A, Haddad PM, Anderson IM. The effect of rate of antidepressant tapering on the incidence of discontinuation symptoms: a randomised study. J Psychopharmacol; 22(3):330–332. doi:10.1177/0269881107081550. 2008. [Cited 2024, September 11]
12. Fava GA, Gatti A, Belaise C, Guidi J, Offidani E. Withdrawal symptoms after selective serotonin reuptake inhibitor discontinuation: a systematic review. Psychother Psychosom; 84(2):72–81. doi:10.1159/000370338. 2015. [Cited 2024, September 11]
13. Riediger C, Schuster T, Barlinn K, Maier S, Weitz J & Siepmann T. Adverse effects of antidepressants for chronic pain: a systematic review and meta-analysis. Frontiers in neurology, 8, 307. 2017. [Cited 2024, September 11]
14. Lejoyeux M & Adès J. Antidepressant discontinuation: a review of the literature. Journal of Clinical Psychiatry, 58(7), 11-16. 1997. [Cited 2024, September 11]
15. Berber MJ. FINISH: remembering the discontinuation syndrome. Flu-like symptoms, insomnia, nausea, imbalance, sensory disturbances, and hyperarousal (anxiety/agitation). J Clin Psychiatry; 59(5):255. Pmid:9632038. 1998. [Cited 2024, September 11]
16. Colzato L, Zhang W, Walter H, Beste C & Stock AK. An oppositional tolerance account for potential cognitive deficits caused by the discontinuation of antidepressant drugs. Pharmacopsychiatry, 54(06), 252-260. 2021. [Cited 2024, September 11]
17. Narayan V, Haddad PM. Antidepressant discontinuation manic states: a critical review of the literature and suggested diagnostic criteria. J Psychopharmacol; 25(3):306–313. doi:10.1177/0269881109359094. 2023. [Cited 2024, September 11]
18. Healy D, Herxheimer A, Menkes DB. Antidepressants and violence: problems at the interface of medicine and law. PLoS Med. 2006 Sep;3(9):e372. doi: 10.1371/journal.pmed.0030372. PMID: 16968128; PMCID: PMC1564177.
19. Sohel AJ, Shutter MC, Patel P, et al. Fluoxetine. [Updated 2024 Feb 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459223/
20. Bourin M, Chue P, Guillon Y. Paroxetine: a review. CNS Drug Rev. 2001 Spring;7(1):25-47. doi: 10.1111/j.1527-3458.2001.tb00189.x. PMID: 11420571; PMCID: PMC6741642.
21. Chu A, Wadhwa R. Selective Serotonin Reuptake Inhibitors. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554406/