Gulfport Healthcare

Do it slowly, carefully and under the supervision of a clinician. There are two primary reasons that I recommend caution.


The first is that stopping an antidepressant suddenly can significantly increase the risk of developing withdrawal symptoms.

The second reason is that, unfortunately, many people will have their depression and anxiety return when the antidepressant is discontinued. Going off the antidepressant slowly allows a patient to catch this process in its early stages and reverse it before a full relapse has occurred.

So if you do elect to go off your antidepressant, what would you worry about in terms of withdrawal, or discontinuation, symptoms?

Most of the time when people have trouble, it takes the form of feeling jittery, anxious and nauseated. Headaches are common. People often have trouble sleeping and have mood swings and/or feel irritable or sad. People will also sometimes report weird sensory experiences such as ringing in the ears, "electric shock" feelings or jerking movements in their arms or legs.

The solution for these symptoms is very straightforward -- just go back on the antidepressant and they go away. The best way to avoid them, as I said above, is to go down on your dose as slowly as possible. Of course, some people can just stop the antidepressant with no ill effects. Everyone is different. Sometimes when people are trying to get off an antidepressant such as Zoloft that goes in and out of the body quickly, it helps to have your doctor switch you over to fluoxetine (aka Prozac), which stays around in the body for long periods of time and thus tapers itself slowly to zero.

One of the challenges a doctor faces in trying to help a patient get off an antidepressant is to figure out whether the patient's symptoms are really the result of withdrawing from the antidepressant or rather represent a return of the patient's depression or anxiety problem.

After all, most people with major depression feel sad, anxious and irritable and can have mood swings. In fact, the symptoms of withdrawal share a lot in common with the underlying problem for which the medication was given in the first place. This has really been highlighted for me by studies showing that people will also have withdrawal symptoms when they are taken off an inactive placebo.

Interestingly, these symptoms get worse and worse as the weeks pass, which almost certainly reflects the fact that the depressive illness that was being treated by the placebo is coming back.

One of the most discouraging and challenging things about depression is that it is often a chronic condition, and people who have done great on an antidepressant for years will suddenly relapse when the antidepressant is removed.

This is another reason to try to go off an antidepressant slowly. If the depression and anxiety start creeping back in, you can go back up on the antidepressant in time to avoid a full relapse. If you find that you are someone who needs an antidepressant not to suffer with emotional symptoms, then you are confronted with a choice between relying on a medication long-term -- which often distresses people -- or paying the high price of chronic depression.

I strongly believe that it is much better to commit to taking a medication for years than to lose so much of one's life to emotional misery.

Community Answers

Nancy Hamma
Sag Harbor NY
updated Wed May 6, 2009

Dr. Raison's answer is helpful to me as I have tried many times to wean myself off antidepressants that I have been on for over 15 years. I was on Prozac for several years and that stopped working and then I switched

Dr. Raison's answer is helpful to me as I have tried many times to wean myself off antidepressants that I have been on for over 15 years. I was on Prozac for several years and that stopped working and then I switched over to Lexapro. I have tried very slowly decreasing my dose over time because I do not want to be on medication for the rest of my life and because it has had strong sexual side effects. Each time I have felt myself falling back into the black hole of depression which is unbearable and I've gone back to my regular dose. My doctor has always said I could try to go off and has advised me to do it gradually but I have finally come to the conclusion that I will be on medication for the rest of my life. It is helpful to hear a doctor say that some people need to do this. I felt weak that I could not give up the med. Suffering with the side effect is the lesser of two evils so I have to go with that. I would say that if you feel depression coming back as you wean off the medication, to get back on it right away. less

Heather Franek
St. Paul, MN
updated Wed May 6, 2009

To go off of an SSRI such as Zoloft, cut your dose in half and take the half dose RELIGIOUSLY every day for at least a month, until you are confident you have no weird mood swings. Then cut it to 1/4, and again take to go off of an SSRI such as Zoloft, cut your dose in half and take the half dose RELIGIOUSLY every day for at least a month, until you are confident you have no weird mood swings. Then cut it to 1/4, and again take it religiously every day until you are sure you have no symptoms or that your symptoms have subsided. Then, if you can, cut to 1/8 and do the same.

Be aware that 2-3 weeks after stopping or changing the dose of an SSRI, you can get a reaction in which you become massively depressed, suicidal, and even violent due to the body's sudden reaction to the loss of the serotonin "re-uptake" effect of the drug. You need to stay at least one month on each new dose to guard against this effect, even when you are weaning yourself off. NEVER go cold turkey off of an antidepressant as the biological withdrawal from the drug can, in and of itself, cause you to commit suicide or violence as a result of this reaction. The psychiatrist is covering this up when he vaguely refers to "withdrawal symptoms". This reaction can also occur 2-3 weeks after your dose is raised. The suicide-causation effect is well known and in most industrialized countries of the world, antidepressants are banned for use in anyone under the age of 25 because they know that the risk of suicide from the withdrawal effect is higher than the risk of suicide from not taking the drug at all. less

Lissa
Marion, MA
updated Wed May 6, 2009

Make sure that you go very slowly!! We were not told anything about the physical effects of weaning off of Zoloft and my son experienced very bad flu-like symptoms which improved when he went back on the medication. W .

Make sure that you go very slowly!! We were not told anything about the physical effects of weaning off of Zoloft and my son experienced very bad flu-like symptoms which improved when he went back on the medication. We will try again to keep going (we were almost finished) off, but will take it even slower next time. I also went off of Celexa at the end of Feb (a very low dose) and am still experiencing achiness in my legs and feet on a daily basis. Taking 800mg of ibuprofen has helped both me and my son with our achiness. All I can say is Good Luck and go into this with your eyes wide open!! less

Neill
TX
updated Wed May 6, 2009

This is absolutely correct. Having myself experienced these "withdrawl" sypmtoms after missing a few days of the prescribed dose I experienced "electric shock" sensations as well as nauesea and dizziness. The only way to discontinue meds such as these is to "ween" oneself off these drugs.
This is absolutely correct. Having myself experienced these "withdrawl" sypmtoms after missing a few days of the prescribed dose I experienced "electric shock" sensations as well as nauesea and dizziness. The only way to discontinue meds such as these is to "ween" oneself off these drugs. less
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