Does Withdrawal Occur from Antidepressants?
Antidepressant medications—used to treat depression and several other conditions—are some of the most prescribed medications in the world. This page will provide a brief overview on the different types of antidepressants, how they work, and whether they can trigger withdrawal symptoms when someone stops using them.
Types of Antidepressant Medications
There are several major classes of antidepressants, which are organized based on their major method of action. Before going any further in discussing potential withdrawal symptoms, it is important to specify the general sub-classes of antidepressants:
- Selective serotonin reuptake inhibitors (SSRIs): This remains the most popularly prescribed class of antidepressants. These medications are believed to function by primarily increasing the levels of serotonin in the central nervous system by blocking the reuptake of serotonin once it is released in the neurons. They do not produce more serotonin; they simply are believed to block the reabsorption once the neurotransmitter is released. These include well-known drugs, such as Prozac, Paxil, Zoloft, and Lexapro.
- Tricyclic antidepressants: This was the major class of antidepressants before SSRIs were developed. These medications, such as Elavil and Anafranil, have a much broader mechanism of action than SSRIs. While their effectiveness in treating depression is similar to SSRIs, they have a much harsher side effect profile. They are as not commonly prescribed in the treatment of depression, but still have uses in other areas.
- MAO inhibitors: This class of drugs is rarely prescribed these days due to potential severe side effects. Their mechanism of action is to inhibit monoamine oxidase, a substance that breaks down certain neurotransmitters in the brain. Nardil and Parnate are examples of these drugs.
- Atypical antidepressants: This group consists of a number of different medications that have a different mode of action from the other three groups. The medicinal drugs here are Effexor, Wellbutrin, Cymbalta, and Remeron.
Can Quitting Antidepressant Medications Result in Withdrawal?
It is generally believed that there is a potential to experience withdrawal when quitting or reducing the dosage of antidepressant medications under certain circumstances.
It’s important to note that someone may experience withdrawal when they quit taking prescribed medication even when they do not have a substance use disorder (SUD).
Withdrawal from antidepressants is known as antidepressant discontinuation syndrome (ADS). Anyone who goes through ADS is not necessarily suffering from a substance use disorder or an addiction, but that does not make the distress associated with the withdrawal syndrome any less severe.
Although it is generally recognized that ADS can occur in anyone taking any antidepressant medications, it is generally recognized that medications that have actions on the neurotransmitter serotonin are significantly more likely to lead to the development of ADS. ADS can occur if:
- The person has regularly taken the antidepressant medication for a period longer than 6-8 weeks. It is extremely rare for ADS to occur in individuals who have taken antidepressants for less than a 6-week time period.
- The person must abruptly stop taking the antidepressant after this time in order for potential ADS symptoms to occur.
- Not everyone who takes antidepressant medications for the above specified time period and abruptly stops using them will develop ADS. Approximately 20 percent of individuals who abruptly stop using antidepressant medications after taking them for longer than 6 weeks will display some symptoms of ADS.
Timeline of the Development of ADS
The actual timeline for antidepressant withdrawal that will develop in individual cases may vary depending on the type of antidepressant medication used, the amount of the medication taken, the length of time using the medication, and individual differences in physiology.
However, research on ADS suggests that unlike other types of withdrawal syndromes, the timeline is relatively linear and not defined by specific stages or specific symptom clusters as in withdrawal from alcohol or narcotic medications.
The general timeline for ADS is reported as following this pattern:
- People who develop ADS begin feeling symptoms within 1-3 days after stopping the antidepressant.
- The duration of the symptoms lasts 1-3 weeks.
- The symptoms peak within a week and then steadily decrease in severity.
- The symptoms are typically reported as being relatively mild and not lasting very long. They are often mistaken for having the flu or some other illness. They are also often misinterpreted as indicating the person’s depression is returning.
- ADS symptoms can be relieved within 24 hours by taking the antidepressant medication that the person quit using.
As mentioned above, there are no clusters of withdrawal symptoms that appear together and designate different phases of the withdrawal process. The symptom profile is variable, and different individuals may experience different combinations of symptoms. For reasons of simplicity, the symptom profile can be generally broken down into groups of potential symptoms; however, please be aware that these may not occur together but most likely will occur in different combinations.
- It is not uncommon for individuals experiencing ADS to have some gastrointestinal issues. Typically, these symptoms include stomach queasiness or mild nausea. Sometimes, the nausea can be severe and leads to vomiting, but this is rare.
- Cold or flulike symptoms that include headache, fatigue, mild fever, chills, blurred vision, runny nose, and general malaise.
- Some individuals may experience dizziness, tingling sensations, mild problems with balance, and/or mild issues with walking as a result of these symptoms. Some individuals may also experience some mild tremors or shakiness.
- Mood swings, anxiety, depression, irritability, crying spells, and trouble sleeping may occur. Some individuals may have vivid dreams that are distressing.
- There are reports of the development of manic behavior or hallucinations; however, these are typically only associated with individuals who have a history of a severe psychological disorder, such as a psychotic disorder or bipolar disorder.
Unlike withdrawal from alcohol or benzodiazepines, the withdrawal that occurs from using antidepressant medications is not generally considered to be potentially dangerous. However, individuals who experience significant mood swings or depression might be at risk for self-harm. Moreover, individuals who have extreme physical reactions may be at risk for accidents or potential mishaps due to impaired judgment as a result of their compromised physical and mental condition.
Medically Assisted Treatment and Medical Detox for ADS
Because the symptoms of ADS are generally mild, and there are no specific medications to address ADS, medically assisted treatment most often considers administering medications to treat certain symptoms, such as nausea, headache, etc.
The common approach to negotiating ADS in individuals who want to discontinue using their antidepressant medication is to adhere to a medically assisted tapering strategy.
Under the supervision of a psychiatrist or other physician, the dosage of the antidepressant medication is periodically tapered down to allow the person’s system to become used to functioning with decreasing levels of the drug present. Once the level of the medication reaches a minimum amount, the physician discontinues it altogether. This tapering medical detox strategy typically avoids any symptoms of ADS that are potentially distressing.
River Oaks Treatment Center is an inpatient rehab facility near Tampa, Florida that can help you or your loved one detox safely and comfortably, as well as instill the necessary skills to remain in long-term recovery. Please fill out the confidential to verify insurance coverage or call an admissions navigator at to learn more about the inpatient rehab program or our outpatient rehab program in Riverview, FL.
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