Medication Withdrawal
Antidepressant withdrawal symptoms
Neurotransmitters act throughout the body, and you may experience physical as well as mental effects when you stop taking antidepressants or lower the dose too fast.
Common complaints include the following:
Neurotransmitters act throughout the body, and you may experience physical as well as mental effects when you stop taking antidepressants or lower the dose too fast.
Common complaints include the following:
- Digestive. You may have nausea, vomiting, cramps, diarrhea, or loss of appetite.
- Blood vessel control. You may sweat excessively, flush, or find hot weather difficult to tolerate.
- Sleep changes. You may have trouble sleeping and unusual dreams or nightmares.
- Balance. You may become dizzy or lightheaded or feel like you don't quite have your "sea legs" when walking.
- Control of movements. You may experience tremors, restless legs, uneven gait, and difficulty coordinating speech and chewing movements.
- Unwanted feelings. You may have mood swings or feel agitated, anxious, manic, depressed, irritable, or confused — even paranoid or suicidal.
- Strange sensations. You may have pain or numbness; you may become hypersensitive to sound or sense a ringing in your ears; you may experience "brain-zaps" — a feeling that resembles an electric shock to your head — or a sensation that some people describe as "brain shivers."
How to go off antidepressants
From www.health.harvard.edu/diseases-and-conditions/going-off-antidepressants
If you're thinking about stopping antidepressants, you should go step-by-step, and consider the following:
Take your time. You may be tempted to stop taking antidepressants as soon as your symptoms ease, but depression can return if you quit too soon. Clinicians generally recommend staying on the medication for six to nine months before considering going off antidepressants. If you've had three or more recurrences of depression, make that at least two years.
Talk to your clinician about the benefits and risks of antidepressants in your particular situation, and work with her or him in deciding whether (and when) to stop using them. Before discontinuing, you should feel confident that you're functioning well, that your life circumstances are stable, and that you can cope with any negative thoughts that might emerge. Don't try to quit while you're under stress or undergoing a significant change in your life, such as a new job or an illness.
Make a plan. Going off an antidepressant usually involves reducing your dose in increments, allowing two to six weeks between dose reductions. Your clinician can instruct you in tapering your dose and prescribe the appropriate dosage pills for making the change. The schedule will depend on which antidepressant you're taking, how long you've been on it, your current dose, and any symptoms you had during previous medication changes. It's also a good idea to keep a "mood calendar" on which you record your mood (on a scale of one to 10) on a daily basis.
Consider psychotherapy. Fewer than 20% of people on antidepressants undergo psychotherapy, although it's often important in recovering from depression and avoiding recurrence. In a meta-analysis of controlled studies, investigators at Harvard Medical School and other universities found that people who undergo psychotherapy while discontinuing an antidepressant are less likely to have a relapse.
Stay active. Bolster your internal resources with good nutrition, stress-reduction techniques, regular sleep — and especially physical activity. Exercise has a powerful antidepressant effect. It's been shown that people are far less likely to relapse after recovering from depression if they exercise three times a week or more. Exercise makes serotonin more available for binding to receptor sites on nerve cells, so it can compensate for changes in serotonin levels as you taper off SRIs and other medications that target the serotonin system.
Seek support. Stay in touch with your clinician as you go through the process. Let her or him know about any physical or emotional symptoms that could be related to discontinuation. If the symptoms are mild, you'll probably be reassured that they're just temporary, the result of the medication clearing your system. (A short course of a non-antidepressant medication such as an antihistamine, anti-anxiety medication, or sleeping aid can sometimes ease these symptoms.) If symptoms are severe, you might need to go back to a previous dose and reduce the levels more slowly. If you're taking an SRI with a short half-life, switching to a longer-acting drug like fluoxetine may help.
You may want to involve a relative or close friend in your planning. If people around you realize that you're discontinuing antidepressants and may occasionally be irritable or tearful, they'll be less likely to take it personally. A close friend or family member may also be able to recognize signs of recurring depression that you might not perceive.
Complete the taper. By the time you stop taking the medication, your dose will be tiny. (You may already have been cutting your pills in half or using a liquid formula to achieve progressively smaller doses.) Some psychiatrists prescribe a single 20-milligram tablet of fluoxetine the day after the last dose of a shorter-acting antidepressant in order to ease its final washout from the body, although this approach hasn't been tested in a clinical trial.
Check in with your clinician one month after you've stopped the medication altogether. At this follow-up appointment, she or he will check to make sure discontinuation symptoms have eased and there are no signs of returning depression. Ongoing monthly check-ins may be advised.
From www.health.harvard.edu/diseases-and-conditions/going-off-antidepressants
If you're thinking about stopping antidepressants, you should go step-by-step, and consider the following:
Take your time. You may be tempted to stop taking antidepressants as soon as your symptoms ease, but depression can return if you quit too soon. Clinicians generally recommend staying on the medication for six to nine months before considering going off antidepressants. If you've had three or more recurrences of depression, make that at least two years.
Talk to your clinician about the benefits and risks of antidepressants in your particular situation, and work with her or him in deciding whether (and when) to stop using them. Before discontinuing, you should feel confident that you're functioning well, that your life circumstances are stable, and that you can cope with any negative thoughts that might emerge. Don't try to quit while you're under stress or undergoing a significant change in your life, such as a new job or an illness.
Make a plan. Going off an antidepressant usually involves reducing your dose in increments, allowing two to six weeks between dose reductions. Your clinician can instruct you in tapering your dose and prescribe the appropriate dosage pills for making the change. The schedule will depend on which antidepressant you're taking, how long you've been on it, your current dose, and any symptoms you had during previous medication changes. It's also a good idea to keep a "mood calendar" on which you record your mood (on a scale of one to 10) on a daily basis.
Consider psychotherapy. Fewer than 20% of people on antidepressants undergo psychotherapy, although it's often important in recovering from depression and avoiding recurrence. In a meta-analysis of controlled studies, investigators at Harvard Medical School and other universities found that people who undergo psychotherapy while discontinuing an antidepressant are less likely to have a relapse.
Stay active. Bolster your internal resources with good nutrition, stress-reduction techniques, regular sleep — and especially physical activity. Exercise has a powerful antidepressant effect. It's been shown that people are far less likely to relapse after recovering from depression if they exercise three times a week or more. Exercise makes serotonin more available for binding to receptor sites on nerve cells, so it can compensate for changes in serotonin levels as you taper off SRIs and other medications that target the serotonin system.
Seek support. Stay in touch with your clinician as you go through the process. Let her or him know about any physical or emotional symptoms that could be related to discontinuation. If the symptoms are mild, you'll probably be reassured that they're just temporary, the result of the medication clearing your system. (A short course of a non-antidepressant medication such as an antihistamine, anti-anxiety medication, or sleeping aid can sometimes ease these symptoms.) If symptoms are severe, you might need to go back to a previous dose and reduce the levels more slowly. If you're taking an SRI with a short half-life, switching to a longer-acting drug like fluoxetine may help.
You may want to involve a relative or close friend in your planning. If people around you realize that you're discontinuing antidepressants and may occasionally be irritable or tearful, they'll be less likely to take it personally. A close friend or family member may also be able to recognize signs of recurring depression that you might not perceive.
Complete the taper. By the time you stop taking the medication, your dose will be tiny. (You may already have been cutting your pills in half or using a liquid formula to achieve progressively smaller doses.) Some psychiatrists prescribe a single 20-milligram tablet of fluoxetine the day after the last dose of a shorter-acting antidepressant in order to ease its final washout from the body, although this approach hasn't been tested in a clinical trial.
Check in with your clinician one month after you've stopped the medication altogether. At this follow-up appointment, she or he will check to make sure discontinuation symptoms have eased and there are no signs of returning depression. Ongoing monthly check-ins may be advised.
4 Things You Should Know Before Stopping Your Medication
From themighty.com/2018/09/how-to-stop-taking-antidepressants/
Psychiatric medications work differently for everyone because of our unique biological makeup and individual environmental triggers. Which drugs work for you may be useless to someone else. You may have side effects and your best friend on the same medication may not. Accordingly, whether or not to stop taking antidepressants is a decision that only you — with input from a doctor you trust — can make.
1. There’s a Risk of Mental Illness Relapse
One major risk of stopping your medications is a risk of relapse. Some doctors consider the danger of a mental health relapse a greater concern over any hypothetical negative impacts of using antidepressants for years. Mental illnesses like depression or bipolar disorder are prone to recur. Medication may be the best option to prevent future episodes and maintain a higher quality of life.
“Once a person has a second episode, that person will almost always have recurrent episodes,” Seidman told The Mighty. In the case of a condition like bipolar disorder, a manic episode that’s left untreated may turn into a psychotic break. Those with untreated depression or bipolar disorder have a higher risk of suicide.
“It’s a generalization but it really holds true for all the major mental illnesses like schizophrenia, recurrent unipolar major depression [and] bipolar depression,” Miller told The Mighty. “[The] more episodes a person has over the course of their life and the longer they go untreated, the greater the risk they have for future episodes and the harder those future episodes will be to treat.”
2. You May Experience Withdrawal Symptoms
When you stop taking your medication, you may experience withdrawal, or discontinuation, symptoms. These could include “flu-like symptoms, insomnia, nausea, imbalance, sensory disturbances, and hyperarousal,” said Johnny Williamson, MD, a psychiatrist and medical director at Timberline Knolls in Illinois.
You may also experience “headaches, dizziness, fatigue, electric shock type symptoms (sometimes referred to as zingers) and irritability.” Usually, any withdrawal symptoms start within a few days of lowering the dose of your antidepressants and last one to two weeks. Most symptoms are mild, though that’s not always the case.
3. You Should Do It With the Support of a Medical Professional
Before stopping psychotropic medications, talk to your doctor first. You’ll want to discuss your reasons for discontinuing medication, how the process might work and the potential effects of withdrawal. A doctor — or even a pharmacist — can help decide how fast (or slow) you should go while lowering doses to minimize any potentially dangerous consequences, including side effects or interactions with other drugs you’re taking.
4. You Need to Go Slowly and Taper Off
Clinicians usually suggest waiting at least six months to a year after your mental illness symptoms have subsided before considering quitting your meds. From there, you’ll work with your doctor to create a plan to taper your medications slowly over time, which could mean weeks, months or even a year or more. Slow tapering has two major benefits. First, it reduces the discontinuation symptoms you’re likely to experience.
From themighty.com/2018/09/how-to-stop-taking-antidepressants/
Psychiatric medications work differently for everyone because of our unique biological makeup and individual environmental triggers. Which drugs work for you may be useless to someone else. You may have side effects and your best friend on the same medication may not. Accordingly, whether or not to stop taking antidepressants is a decision that only you — with input from a doctor you trust — can make.
1. There’s a Risk of Mental Illness Relapse
One major risk of stopping your medications is a risk of relapse. Some doctors consider the danger of a mental health relapse a greater concern over any hypothetical negative impacts of using antidepressants for years. Mental illnesses like depression or bipolar disorder are prone to recur. Medication may be the best option to prevent future episodes and maintain a higher quality of life.
“Once a person has a second episode, that person will almost always have recurrent episodes,” Seidman told The Mighty. In the case of a condition like bipolar disorder, a manic episode that’s left untreated may turn into a psychotic break. Those with untreated depression or bipolar disorder have a higher risk of suicide.
“It’s a generalization but it really holds true for all the major mental illnesses like schizophrenia, recurrent unipolar major depression [and] bipolar depression,” Miller told The Mighty. “[The] more episodes a person has over the course of their life and the longer they go untreated, the greater the risk they have for future episodes and the harder those future episodes will be to treat.”
2. You May Experience Withdrawal Symptoms
When you stop taking your medication, you may experience withdrawal, or discontinuation, symptoms. These could include “flu-like symptoms, insomnia, nausea, imbalance, sensory disturbances, and hyperarousal,” said Johnny Williamson, MD, a psychiatrist and medical director at Timberline Knolls in Illinois.
You may also experience “headaches, dizziness, fatigue, electric shock type symptoms (sometimes referred to as zingers) and irritability.” Usually, any withdrawal symptoms start within a few days of lowering the dose of your antidepressants and last one to two weeks. Most symptoms are mild, though that’s not always the case.
3. You Should Do It With the Support of a Medical Professional
Before stopping psychotropic medications, talk to your doctor first. You’ll want to discuss your reasons for discontinuing medication, how the process might work and the potential effects of withdrawal. A doctor — or even a pharmacist — can help decide how fast (or slow) you should go while lowering doses to minimize any potentially dangerous consequences, including side effects or interactions with other drugs you’re taking.
4. You Need to Go Slowly and Taper Off
Clinicians usually suggest waiting at least six months to a year after your mental illness symptoms have subsided before considering quitting your meds. From there, you’ll work with your doctor to create a plan to taper your medications slowly over time, which could mean weeks, months or even a year or more. Slow tapering has two major benefits. First, it reduces the discontinuation symptoms you’re likely to experience.