Jump to content
Lindsay

Antidepressant 'withdrawal': Is There Such A Thing?

Recommended Posts

Antidepressant 'withdrawal': Is there such a thing?

content provided by mayoclinic.com

Question

What are the symptoms of antidepressant withdrawal? Do withdrawal symptoms mean you were addicted to the drug?

Lori

Illinois

Answer

Antidepressant withdrawal refers to signs and symptoms caused by the abrupt discontinuation of an antidepressant medication after taking it for an extended period

Antidepressant_Discontinuation_Syndrome.pdf

Share this post


Link to post
Share on other sites

When I stopped my long time med (Effexor), I had no withdrawal symptoms, but I was scared and started it again for a few days, before I finally quit for good.

Doug

Share this post


Link to post
Share on other sites

Hi,

Ive been on several meds over the last 20 years and the only one I had trouble

coming off of was effexor. I had dizzy spells for several weeks but everyone is

different.

best wishes,

starr

Share this post


Link to post
Share on other sites

I was on Paxil CR for over a month, Pdoc told me to cease the med due to my BP.

Ok, I trusted him and did what he said.

1 week with mood swings, thoughts of suicide to end the pain I was going through mentally, and the zaps. I had body shocks and tinnitus for 9 months after stopping the med. Taper down is the way to go, even if your doc says otherwise. They're not going to go through the hell like you are.

Share this post


Link to post
Share on other sites

I had no withdrawal symptoms after stopping 60mg prozac, but I wouldn't reccommend it as I stopped Citalopram and had really bad side effects. I think each person reacts differently and you don't know what the effects will be until you go through withdrawal- therefore do it with doctors advice and support only

Cokes x

Share this post


Link to post
Share on other sites
hell yes it exists

some meds are worse than others

cymbalta had terrible side effects for me and getting off it was just as bad

it is real and sux

like all meds it is individual specific

good luck

lol-Hell yes indeed! Cymbalta and effexor were the worst for me. The dizziness, the headaches, my depression got worse---just to name a few. I wish someone would figure out a way that actually worked to stop this. It feeds into the theory that people taking depression meds are drug addicts. At least this is the reaction my family had. My husband and kids actually feel that since there is the withdrawal effect when you stop taking antidepressants that 1. You're a drug addict. And. 2. It's all a scam that the doctors are in on that get you hooked and cause you to forever "need" drugs.

I've tried and my pdoc has tried to explain this to them but it always ends up with them walking out in righteous indignation that I'm a drug addict. Have to admit this really messes with my head sometimes more than others and I end up going off my meds, feeling like hell and going back on them and wondering if they're right and/or wondering if I'm ever going to get well.

Share this post


Link to post
Share on other sites

Having had major depressive disorder, anxiety and insomnia for 25 yrs I've been on huge range of drugs and have had to come off lots for various reasons. From what I know it's not actual "withdrawal symptoms" but discontinuation effects instead. Think the difference is that you don't actually crave the drug like you do with illegal drugs or benzodiazepines. However you can get a horrible range of symptoms that can feel like hell. The slower you cut down and taper off a drug the easier it is on your system. But everybody's response seems to be different and there's no way of telling in advance how you will feel

Share this post


Link to post
Share on other sites

Most doctors taper you off. I did experience some withdrawal symptoms when I decided to quit my meds cold turkey. I have heard that controlled decreases in your dose with the supervision of your doc. are not nearly as bad though and most people dont miss a beat.

Share this post


Link to post
Share on other sites

Going through a taper schedule from Paxil right now. Going very slowly over 5 weeks and switching to Prozac. I'm kind of mourning Paxil since we've been together for about 13 years, but it isn't working well anymore. Having mood swings, tearfulness, tiredness, head "buzzing" and eye swooshes. Hubbs is doing his best to cope, cleaning and such when I can't get out of bed. I hope Prozac is the answer.

Share this post


Link to post
Share on other sites

Hi BlondMush,

I do think you are doing the right thing and you sound like you have a marvelous guy helping you! You should do great on Prozac.

Hugs,

~Lindsay

Share this post


Link to post
Share on other sites

I once tryed to take 75mg of Effexor rather than 150. Big mistake, depression came with full force. Then, doctor put me again at 150.

Other types of drugs are much worse in this respect. I once quit clonazepan (clonopin/rivotril) a benzo that I used to take to sleep. Worse than quitting smoking. I can say, I did both things. I would have weird contractions in my belly, and stay two days without sleeping. Benzos are hell. There are better things for sleeping.

Share this post


Link to post
Share on other sites

Hi there,

 

 I was started on Remeron in July 2015 for sleeping difficulties due to worsening depression due to an abusive relationship.  I attempted to cold turkey the Remeron in Nov 2015 and was up for 7 days.  I was also experienced flu-like symptoms, severe anxiety and intense fear.  I had to restart the Remeron per my MD suggestion.   I was doing ok for a couple months but still battling with depression.  By Feb 2016 I had sought out an intensive outpatient program for treatment.  I was told it was ok to tape my Remeron AND Lexapro (I have been on an SSRI for 20 yrs, Prozac first, then Lexapro).  I was tapered off Lexapro in 3 weeks and the hell began shortly there after.  I began to experience the worst nausea of my life, insomnia, balance and co-ordination changes, visual distortion and blurriness, weakness in my arms and legs, burning in my arms and legs, headaches, persistent tinnitus.  I was told to restart the Lexapro and to resume Remeron at 15 mg (I was down to 3.75 mg, too).  I ended up in the ER 5 times with mild serotonin syndrome. Once discontinuation started my body was unable to tolerate the original doses of medication.  After 3 months of literal torture, the inability to drive or work, testing by neurology, emergent ophthalmology, rheumatology, endocrinology and I am still suffering.  My testing has come back normal. I had 2 brain MRI's, EEG, visual testing which most recently included a VEP for which I will see a neuropthalmologist at the end of the month.  I am devastated.  I was NEVER informed about Discontinuation Syndrome. The first time I presented to the ER they thought I was having a stoke.  I would have never done such a rapid taper had I known that I could hurt myself in the process.  I went from being a high functioning professional who worked out  5x/week to nearly bed-ridden.  This has been the most devastating thing that could have ever happened.  I was healthy before this.  I had NEVER been in an ER.  Has anyone else suffered this type of scenario?  I feel so alone and broken by this entire process.  The visual issues are the most upsetting to me.  My vision is blurred and just not quite right I never had any issues with my vision until I attempted to wean off medication. 

Thank you for listening.

Share this post


Link to post
Share on other sites

This is long, but helpful

 

Going off antidepressants

Harvard Women’s Health Watch

If not handled carefully, coming off your antidepressant medication can cause disturbing symptoms and set you up for a relapse of depression.

About 10% of women ages 18 and over take antidepressants. As many of us know, these medications can be a godsend when depression has robbed life of its joy and made it hard to muster the energy and concentration to complete everyday tasks. But as you begin to feel better and want to move on, how long should you keep taking the pills?

If you’re doing well on antidepressants and not complaining of too many side effects, many physicians will renew the prescription indefinitely — figuring that it offers a hedge against a relapse of depression. But side effects that you may have been willing to put up with initially — sexual side effects (decreased desire and difficulty having an orgasm), headache, insomnia, drowsiness, vivid dreaming, or just not feeling like yourself — can become less acceptable over time, especially if you think you no longer need the pills.

The decision to go off antidepressants should be considered thoughtfully and made with the support of your physician or therapist to make sure you’re not stopping prematurely, risking a recurrence of depression. Once you decide to quit, you and your physician should take steps to minimize or avoid the discontinuation symptoms that can occur if such medications are withdrawn too quickly.

Why discontinuation symptoms?

Antidepressants work by altering the levels of neurotransmitters — chemical messengers that attach to receptors on neurons (nerve cells) throughout the body and influence their activity. Neurons eventually adapt to the current level of neurotransmitters, and symptoms that range from mild to distressing may arise if the level changes too much too fast — for example, because you’ve suddenly stopped taking your antidepressant. They’re generally not medically dangerous but may be uncomfortable.

Among the newer antidepressants, those that influence the serotonin system — selective serotonin reuptake inhibitors (SSRIs, now commonly known as SRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) — are associated with a number of withdrawal symptoms, often called antidepressant or SRI discontinuation syndrome. Stopping antidepressants such as bupropion (Wellbutrin) that do not affect serotonin systems — dopamine and norepinephrine reuptake inhibitors — seems less troublesome over all, although some patients develop extreme irritability.

Having discontinuation symptoms doesn’t mean you’re addicted to your antidepressant. A person who is addicted craves the drug and often needs increasingly higher doses. Few people who take antidepressants develop a craving or feel a need to increase the dose. (Sometimes an SRI will stop working — a phenomenon called “Prozac poop-out” — which may necessitate increasing the dose or adding another drug.)

Discontinuation symptoms can look like depression

Discontinuation symptoms can include anxiety and depression. Since these may be the reason you were prescribed antidepressants in the first place, their reappearance may suggest that you’re having a relapse and need ongoing treatment. Here’s how to distinguish discontinuation symptoms from relapse:

  • Discontinuation symptoms emerge within days to weeks of stopping the medication or lowering the dose, whereas relapse symptoms develop later and more gradually.

  • Discontinuation symptoms often include physical complaints that aren’t commonly found in depression, such as dizziness, flulike symptoms, and abnormal sensations.

  • Discontinuation symptoms disappear quickly if you take a dose of the antidepressant, while drug treatment of depression itself takes weeks to work.

  • Discontinuation symptoms resolve as the body readjusts, while recurrent depression continues and may get worse.

If symptoms last more than a month and are worsening, it’s worth considering whether you’re having a relapse of depression.

A range of 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:

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.”

As dire as some of these symptoms may sound, you shouldn’t let them discourage you if you want to go off your antidepressant. Many of the symptoms of SRI discontinuation syndrome can be minimized or prevented by gradually lowering, or tapering, the dose over weeks to months, sometimes substituting longer-acting drugs such as fluoxetine (Prozac) for shorter-acting medications. The antidepressants most likely to cause troublesome symptoms are those that have a short half-life — that is, they break down and leave the body quickly. (See the chart “Antidepressant drugs and their half-lives.”) Examples include venlafaxine (Effexor), sertraline (Zoloft), paroxetine (Paxil), and citalopram (Celexa). Extended-release versions of these drugs enter the body more slowly but leave it just as fast. Antidepressants with a longer half-life, chiefly fluoxetine, cause fewer problems on discontinuation.

Besides easing the transition, tapering the dose decreases the risk that depression will recur. In a Harvard Medical School study, nearly 400 patients (two-thirds of them women) were followed for more than a year after they stopped taking antidepressants prescribed for mood and anxiety disorders. Participants who discontinued rapidly (over one to seven days) were more likely to relapse within a few months than those who reduced the dose gradually over two or more weeks.

Antidepressant drugs and their half-lives*

Drug

Half out of body in

99% out of body in

Serotonin reuptake inhibitors

paroxetine (Paxil)

24 hours

4.4 days

sertraline (Zoloft)

26 hours

5.4 days

escitalopram (Lexapro)

27 to 32 hours

6.1 days

citalopram (Celexa)

36 hours

7.3 days

fluoxetine (Prozac)

Four to six days

25 days

Serotonin and norepinephrine reuptake inhibitors

venlafaxine (Effexor)

5 hours

1 day

duloxetine (Cymbalta)

12 hours

2.5 days

desvenlafaxine (Pristiq)

12 hours

2.5 days

Dopamine and norepinephrine reuptake inhibitor

bupropion (Wellbutrin)

21 hours

4.4 days

*Discontinuation symptoms typically start when 90% or more of the drug has left your system.

Source: Adapted from Joseph Glenmullen, M.D., The Antidepressant Solution: A Step-by-Step Guide to Safely Overcoming Antidepressant Withdrawal, Dependence, and “Addiction” (Free Press, 2006).

Slow and steady

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 it. 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.

 

~Lindsay, Forum Super Administrator

Share this post


Link to post
Share on other sites

I have to say that for me there is only ONE discontinuation effect that I have felt with every single SSRI and SNRI that I have ever taken and that is the infamous "brain zaps". Like there is a lightning storm going on in your body. Physical touch is very uncomfortable, even just wearing clothes is enough.

I went through this with Zoloft in my early teens. I went to the beach with my family and forgot to bring my Zoloft. It was easily the worst beach trip in memory. The lights were too bright, I was irritable and I felt like I was being repeatedly electrocuted. I ended up staying in bed the first 2-3 days I was there and even then it was barely tolerable. If I ever missed a dose of Zoloft, I would definitely realize it by mid afternoon.

With Celexa and Lexapro, I could usually miss one dose, but I would wake up the following morning feeling terrible. I would usually feel better 2-4 hours after taking it. Effexor and Pristiq, I knew it if I missed it by so much as an hour. And Cymbalta was similar to Zoloft in regards to timing of the discontinuation syndrome.

I can say that I have never experienced this with Wellbutrin. If I miss it, I just feel really tired and unmotivated.

Share this post


Link to post
Share on other sites

I absolutely have to taper off meds when I take them. It would be dangerous otherwise. Even with very slow tapering I find it to be almost unbearable. Same with starting medication. Everyone is different. I know I am very sensitive to medication 

Share this post


Link to post
Share on other sites

oh yeah...mind zaps Like little electric zaps in your brain.Best never to quit cold turkey but taper off.

Share this post


Link to post
Share on other sites

Absolutely yes you can get withdrawal effects from these drugs.

I am tapering off now – nearly 20 months in – and expect to have at least 6 months to go.

Doctors advise a quick taper (2-3 months) that is just not slow enough for most people, and they are hit with withdrawal symptoms that are then ascribed to relapse (even though the symptoms themselves may be quite different from original condition). This is what happened to me twice before I found out about withdrawal from Surviving Antidepressants.

There are several really good sources of information now on AD withdrawal (the site I mentioned above and others) – and unfortunately they know much more than most doctors.

PLEASE don't come off quickly, and please don't let a quick taper make you believe that you need these drugs for life.

Share this post


Link to post
Share on other sites

I did the responsible thing and had a doctor help me gradually get off mine--and it was the most excruciating experience, and not the getting off of it that was slow and careful.

It was my mind, brain, whole body (after that very last tablet) reacted in a way and I can't explain it now, but people in the medical field marvel that I not only got off of it but requested to.  They said people getting off this particular antidepressant have such a horrible negative experience--that few get off, few stay off and most just won't try to.  I did.  It's been h.*l.l it still feels like I'm experiencing something from it.

Edited by HeatherG
correction

Share this post


Link to post
Share on other sites

Possibly? I don't know what is a discontinuation effect vs a side effect because while I'm tapering off one AD I'm starting another. I always taper and I rarely miss a dose.

Tremors, ataxia, fatigue, restless legs, depression or anxiety increasing - I've experienced them. Insomnia always but I have chronic insomnia despite the antidepressants. 

Share this post


Link to post
Share on other sites
On 11/5/2018 at 5:05 PM, Atra said:

Possibly? I don't know what is a discontinuation effect vs a side effect because while I'm tapering off one AD I'm starting another. I always taper and I rarely miss a dose.

Tremors, ataxia, fatigue, restless legs, depression or anxiety increasing - I've experienced them. Insomnia always but I have chronic insomnia despite the antidepressants. 

Sounds awful. And not being able to identify the cause (withdrawal vs new drug side-effect) is disheartening. Have you ever tried getting off all AD's and focusing just on the insomnia? I never took a psych med until my late 30's when I started having trouble sleeping. And in the 20+ years since, I still don't have good quality sleep. I'm in the uncomfortable process of getting off Lamictal, but keeping the Klonopin for now. I've become increasingly skeptical of the value of *long-term* psychiatric drug use (I do still think they have value short-term). I haven't seen a lot of recent discussion on these forums about these topics, so thank you for sharing your experience. Best wishes

Share this post


Link to post
Share on other sites
5 hours ago, uncertain1 said:

Have you ever tried getting off all AD's and focusing just on the insomnia? 

I struggled with insomnia years before I began taking meds. My brother and late father also. I suspect anxiety plays a role and like yourself, I keep a benzodiazepine for the worst of times. 

If you'd like to strike up a discussion about insomnia I'm sure there are many who would contribute to a new topic. I appreciate your thoughts on it and your well wishes, thank you. 

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

×
×
  • Create New...