What You Should Know Before Stopping Your Antidepressants
Depression can loom over you like a dark unmoving cloud. While many effective treatments are available, everyone is different, and pinpointing the proper medication can take lots of effort, trial, and error.
Depression presents in many forms with symptoms such as loss of interest, low mood, changes in appetite, difficulty thinking, trouble sleeping, and suicidal thoughts (per American Psychiatry Association). One in six people will experience depression at some point in their lifetime. Depression can come from nowhere or be triggered by life-changing events, though it seems more likely in those with affected family members.
Antidepressants are medications used to treat the symptoms of mental health issues such as depression, anxiety disorder, obsessive-compulsive disorder (OCD), panic disorder, and post-traumatic stress disorder (PTSD), among others (per National Health Service). They work by affecting chemical messengers called neurotransmitters in the brain, such as serotonin, dopamine, and norepinephrine, that allow brain cells to communicate (via Mayo Clinic).
The many types work differently and therefore have varying results and cause unique side effects from person to person, such as nausea, dry mouth, or weight gain. Medical News Today reports that side effects, high costs, or feelings of recovery lead many people to stop taking their antidepressants. There are some things you should know before going through this process, though.
Ceasing antidepressants is difficult
Antidepressants can take weeks before they begin to work, and it is strongly advised to speak to your doctor before deciding to stop (per Medical News Today). Since antidepressants change the chemicals in the brain, stopping suddenly would likely be difficult and possibly even dangerous. The body adjusts to the changes made by the chemicals, and once they stop, various symptoms can occur.
Even if medication is ceased suddenly, it will take time to leave the system entirely. According to Harvard Medical School, the time it takes for serotonin reuptake inhibitors to be 99% out of the body is often between 4.4 and 25 days, while serotonin and norepinephrine reuptake inhibitors can take 1 to 2.5 days and dopamine and norepinephrine reuptake inhibitors usually take around 4.4. During these periods and even afterward, you may experience various withdrawal symptoms such as anxiety, depression, headache, nausea, muscle spasms, trouble sleeping, fatigue, dizziness, tremors, and nightmares (via WebMD).
Since the symptoms of discontinuing antidepressants can include mood changes, depression, and anxiety, they can be mistaken for a relapse of depression, reports Harvard Medical School. When symptoms are still present and worsening after a month of ceasing medication, you may indeed be experiencing a relapse.
It's important to discuss these symptoms with your healthcare professional to determine whether or not they are caused by withdrawal and get appropriate treatment. Despite all the challenges when stopping antidepressants, there are ways to make it easier.
How to safely stop antidepressants
When you decide to stop taking your antidepressants, it's best first to make a plan with your doctor. They may first discuss the benefits and risks of staying on your medication or switching to another (per Harvard Medical School).
Once it's decided you should stop, it's likely they will provide you with a schedule to slowly taper off the medication to help reduce the severity of the adverse effects and risk of relapse. This process may take weeks as your dose drops over time, but ultimately will depend on how long you've been taking the medication, how high your dose is, and any issues you've had with switching medications. There's also a chance that you may be prescribed another short-term medication to manage symptoms of discontinuation.
Since you are likely dealing with some aspect of depression, exercising at least three times a week is recommended as it can have an antidepressant effect. Along with increased activity, it is essential to support yourself with good nutrition, adequate sleep, and healthy stress management techniques.
Another non-medication support strategy when stopping an antidepressant is psychotherapy. Psychotherapy or talk therapy, with a licensed therapist, can provide symptom relief or improvement in functioning (per American Psychiatric Association). Psychotherapy can help with recovery from depression and prevention of recurrence, and has been found to be beneficial to those discontinuing an antidepressant, adds Harvard Medical School. Similarly, making your close friends and family aware may make the transition easier and provide additional support.