Antidepressants are the most commonly prescribed medication in the country, so mental health experts are trying to understand if, when, and how patients should cease taking them. Unfortunately, despite the dramatic increase in use, there isn't a lot of information about life after antidepressants.
Patients choose to discontinue antidepressants for various reasons. They may be symptom free and don't want to stay on medications long term, or they may suffer too many side effects. Pregnant women worry about the effect of antidepressants on their baby.
Withdrawal Symptoms
Some patients experience antidepressant withdrawal symptoms that can be as bad as or worse than the original depression. Common effects of antidepressant withdrawal include jitteriness, anxiety, insomnia, headaches, fatigue, dizziness, nausea, and the return of depression symptoms. Experiencing withdrawal symptoms does not mean you're addicted to antidepressants.
You need to determine if the symptoms are temporary and due to withdrawal, or if they indicate a recurrence of depression. There are a few clues. Withdrawal symptoms tend to occur immediately, while the symptoms of a depression recurrent take longer to appear. Symptoms may include sensations you didn't originally experience, such as pins and needles or tingling. Furthermore, if symptoms go away when you resume taking antidepressants, then they are likely due to withdrawal.
Patients whose original depression was mild and not terribly disruptive often find it easier to discontinue antidepressants than those with more severe depression.
How to Discontinue Antidepressants
Effective and responsible antidepressant cessation involves two important decisions.
1. Taper slowly. Stopping abruptly is usually the culprit when patients suffer withdrawal symptoms. Reduce your dose of antidepressants gradually and under the care of your physician. He may recommend taking another medication short term to ease the transition. For example, withdrawal symptoms are common with Zoloft, and Prozac may provide relief. By discontinuing gradually, you can also catch a recurrence of depression before you suffer a full relapse.
2. Choose when to stop. Taper off your medications in the spring and summer. Some patients struggle with short days and too little sunlight during the fall and winter months. Don't stop when you're under a lot of stress.
Life after Antidepressants
Nearly 80 percent of people with depression experience a relapse after discontinuing antidepressants; about half resume taking medications. There are other ways to treat depression, and you may keep your symptoms at bay with psychotherapy and lifestyle changes instead of antidepressants.
If you're considering taking antidepressants, ask your physician about how to discontinue them before you begin.
Sources:
Silberner, Joanne. "Coming Off Antidepressants Can Be Tricky Business." NPR. Web. 24 May 2010. http://www.npr.org/templates/story/story.php?storyId=127032255
Raison, Charles, MD. "Expert Q & A." CNN. Web. 31 May 2011.
Hall-Flavin, Daniel K. M.D. "Depression." Mayo Clinic. Web. 10 September 2010.
http://www.mayoclinic.com/health/antidepressant-withdrawal/AN01425
Cohen, Elizabeth. "CDC: Antidepressants most prescribed drugs in U.S." CNN. Web. 8 July 2007. http://www.cnn.com/2007/HEALTH/07/09/antidepressants/index.html
Healy, David MD, FRCPsych. "Dependence on Antidepressants & Halting SSRIs." Benzodiazepine Addiction, Withdrawal & Recovery. Web. http://www.benzo.org.uk/healy.htm
