Effexor Withdrawal: Symptoms & Timeline

Last Updated:October 27, 2022

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Effexor (venlafaxine) is notorious for causing uncomfortable withdrawal symptoms, known as “antidepressant discontinuation syndrome.” Effexor is generally prescribed starting at 75 mg per day, but the max dose can range from 225 mg daily to 375 mg daily, depending on the dosage form of the drug. Skipping doses of Effexor or quitting the drug cold turkey, especially at higher doses, can lead to unpleasant withdrawal symptoms. For this reason, it’s important to take Effexor exactly as your doctor prescribes.

Effexor Withdrawal

When your body becomes used to a substance, suddenly stopping it can cause withdrawal symptoms. Someone who abruptly stops taking Effexor may start to experience withdrawal symptoms 8–12 hours after the last dose. Effexor withdrawal symptoms usually resolve within two weeks. 

The most reliable way to prevent or minimize withdrawal symptoms is to gradually taper the Effexor dose over a minimum of two weeks, although a longer taper may be needed. No matter what, it is important to taper Effexor under a doctor’s supervision, especially if you are taking Effexor for a mental health condition like depression. Suddenly stopping Effexor while leaving your mental health untreated may be dangerous.

Effexor Withdrawal Symptoms

Among antidepressants, Effexor is one of the most difficult to quit. Antidepressant discontinuation syndrome (ADS) is characterized by a variety of withdrawal symptoms that occur because of physical dependence. Dependence develops with the regular use of antidepressants. Though it usually develops in six weeks or more, it can develop within just three weeks in some cases.

The presence and severity of Effexor withdrawal symptoms do not seem to be correlated with dose. Currently, it is impossible to reliably predict who will experience symptoms of ADS.

*The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. Consult your doctor if you have any questions or concerns regarding your medications.

Effexor Brain Zaps

Venlafaxine has one of the highest rates of “brain zap” frequency associated with antidepressant discontinuation. Brain zaps are an electric shock sensation that may also include visual disturbances. Doctors are not sure why this phenomenon occurs. Although this symptom resolves quickly in most people, others experience brain zaps for months or years.

Other Effexor Withdrawal Symptoms

Other common Effexor withdrawal symptoms can be uncomfortable or even debilitating, including:

• Vertigo
• Electric shock sensations in hands or feet
• Nausea
• Lethargy
• Flu-like symptoms
• Loss of coordination
• Anxiety
• Irritability
• Vivid dreams
• Insomnia

Effexor Withdrawal Timeline

The Effexor withdrawal timeline can vary. Symptoms typically begin as early as 12 hours after the last dose and generally resolve within one to two weeks. Because Effexor has a half-life of four hours, it is completely out of the system within a day. Antidepressants with longer half-lives stay in the body for longer amounts of time and may limit the onset and severity of ADS.

Factors Affecting Effexor Withdrawal

ADS typically affects about 20% of people who abruptly stop antidepressant use. However, Effexor may have a somewhat higher rate of ADS frequency — possibly up to 34%. There is currently no reliable way to predict the occurrence of ADS or its severity. Studies have even shown that higher Effexor doses are not predictive of ADS development.

A number of studies have shown that people who taper off of Effexor are significantly less likely to experience ADS, and their symptoms are milder and resolve more quickly compared to people who abruptly stop taking Effexor.

Effexor Withdrawal Treatment

The most reliable way to prevent Effexor withdrawal is to work with your doctor to develop a tapering regime. If you abruptly stop taking Effexor and are experiencing withdrawal symptoms, the only proven way to relieve them is to resume taking Effexor and gradually taper the dose with your doctor. Some studies have shown that cognitive behavioral therapy or mindfulness-based therapies can help people better manage their symptoms.

Medical Detox

Medical detox is not required for Effexor withdrawal, but people with ADS could find success in a rehab center that can help them taper off Effexor safely while providing behavioral therapy and other treatment. 

People who take Effexor along with other substances may benefit from a medical detox to avoid withdrawal complications. This is especially true if you take Effexor for a mental health condition, which can worsen withdrawal symptoms.

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How to Taper Off Effexor

Anyone who is considering quitting Effexor or other antidepressants should consult with a medical professional. Several studies have shown that the best way to prevent ADS and withdrawal symptoms is to gradually discontinue use. 

An Effexor taper schedule may vary from person to person, but a general guideline is to reduce the Effexor dose by 10 mg every two weeks, for a minimum of four weeks. Your doctor can work with you to develop an appropriate tapering schedule that is most effective for your unique situation.

Effexor Withdrawal Remedies

There are no verified remedies for Effexor withdrawal. If you stop Effexor and start to notice withdrawal symptoms, talk to your prescriber immediately. They may be able to restart you on Effexor or another antidepressant, which can resolve your withdrawal.

In addition, it is important to focus on your health, as this may ease withdrawal symptoms. Some tips include:

• Eat a nutritious diet
• Stay well-hydrated 
• Consider regular, light exercise, like yoga
• Consider therapy or counseling, especially if you were taking Effexor for a mental health condition

Alternative Treatments for Effexor Withdrawal

Cross-tapering may be an effective method to prevent or minimize Effexor ADS symptoms. Cross-tapering involves transitioning from high doses of Effexor to another antidepressant, often duloxetine, that has a similar makeup. However, there is a risk of serotonin syndrome if cross-tapering is done incorrectly. A “wash-out” period of approximately five half-lives — about 20 hours for Effexor —  must be done before starting another medication that inhibits serotonin reuptake.

Outpatient Treatment for Effexor Withdrawal

Outpatient rehab programs that offer cognitive behavioral therapies and other forms of psychotherapy may help people experiencing Effexor withdrawal symptoms. Behavioral therapies are also likely to be incredibly beneficial for people who are concerned about experiencing a recurrence of depression or anxiety.

Detoxing From Effexor at Home

Many people who stop using Effexor, either abruptly or with a taper, do so at home. Since quitting abruptly can increase the risk of ADS, it’s essential to follow your doctor’s advice when it comes to quitting Effexor and home and managing side effects. This includes having a friend or loved one available for support, or to help identify mood changes that can come from stopping an antidepressant.  

Finding a Detox Center

If you are concerned about Effexor ADS, it is advised to follow a tapering regimen under the care of medical professionals. Look for a rehab facility that has experience with tapering clients off of antidepressants and provides cognitive behavioral therapy.

How long do venlafaxine withdrawal symptoms last?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on April 20, 2023.

Venlafaxine withdrawal symptoms typically last up to 3 to 4 weeks, but may persist even longer. You should avoid abruptly stopping venlafaxine treatment unless otherwise directed by your healthcare provider. Gradually reducing the dose over 4 weeks can help to prevent severe withdrawal symptoms in most people.

Do not stop treatment on your own. Your doctor can set up a tapering schedule to help you safely discontinue venlafaxine.

What is antidepressant discontinuation syndrome?

Withdrawal side effects from antidepressants, also called antidepressant discontinuation syndrome, is a common occurrence with all classes of antidepressants.

Abruptly stopping antidepressant treatment, or tapering your dose down too quickly, can result in side effects if you’ve been on treatment for at least a few weeks. These withdrawal side effects, which are usually mild but can be severe in some people, typically start 1 to 3 days after stopping treatment.

Which side effects occur if venlafaxine is stopped too quickly?

The most common side effects that may occur with abruptly stopping venlafaxine (Effexor, Effexor XR) may include:

• dizziness
• headache
• feeling tired
• anxiety
• trouble sleeping
• nausea
• loss of appetite
• irritability

Other reported symptoms are: chills, confusion, diarrhea, dry mouth, excessive sweating, feeling of unease, electric shock-like sensations (“brain zaps”), muscle aches, burning or tingling sensation in hand, arm, foot or other extremity (paresthesias), runny nose, tremor, vertigo, vomiting and vivid dreams or nightmares.

How slowly should venlafaxine be stopped?

Follow your doctor’s directions on how to best discontinue venlafaxine (Effexor, Effexor XR).

In general, it is recommended the daily dose of venlafaxine be reduced by 37.5 to 75 mg each week over four weeks to reduce symptoms. This applies to both immediate-release and extended-release formulations.

• For example, if you are taking 300 mg per day of venlafaxine, your doctor may decide to lower your dose by 75 mg each week for 4 weeks until you are done with the medicine at the end of week 4.
• As another example, if you take a 150 mg dose, your doctor may decide to taper your dose by 37.5 mg each week for 4 weeks until you are done with the medicine at the end of week 4.

For some doses, your doctor may need to prescribe different strengths to help you correctly taper your dose over 4 weeks.

Why does venlafaxine cause withdrawal symptoms?

Quickly stopping venlafaxine treatment can lead to withdrawal symptoms due to its short half-lives, ranging from 5 to 13 hours. Studies have shown that SNRIs such as venlafaxine and desvenlafaxine can have relatively more side effects when treatment is stopped abruptly.

A half-life is the time it takes a dose of the drug to be reduced by one-half. It takes on average 4 to 5 half-lives for a drug to be fully eliminated.

Quick elimination from the body of drugs with short-half lives can worsen discontinuation withdrawal symptoms, especially drugs that work in the central nervous system like antidepressants or benzodiazepines. Taking higher doses and being on treatment for a longer period of time may also worsen these side effects.

The half-life can vary based on your age, weight, genetic make-up, kidney or liver function, drug interactions, and even your medical conditions. Your doctor may decide to discontinue your dose even more slowly due to these factors.

Do not stop treatment on your own. Conact your doctor, who can set up a safe and more comfortable tapering schedule for you.

In contrast, Prozac (fluoxetine) is an SSRI antidepressant with a very long half-life (ranging from 4 to 16 days). Plasma levels of the drug decrease gradually when treatment is stopped which may minimize the risk of discontinuation symptoms with this drug, but a long half-life also means that side effects due to the drug itself may be ongoing as the drug slowly eliminates from the body.

What should I do if I get withdrawal symptoms with venlafaxine?

• Contact your doctor right away.
• If you abruptly stopped treatment, your healthcare provider may decide to restart your venlafaxine and slowly lower your dose over several weeks or longer to help reduce the incidence of side effects.
• If you are already undergoing a gradual treatment discontinuation, your dose may need to be slightly increased and then stopped even more slowly to help reduce your side effects.

This is not all the information you need to know about venlafaxine (Effexor, Effexor XR) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.

References

• Gabriel M, Sharma V. Antidepressant discontinuation syndrome. CMAJ. 2017 May 29;189(21):E747. doi: 10.1503/cmaj.160991. PMID: 28554948; PMCID: PMC5449237.
• Venlafaxine prescribing information. US Food and Drug Administration (FDA). Drugs.com. Accessed Apr 20, 2023 at https://www.drugs.com/monograph/venlafaxine.html
• Hirsch M, Birnbaum R (authors). Discontinuing antidepressant medications in adults. Up to Date. Accessed Apr 20, 2023 at https://www.uptodate.com/contents/discontinuing-antidepressant-medications-in-adults#h311781

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Medical Disclaimer

Consequences of withdrawal of antidepressants: how to stop treatment?

Contents

• 1 How to safely stop antidepressants
  • 1. 1 Definition and functions of antidepressants
  • 1.2 Why it is important to stop antidepressants correctly
  • 1.3 Possible consequences of stopping antidepressants 90 008
  • 1.4 How to properly reduce the dose of antidepressants
  • 1.5 How long should take termination of treatment
  • 1.6 Side effects of antidepressant withdrawal
  • 1.7 Who can help stop antidepressant treatment
  • 1.8 Advice for patients self-discontinuing treatment
  • time to stop treatment problems
  • 1.11 How to approach discontinuation of different types of antidepressants
    • 1.11.1 Selective serotonin reuptake inhibitors (SSRIs)
    • 1.11.2 Third generation antidepressants
    • 1.11.3 Tricyclic antidepressants
    • 1.11.4 Monoamine oxidase inhibitors
  • 1.12 Related videos:

  90 005 1.13 Q&A:

  • • 1.13.0.1 What happens if I stop taking antidepressants on my own?
    • 1.13.0.2 How long should I continue taking antidepressants?
    • 1. 13.0.3 Can antidepressants be taken for several years?
    • 1.13.0.4 What unpleasant symptoms can occur when antidepressants are stopped?
    • 1.13.0.5 What is the correct antidepressant withdrawal regimen?
    • 1.13.0.6 Can one antidepressant be substituted for another?

The article talks about how to stop antidepressants correctly, what patients need to know and what consequences can be if the wrong cancellation occurs. Doctors’ advice and recommendations for the gradual change of drugs.

Antidepressants are widely used to treat depression and anxiety disorders. These drugs can significantly improve the quality of life of patients, thoughts of suicide will disappear, anxiety levels will decrease. However, no matter how effective the therapy is, its termination can lead to a number of unpleasant consequences if the rules for discontinuing drugs are not followed.

However, many patients stop treatment on their own without consulting their doctor. This can lead to serious consequences: a rebound depressive syndrome, sleep disorders, aggression, panic attacks, as well as an increase in the symptoms of reverse inhibition of monoamine oxidase. In addition, with a sudden cessation of treatment, patients may experience a withdrawal syndrome, which manifests itself in the form of weakness, nausea, headache, irritability, depression and other unpleasant symptoms.

Therefore, it is very important to consult your doctor before starting or stopping antidepressants. If the decision to stop treatment has already been made, then this should happen gradually and under medical supervision. The doctor will determine the optimal dose reduction scheme and the time schedule for drug withdrawal, depending on the individual characteristics and the patient’s condition.

Definition and function of antidepressants

Antidepressants are a group of pharmacological preparations for the treatment of depression and other mental disorders. Their action is aimed at changing the level of neurotransmitters in the brain, such as serotonin, norepinephrine and dopamine, which are responsible for mood, as well as improving hormonal balance.

Antidepressants may be used to treat a variety of mental disorders, including depression, anxiety, bipolar disorder, and panic attacks. They help improve mood, increase energy and reduce anxiety levels. Antidepressants may also be helpful in treating pain and insomnia.

• Selective serotonin reuptake inhibitors: Popular drugs include citalopram, fluoxetine, and sertraline.
• Serotonin and norepinephrine reuptake inhibitors: Popular drugs include venlafaxine, duloxetine, and milnaceprane.
• Norepinephrine and dopamine reuptake inhibitors: Bupropion is a commonly used drug in this group.

Why it is important to stop antidepressant treatment correctly

Stopping antidepressant treatment must be done correctly, as improper termination can lead to nervous breakdowns and an increase in symptoms of depression.

In addition to discomfort, improper discontinuation of antidepressants can lead to severe mental deterioration. However, gradually reducing the dose of the drug under the supervision of a doctor can significantly reduce the likelihood of all these problems.

It is important to remember that discontinuation of antidepressant medication should only be done under specialist supervision. Independent decision to cancel the drug or change the dosage can lead to negative consequences, serious health losses, and sometimes death.

In order to properly stop antidepressant treatment, you need to consult your doctor and be patient during the transition period. This is the only way to avoid possible negative consequences and achieve a positive effect from the use of the drug.

Possible consequences of stopping antidepressants

Stopping antidepressants without consulting a doctor can lead to various consequences, including the appearance or worsening of symptoms of depression. A significant dose reduction can cause mood disturbances, irritability, dizziness, nausea, and even hallucinations. Complete cessation of use can lead to a serious decrease in mood and panic attacks.

Some people who take antidepressants may also find that they become dependent on the medication, especially if they have been taking it for a long time. In this case, discontinuation may be accompanied by withdrawal symptoms, including anxiety and depression.

In addition, with the withdrawal of antidepressants, a withdrawal syndrome may develop, which can manifest itself in the form of headaches, nausea, dizziness and muscle pain. In more rare cases, more severe symptoms may appear, such as nightmares, anxiety, and seizures.

1. 1. When you stop taking antidepressants, you should:
      • Seek medical advice and help, if necessary, gradually reduce the dose of the drug
      • Stick to the plan suggested by the doctor and do not deviate from it
      • Lead a healthy lifestyle, including proper nutrition, regular exercise and adequate rest
      • Do not drink alcohol and do not get addicted to drugs or other drugs
      • If severe side effects occur immediately see a doctor

How to reduce the dose of antidepressants correctly

Reducing the dose of antidepressants should only take place on the recommendation of a doctor, otherwise it can lead to serious consequences. When the dose is reduced, it is necessary to monitor changes in mood, appetite, sleep, possible pain in the head and chest.

It is recommended to gradually reduce the dose of antidepressants. The time it takes to reduce the dose may be individual and depends on the individual case. The transition to a lower dose should be gradual. A single dose reduction may lead to drug withdrawal.

1. 1. • Dose reduction should only occur under the supervision of a physician
      • Symptoms that may occur with dose reduction should be recorded
      • Gradual dose reduction will help avoid serious consequences
      • Switching to a lower dose should be gradual and individualized

How long should it take to stop treatment

Stopping antidepressant treatment has its own characteristics, due to the fact that these drugs affect a special chemical reaction in the brain. Most often, it is advisable to stop treatment gradually, over several weeks or months, depending on the regimen approved by the attending physician in a particular situation.

Stopping treatment prematurely can lead to serious consequences for the patient, including severe deterioration of well-being, depression, suicidal thoughts and even suicidal behavior. Therefore, it is important to follow an individual treatment regimen and regularly follow all the doctor’s recommendations.

All types of antidepressants affect the brain in different ways, so the duration of stopping treatment may be different. Some types of antidepressants may require dose reduction and discontinuation over several weeks, while others may require gradual dose reduction over months.

When approaching discontinuation of antidepressant treatment, the treating physician should take into account the patient’s individual characteristics, disease severity, general health, and any concomitant factors that may affect the patient’s recovery after discontinuation of treatment.

Side effects of antidepressant withdrawal

Stopping antidepressant medication may lead to unwanted side effects. Symptoms depend on the type of drug, duration of administration and dosage. It is important to remember that drug withdrawal should occur gradually and under the supervision of a specialist.

1. 1. • Withdrawal symptoms: severe anxiety, irritability, inability to concentrate, outwardly observed nervousness and restlessness, anxiety, dizziness, nausea, headaches, drowsiness and sweating;
      • Masking symptoms: increased depression, return of symptoms, worsening of mood, disorientation;
      • Withdrawal symptoms: sleep disturbance, headaches, dizziness, nausea, increased anxiety, bowel changes, sweating, palpitations.

To avoid these side effects, it is necessary to gradually reduce the dose of the drug and be under the supervision of a psychiatrist. It is necessary to discuss the situation with the doctor and consider changing the drug to another or adding additional treatments.

Who can help stop antidepressant treatment

Stopping antidepressant treatment is an important step in coping with depression and other disorders. Undesirable effects may occur if you complete the treatment yourself without consulting your doctor.

However, besides your doctor, other specialists can also help you stop taking antidepressants. These include psychologists and psychotherapists. They can talk with you about the psychological aspects of stopping treatment, help you develop a plan of action, and support you through the process.

1. 1. • Physician
      • Psychologist
      • Psychotherapist

len and, therefore, the approach to stopping treatment should be individualized and created in a timely manner. Regardless of the path you choose, there is always the opportunity to discuss your concerns and questions with a specialist who will help you make the decision that best suits your individual needs.

Tips for self-discontinuing patients

Antidepressants should never be stopped on their own. However, if you strongly want to do this, then you should follow a few tips.

1. 1. • Do not stop treatment on the same day. This can lead to severe mental impairment and deterioration of your health.
      • Follow your doctor’s instructions. Depending on the diagnosis and nature of treatment, stopping antidepressants can occur in different ways. You need to know exactly how to do it.
      • Consult a doctor. Discuss this with your doctor before making a decision to stop your medication. He will be able to tell you about all the consequences of withdrawal, prescribe the necessary drugs and monitor your condition.
      • Watch your health. Monitor how you feel after stopping medication. If you experience unpleasant symptoms, be sure to consult a doctor.

Note that only a doctor can correctly determine when and how to stop antidepressant treatment. If you make a mistake, it can lead to negative consequences for your health.

Protection against depression relapse after antidepressant withdrawal

After antidepressant withdrawal, many patients experience a possible relapse of depression. In order to prevent it, it is necessary to take certain measures and follow the recommendations of experts.

Secondly, try to monitor your emotional state: at the slightest sign of depression, seek timely help. Do not delay to prevent a relapse.

Third, get regular physical activity to reduce your risk of oxidative stress and improve your emotional well-being. Scientific studies show that exercise reduces the likelihood of a relapse of depression by almost 50%.

Finally, follow your doctor’s orders and don’t make any changes to your treatment without his input, even if you feel healthy. This will help you not only avoid relapses, but also reduce the likelihood of premature death caused by depression.

What to do if you have problems stopping treatment

When you decide to stop taking antidepressants, it is very important to do so gradually and under the supervision of a doctor. However, in some cases, even if all recommendations are followed, problems may arise.

If you experience any symptoms or sensations that make you anxious, be sure to consult your doctor. You may experience dizziness, nausea, insomnia, or other symptoms that may be associated with antidepressant withdrawal.

Your doctor can assess your condition and decide if you need help. If symptoms are severe or do not go away after a few days, you may be asked to restart the medicine and take it for a longer period of time.

1. 1. • Do not stop treatment yourself! This solution can be dangerous.
      • Be sure to discuss the decision with your doctor! Only he can give useful advice and recommendations in cases where problems arise during the period of drug withdrawal.

In general, properly discontinued treatment should leave a feeling of ease and comfort. If you’re having trouble canceling, don’t panic – it can almost always be fixed. Just remember that only a qualified professional can give you advice based on research into your health and your specific situation.

How to approach discontinuation of treatment with different types of antidepressants

Selective serotonin reuptake inhibitors (SSRIs)

When discontinuing treatment with SSRIs, the dose should be gradually reduced under the supervision of a physician. Abrupt withdrawal of the drug can lead to such manifestations as dizziness, nausea, anxiety, insomnia and headaches. To reduce and relieve symptoms, you can contact a psychotherapist and use relaxation and meditation methods.

Third-generation antidepressants

For third-generation antidepressants such as sertraline, venlafaxine and duloxetine, a similar approach to stopping treatment. It is necessary to gradually reduce the dose under the supervision of a physician and additionally consult a psychotherapist to reduce symptoms. You should also pay attention to a healthy lifestyle and proper nutrition, which can help reduce many of the symptoms.

Tricyclic antidepressants

When stopping treatment with tricyclic antidepressants such as amiitriptyline and imipramine, a doctor’s visit is necessary to gradually reduce the dose. An important point is the competent choice of additional methods to reduce the manifestations of symptoms through lifestyle changes and the use of alternative methods of treatment.

Monoamine oxidase inhibitors

When treated with antidepressants of the monoamine oxidase inhibitor type, do not stop abruptly without medical supervision. This can lead to a sharp increase in blood pressure and serious mental disorders. To stop treatment, you must definitely consult a doctor who will select the most optimal strategy for the gradual cessation of treatment.

Related videos:

Q&A:

What happens if I stop taking antidepressants on my own?

Stopping antidepressants without consulting your doctor can lead to unpleasant symptoms such as depression or irritability, insomnia, dizziness, nausea, and even suicidal thoughts. Therefore, before stopping antidepressants, be sure to consult with your doctor so that he develops an individual drug withdrawal regimen for you.

How long should I continue taking antidepressants?

The duration of antidepressant treatment depends on many factors: the presence and degree of depressive disorder, the patient’s individual characteristics, the results of therapy, etc. Usually, doctors recommend taking antidepressants for at least 6 months to prevent recurrence of the disease. However, sometimes it may be necessary to continue the course up to a year or even more.

Can I take antidepressants for several years?

Yes, in some cases antidepressants may be taken for several years. However, it is necessary to regularly consult with your doctor and evaluate the results of treatment. The doctor may suggest lowering the dose of the drug or changing it to a different one if it is necessary to increase the effectiveness of therapy and reduce the risk of side effects.

What unpleasant symptoms can occur when antidepressants are stopped?

When antidepressants are discontinued, the following unpleasant symptoms may appear: depression or irritability, insomnia, dizziness, nausea, increased sensitivity to sounds and light, loss of appetite, loss of interest in life, suicidal thoughts. Therefore, before the abolition of antidepressants, it is necessary to consult a doctor and agree with him on an individual drug withdrawal regimen.

What is the correct antidepressant withdrawal regimen?

The antidepressant withdrawal regimen should be individualized and developed by the clinician based on many factors such as duration of treatment, dosage, presence of comorbidities, etc. Usually, the antidepressant withdrawal regimen involves a gradual reduction in the dose of the drug over several weeks or months. This avoids the occurrence of unpleasant symptoms when the drugs are discontinued.

Can one antidepressant be substituted for another?

Yes, switching from one antidepressant to another may be recommended by your doctor if you want to improve the effectiveness of treatment or reduce the risk of side effects. Also, the replacement of the drug may be necessary if the patient does not tolerate the effects of the drug or there are contraindications to taking it. However, the replacement of an antidepressant should take place under the supervision of a physician and in compliance with an individual treatment regimen.

Antidepressant withdrawal syndrome. Symptoms and overcoming

Author Asya Melkonyan, psychologist Hits 3.4k. Posted by 06/14/2022 Updated 03/07/2023

Contents

Antidepressant withdrawal occurs in about 20% of patients after abrupt discontinuation of treatment.

Typical withdrawal symptoms include: flu-like symptoms, insomnia, nausea, imbalance, sensory disturbances, and irritability.

These symptoms are usually mild, last one to two weeks, and disappear quickly when antidepressants are restarted.

Do not stop your medications unless directed by your doctor. This is usually done gradually, the dosage is reduced every few days. But in the case of a phase inversion, when you switch from depression to hypomania or mania, withdrawal may occur more quickly.

If you are considering changing or stopping antidepressants, you need to know how your body may respond to chemical changes in the body, and it is even more important to know how you can help ease withdrawal symptoms.

Best possible situation: you don’t even need to read this article because there is no syndrome (hooray!).

Another option: you are experiencing withdrawal reactions, but you are ready for them and you know that they are temporary.

What are the possible symptoms?

May present as physical symptoms, eg headache, weakness, palpitations, nausea.

So psychiatric: sleep disturbance, anxiety, panic attacks, irritability, suicidal thoughts.

At the same time, it is important to remember that it is quite difficult to distinguish between withdrawal symptoms and recurring signs of depression and only a psychiatrist can do this.

Withdrawal is more common with antidepressants with a short half-life. These drugs include paroxetine, fluoxetine (Prozac), duloxetine, and venlafaxine. Sudden discontinuation of tricyclic antidepressants may also result in a withdrawal syndrome.

How long will it take?

Ask your doctor how long withdrawal symptoms for a particular drug can last. It usually lasts from two days to three weeks. People and drugs are different. If withdrawal symptoms continue for longer, make an appointment with your doctor and let him know what’s going on.

What determines the duration of symptoms?

The duration of symptoms depends on the half-life of the antidepressant. The half-life is a measure of how long it takes for the amount of the drug’s active ingredient in the body to be halved.

Why does antidepressant withdrawal occur?

Most often, it occurs in the event of a spontaneous interruption of treatment or a change in the patient’s drug regimen. It often happens when a patient changes the treatment regimen after feeling an improvement.

It can also occur if the patient forgets to take pills. Withdrawal symptoms occur due to a break between the intake of a substance in the body.

Sometimes it can happen in the morning if you are taking drugs with a short half-life only in the morning. In this case, you should consult with your doctor and try to split the dose in half.

How else does antidepressant withdrawal occur?

Many symptoms are associated with depression or anxiety, so it’s worth keeping an eye on how you feel and how long it lasts. Often, withdrawal syndrome manifests itself as:

• Panic attacks
• Poor motor coordination
• Strong emotionality
• Dizziness or inability to concentrate
• Insomnia and/or nightmares
• Fever
• Strange twitches and “thumps”
• Loss of appetite
• Nausea

This does not sound very pleasant. Withdrawal is not the most pleasant thing. But if you’re experiencing any of the above, remember: it won’t last forever. Everything will be alright. We have a list of tips to help you get through this difficult time.

How to stop antidepressants?

It’s easy to make a decision like, “I don’t want to burden the doctor” and start changing or stopping medication on your own. But please don’t change anything unless your doctor tells you to, even if it’s a small dose reduction. Antidepressants are helpful but potent, so it’s important to consult a professional for the slightest change.

When visiting a psychiatrist, ask how best to change treatment. Usually, your doctor can make a plan to reduce your dosage instead of stopping abruptly. If you start a new medication, it is likely that it will be introduced gradually while lowering the level of the current medication. This will help alleviate withdrawal symptoms.

Get ready for panic attacks

You may feel panic during antidepressant withdrawal— either intermittently or continuously.
If you have already experienced panic attacks, use the techniques that are already suitable for you. If you haven’t encountered them, place a paper bag next to your bed to breathe into during attacks. Practice deep breathing and count the objects in the room until your heartbeat stops.

Cry

Tears go hand in hand with panic attacks. In some cases, you can be very tearful. Our advice is to cry if you want to. You shouldn’t be ashamed of it, and honestly, thanks to tears, you can feel quite refreshed. Do not be afraid.

What to do with withdrawal syndrome?

Free up time in case it occurs.

Especially if you stop treatment completely, take a week or two off the hard stuff to deal with it. Even a couple of days off can help. Give yourself time to adjust.

Of course, not everyone can take a day off at any time, but you can start to “put away” the drugs before the weekend, or at least clear your schedule. If you’re feeling really bad from withdrawal, stay in bed as much as you can.