Antidepressant Withdrawal And Detox

What Is Antidepressant Withdrawal?

Antidepressants are the most widely prescribed medications in the U.S. and are used to treat depression and many other mental health disorders. If an individual suddenly stops taking antidepressants, specifically after taking them for at least 6 weeks, they can experience antidepressant withdrawal symptoms.

People taking antidepressants should never stop “cold turkey,” as quitting suddenly throws the brain into a state of imbalance. It is still unclear how antidepressant withdrawal occurs, but experts believe that it is related to the sudden decrease in serotonin levels when a selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs) is abruptly stopped.

The resulting withdrawal symptoms are both psychological and physical.

What Is Antidepressant Discontinuation Syndrome?

Antidepressant discontinuation syndrome is the formal term for antidepressant withdrawal and occurs when someone abruptly stops taking antidepressants after being on them for at least 6 weeks.

Antidepressant Withdrawal Symptoms

Antidepressant withdrawal symptoms are usually mild, not life-threatening, and are temporary, appearing within 2-4 days after the medication is stopped and lasting 1-2 weeks.

It is important to recognize these symptoms because they can be confused with other medical or mental health disorders, which can lead to misdiagnosis. It is also important to differentiate antidepressant withdrawal symptoms from depression relapse. When stopping an antidepressant, symptoms of depression or anxiety may recur but generally take more than a few days to appear and will minimize when a new antidepressant is introduced.

Symptoms of discontinuation syndrome can be easily remembered using the mnemonic FINISH:

• Flu-like symptoms (fatigue, headache, achiness, lethargy, sweating)
• Insomnia (with vivid dreams or nightmares)
• Nausea (with or without vomiting)
• Imbalance (dizziness, vertigo, light-headedness)
• Sensory disturbances (“burning,” “tingling,” “electric-like” or “shock-like” sensations)
• Hyperarousal (anxiety, irritability, agitation, aggression, mania)

Antidepressant Withdrawal Duration

Approximately 20% of people who abruptly stop their antidepressants will develop antidepressant discontinuation syndrome. For the majority of people, antidepressant withdrawal symptoms usually last one to three weeks, though some studies have shown that symptoms can last up to one year on rare occasions.

A person is at a higher risk of developing antidepressant withdrawal if they:

• Have taken the antidepressant for a long time (several years)
• Take antidepressants that have a higher risk profile for discontinuation syndrome
• Take a high dose of antidepressants
• Have experienced discontinuation syndrome when they have missed one dose of their medication

Certain types of antidepressants are more likely to have a high-risk profile for discontinuation syndrome when abruptly stopped. These medications include:

• Paroxetine (Paxil®, Pexeva®)
• Fluvoxamine
• Venlafaxine (Effexor®)
• Desvenlafaxine (Khedezla®, Pristiq®)
• MAOIs (monoamine oxidase inhibitors)
• Tricyclic antidepressants
• Tetracyclic antidepressants

Antidepressant Withdrawal Timeline

Days 1-3	Most people experience the first signs of antidepressant withdrawal symptoms in the first few days of stopping their medication. This timeline differentiates antidepressant withdrawal from depression relapse. Symptoms of relapse generally take more than a few days to appear.
Days 4-5	Withdrawal symptoms become more intense before they begin to fade. Users start experiencing dizziness, nausea, shakiness, and fever. Those who took antidepressants in higher doses for a longer time have more intense symptoms.
Weeks 1-3	Withdrawal symptoms typically persist for up to three weeks. The symptoms gradually fade during this time. Most people who quit taking their antidepressants stop having symptoms after three weeks.
Weeks 4+	Many factors that affect how long withdrawal symptoms last. Some people have symptoms that last several months or up to one year.

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How To Taper Off Antidepressants

Although antidepressant discontinuation syndrome is not always preventable, the most effective way to prevent symptoms is to speak with your healthcare provider before stopping your antidepressants and coming up with a taper plan. Tapering means slowly decreasing the dosage over a period of time in order to avoid unwanted withdrawal symptoms until the medication is out of the body and the medication is stopped.

Tapering is not a “one size fits all” approach; it is an individualized plan that often takes 4-6 weeks or longer.

Do I Need To Go To Rehab For Antidepressant Detox?

Although withdrawal symptoms may appear after abruptly stopping antidepressants, medical detox is not necessary. Since antidepressants are medications that are not commonly abused and withdrawal symptoms are generally not dangerous, there is no need to go to rehab for antidepressant detox.

If you want to stop taking your antidepressants, it is important to speak to your doctor and come up with a taper plan in order to avoid discontinuation syndrome. Your doctor may advise going off antidepressants and switching you to a different antidepressant or a different class of antidepressants to help treat your symptoms. If your doctor decides that it is safe to go off your antidepressants, then a taper plan will be discussed.

Addiction treatment or rehab is not in the treatment plan for antidepressant withdrawal syndrome, unless they have a co-existing drug or alcohol use disorder. In this case, the person may seek dual diagnosis treatment in rehab.

Find Support Today

Sometimes, people taking antidepressants also abuse drugs like alcohol and marijuana if their medication isn’t working. Polydrug use like this can worsen symptoms of depression and increase the risk of addiction. If you need help giving up antidepressants or another substance, contact a treatment provider or visit our rehab directory for rehab-related help today.