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A few years ago it was estimated that one out of eight Americans took an antidepressant medication (JAMA Internal Medicine, Feb. 2017) daily. According to my current calculations, 46 million people now take drugs like sertraline, escitalopram, bupropion, trazodone, fluoxetine, citalopram, duloxetine, venlafaxine or paroxetine annually. That’s closer to one out of seven Americans. Some of these antidepressants are also prescribed for anxiety, panic, neuropathy, fibromyalgia, back pain, osteoarthritis, OCD and hot flashes. Are patients adequately warned that antidepressant withdrawal can be devastating?
Waking Up To Antidepressant Withdrawal Symptoms:
The mainstream media have suddenly discovered that stopping antidepressants can lead to disastrous symptoms. An article in the New York Times carried the headline, “Many People Taking Antidepressants Discover They Cannot Quit” (April 7, 2018).
A patient who had been on sertraline (Zoloft) described symptoms of antidepressant withdrawal: dizziness, confusion and fatigue. They persisted far longer than most health professionals would imagine.
According to the NYT account:
“It took nine months to wean herself from the drug, Zoloft [sertraline], by taking increasingly smaller doses.
“‘I couldn’t finish my college degree,’ she said. ‘Only now am I feeling well enough to try to re-enter society and go back to work.’”
Medical Researchers Reporting “Discontinuation Symptoms”
An article in Lancet Psychiatry, July, 2024, is now reporting on something the FDA calls “discontinuation syndrome:”
“Antidepressant discontinuation symptoms are becoming an increasingly important part of clinical practice, but the incidence of antidepressant discontinuation symptoms has not been quantified.”
Do you find that somewhat disquieting? Antidepressants have been on the market for many decades. And yet here are psychiatrists admitting that health professionals have not “quantified” the incidence of this problem. The authors reviewed 79 studies of people discontinuing their antidepressants. Of these, 44 were randomized controlled trials, allowing for comparison between placebo and antidepressant.
The findings:
“Considering non-specific effects, as evidenced in placebo groups, the incidence of antidepressant discontinuation symptoms is approximately 15%, affecting one in six to seven patients who discontinue their medication.”
“Our study yielded four main results. First, across all studies and antidepressants, we found that approximately every third patient discontinuing antidepressants will have antidepressant discontinuation symptoms of any kind…”
We cannot verify those stats, though we suspect the likelihood of antidepressant withdrawal symptoms may be even higher. The authors of the Lancet Psychiatry article list these symptoms:
- Dizziness
- Headache
- Insomnia
- Nausea
- Irritability
The medicines that were most frequently associated with discontinuation problems included desvenlafaxine, venlafaxine, imipramine and escitalopram. The most severe symptoms were linked to imipramine, paroxetine, desvenlafaxine and venlafaxine. That does mean, however, that people taking other antidepressants are home free. As you will read shortly, people can experience severe symptoms after stopping duloxetine or some other SSRI or SNRI antidepressant.
The authors discuss tapering the dose of antidepressant medication to reduce the likelihood of developing withdrawal symptoms. The trouble is that there are no clear instructions on how to do that. Each clinician is on her own when it comes to developing a dose reduction plan. Neither drug companies nor the FDA seem inclined to provide much guidance.
Antidepressant Withdrawal an Old Story:
Readers of this column have been reporting the same kind of problem for decades.
In August, 1995, we heard from one person:
“I’m having trouble with rather severe withdrawal effects caused by abrupt discontinuation of paroxetine [Paxil] nearly two months ago. I took 20 mg daily for about two years for depression. When I felt less depressed and realized my inability to have orgasms was a side effect of the drug, I asked my shrink about discontinuation. He said to stop cold, so I did.
“Two days later, I saw sparkling zig-zag colored lights and had tunnel vision. Diarrhea, shakiness, horrible insomnia, wildly brittle emotions, and overwhelming crankiness set in. I was completely unable to concentrate or to do normal mental tasks, such as subtracting one four-digit number from another. I kept saying there was something wrong inside my head! I fell down, ran into things, and got covered with bruises. I was nauseated.
“I called the psychiatrist, who told me to take more Paxil. Instead, I asked him to do a literature search about withdrawal from Paxil, so he would know more about the drug he was prescribing. Two days later I received a letter from him, firing me as a patient.
“I am still emotionally volatile, really mad at the shrink and wondering if my depression is back. Was this doctor out of line, or was I?”
Our 1995 People’s Pharmacy Response:
In our answer, we pointed to a growing recognition that sudden discontinuation of antidepressants like paroxetine (Paxil) can sometimes cause withdrawal symptoms. The manufacturer told us that dizziness, sensory disturbances, nausea, agitation and anxiety had all been reported.
We were disappointed that the psychiatrist wasn’t more understanding and sympathetic about the symptoms this person was experiencing. We weren’t that surprised, however. In the mid 1990s, there still wasn’t widespread realization that stopping drugs like sertraline or paroxetine could lead to long-lasting and severe adverse reactions.
The Official Paxil (Paroxetine) Prescribing Information:
In our 1994 edition of the Physicians’ Desk Reference (PDR), the only mention we could locate about Paxil withdrawal was this:
Physical and Psychological Dependence
“Paxil has not been systematically studied in animals or humans for its potential for abuse, tolerance, or physical dependence.”
Another SSRI-type antidepressant, sertraline (Zoloft) had equally reassuring prescribing information in 1994:
Physical and Psychological Dependence
“ZOLOFT has not been systematically studied in animals or humans for its potential for abuse, tolerance, or physical dependence. However, premarketing clinical experience with ZOLOFT did not reveal any tendency for a withdrawal syndrome or any drug-seeking behavior.”
It’s hardly any wonder that physicians did not think there was such a thing as antidepressant discontinuation symptoms. The official prescribing information for paroxetine and sertraline was reassuring. The FDA did not require studies and drug companies did not feel motivated to investigate this issue. See no evil, hear no evil, speak no evil.
Antidepressant Withdrawal Is Now “Discontinuation Syndrome”:
Fast-forward to 2024. There is much more awareness about antidepressant withdrawal symptoms. The FDA has given this kind of reaction a scientific name: “discontinuation syndrome.” It may seem less scary than antidepressant withdrawal.
Today, the official prescribing information for Zoloft (sertraline) is quite different from the 1994 PDR:
Discontinuation Syndrome
“Adverse reactions after discontinuation of serotonergic antidepressants, particularly after abrupt discontinuation, include: nausea, sweating, dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e.g., paresthesia, such as electric shock sensations), tremor, anxiety, confusion, headache, lethargy, emotional lability, insomnia, hypomania, tinnitus, and seizures. A gradual reduction in dosage rather than abrupt cessation is recommended whenever possible.”
The FDA requires this for generic Zoloft (sertraline):
After a long list of antidepressant withdrawal symptoms comes:
“During marketing of sertraline and other SSRIs and SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors), there have been spontaneous reports of adverse events occurring upon discontinuation of these drugs…While these events are generally self-limiting, there have been reports of serious discontinuation symptoms.
“Patients should be monitored for these symptoms when discontinuing treatment with sertraline. A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose but at a more gradual rate.”
The current prescribing information for paroxetine (Paxil) is quite similar and differs dramatically from the official line of the mid 1990s.
What Does “Gradual Reduction” in Dose Mean?
Neither the FDA nor the drug companies that make antidepressant medications spell out in detail what they mean by gradual reduction. For some physicians that could be interpreted as a week or two. For others it might be several weeks.
We suspect that many health professionals have very little idea what their patients go through when they try to stop antidepressant medications. Just listing symptoms such as brain zaps, dizzy spells, nausea, headaches, sweating, anxiety, fatigue, insomnia and digestive problems does not do antidepressant withdrawal justice.
Some of the other antidepressant drugs that can produce the discontinuation syndrome include citalopram (Celexa), desvenlafaxine (Pristiq), duloxetine (Cymbalta), escitalopram (Lexapro) and venlafaxine (Effexor).
Stories from Readers:
You can find over 1,900 reader comments associated with this article:
Duloxetine (Cymbalta) Side Effects & Withdrawal
If you would prefer to just read just a few case reports, here are some:
Carl in Brisbee, Arizona, is going through hell:
“I was prescribed Cymbalta [duloxetine] and Provigil [modafinil] for PTSD (post-traumatic stress disorder) and narcolepsy.
“In the fall of 2017 my insurance company suddenly decided to not pay for my prescriptions. This lasted for 5 1/2 months. My Provigil alone is $4,500.00 a month! I could not afford to buy anything for 3 1/2 months.
“I had no idea about the side effects of stopping CYMBALTA suddenly! I was going crazy! I was suicidal. It was the most horrible I have ever felt in my life!
“It has been nearly seven months since the onset of withdrawal symptoms. I have been in bed for 3 3/4 months. Just a few steps make me exhausted. I am dizzy. I cannot walk a straight line. I bounce off the walls and hit the sides of doorways. It is as if I have very little control over my upright body.
“I know it is from the suddenly stopping Cymbalta! I took this drug for more than a decade. I just got used to it. I kept taking it for years, until insurance refused to pay in Sept. 2017. My life has been a wreck ever since. It still is going on. I am in a living hell and am unable to find a solution!”
Diane in Texas reduced her dose very gradually:
“I took Cymbalta for years and got off of it a few years ago. It was very difficult. I ended up opening the capsules and counting beads. I made very gradual adjustments and it took months to get off it. I felt withdrawal symptoms from the slightest decrease.”
Cindy in Seattle, Washington, offers an insider’s perspective:
“I worked in psych for 30 years (inpatient units), and one of the main reasons for an admission was to ‘wean’ the patient off SSRI’s. The withdrawal symptoms were that horrible and dangerous.”
Dagny offers an interesting taper tip:
“Antidepressants can quit working and result in withdrawal symptoms that are the same as they would be if the person quit the drug cold turkey. You might want to ask your doctor about switching to a different SSRI and see if that helps.
“I’ve gone through antidepressant withdrawal cold turkey. It was three and a half years of misery. The discomfort slowly decreased over that time period.
“If you want to get off antidepressants, your doctor may be able to prescribe a liquid version. As you get close to reducing the dose in smaller increments this will make it easier to titrate the dose. You can taper very gradually during the last months. That is when it begins to get most difficult. A compounding pharmacy can make up the prescription for you.
“It will no doubt be more expensive than an ordinary prescription, but it would be well worth it. I wish I had known about this when I was suffering. Whatever you do, don’t just stop the drug. After a month or so of going off cold turkey, going back on the drug to stop withdrawal symptoms may not work. Take it slow and easy.”
How to Stop Duloxetine (Cymbalta) from “Hopeful” in Indiana:
Patients who have been through the hell of antidepressant withdrawal often try to help their fellow sufferers. Here is an article we wrote about a year ago with some thoughtful suggestions from “Hopeful” in Indiana. Remember to always check with a health professional about any withdrawal strategy:
How to Stop Duloxetine (Cymbalta) Without Withdrawal Symptoms
Why Is It So Hard to Stop Antidepressants?
To our surprise there has not been a large amount of research devoted to this crucial question. We now know that antidepressants affect a number of important neurochemicals: serotonin, norepinephrine and dopamine for starters. It is likely that other systems are also impacted, including GABA and “neurotrophic factors” (Frontiers in Pharmacology, April 16, 2013).
When drug-induced modifications occur within the body, there are frequently cellular adaptations. Receptor sites on neurons change. This is the way the body attempts to deal with changes in neurochemistry. Because neuroscientists have not devoted a lot of research to this issue, we do not yet have a good explanation for the underlying causes of discontinuation syndrome.
We suspect that withdrawal symptoms occur as the body tries to reestablish homeostasis. Some people are super sensitive to this challenge. It may take them months or years to achieve balance. Others may overcome the challenge over several weeks.
People’s Pharmacy Perspective:
We are glad to learn that the medical profession and the media are starting to wake up to the seriousness of antidepressant withdrawal. This is not the depression returning. That has sometimes been used as an explanation for why people suffer symptoms after stopping an antidepressant. It is much easier to blame the patient than the drug.
We believe this because symptoms are different and people report the discontinuation syndrome even when they were taking the medication for other reasons than depression:
Jan was taking duloxetine for the pain of fibromyalgia:
“I was on Cymbalta for over 10 years for fibromyalgia. I just didn’t feel good on the medication. I asked myself, why I am I taking it? My symptoms were actually worse.
“I decided I need to get off this drug. At my annual checkup my doctor said fine, but let me give you 30 mg for a month (I was on 60 mg.) Then you should be fine.
“NO. I am on my 3rd day and as everyone else has said on this website, I am going a bit crazy. I threw up the first day. I had the brain zaps, crying and the shakes to name a few! I have been drinking tons of water and trying to eat lots of fruits and veggies. I took a long Epson Salt bath with peppermint oil to try and sooth my pain.
“Thank You so much for sharing the idea of opening the capsule and removing the small white balls and weaning that way…who knew?”
Occasionally, patients may need to stay on antidepressant medication for many years. Others may need to be on such drugs indefinitely. But for those who wish to get off their medicine, there are no good guidelines for gradual tapering.
You may be interested in our podcast “Are We Medicating Normal Emotions?” in which we speak with a psychiatrist about the withdrawal phenomenon. And our Show 1389: Getting Off the Medication Treadmill may also be helpful.
It is long past time for the FDA to require drug makers to develop evidence-based strategies to help people discontinue antidepressants safely.
Share Your Own Antidepressant Withdrawal Story
If you needed to stop an antidepressant medication for any reason, please share your experience in the comment section below.
David
There is in fact a newly published clinical guide to deprescribing antidepressants by David Taylor and Mark Horowitz, published by Wiley: https://www.wiley.com/en-gb/The+Maudsley+Deprescribing+Guidelines%3A+Antidepressants%2C+Benzodiazepines%2C+Gabapentinoids+and+Z-drugs-p-9781119823025 . Horowitz has been quite visible in the past several years as a researcher and advocate for more awareness of this issue.
Earl
My wife was on Zoloft for a total of about 25 years. It was originally prescribed for good reason by her family physician. About 15 years later I read an article about slowly withdrawing from it. Over a 6 month period she was doing great and down to 1.4 tablets or 25mg per week, and she started having discontinuation symptoms. Her family MD put her back on it.
A few years later she started to develop dementia. A psychologist who was doing some neuro-diagnostic testing was upset when he realized she was on this drug so long and referred us to a psychiatrist who changed her to Prestiq. I actually think she has some brain damage from the Zoloft but there is nothing that can be done to cure it, and there is no way to my knowledge to prove it.
I guess the message I am trying to send is to avoid staying on these meds for a long period.
Jean
While still working I decided to stop my Prosac, GRADUALLY.
Month 1, skip 1 Prozac a week on Monday. Month 2, skip 2 Prosac a week (Monday, Thursday). Month 3, skip 3 Prozac each week, (Monday, Wednesday, Friday). Etc, etc.
Did it take 7 months for me to eliminate my Prozac? Yes, but I was able to function well, without side effects or withdrawal, in all aspects of my life, including as as a classroom teacher of challenging 5th and 6th graders.
Robyn
I was prescribed Sertraline 25mg and Remeron 15mg in spring 2019. My psychiatrist weaned me, over the course of a month or two, off of both after being on them for about a year in the fall of 2020. At first coming off the meds I was fine but then weeks later, after I was off of it completely, all Hell broke lose. For three months straight I had severe insomnia and panic attacks which I had never experienced before. Terrible anxiety that barely ever left me, akathisia, suicidal ideation, diarrhea, no appetite, headaches, lethargic, no energy, crying spells, agitation, irritability, body vibrations, tingling fingers, burning sensation on skin, etc. I felt absolutely horrible, and I was living in a hell!
It was soooooo hard to take care of my then 2 yr old. After each month my symptoms got worse and worse and worse. By the third month I could not take it anymore, and back to the stupid Psychiatrist I went, who then proceeded to tell me that I had relapsed, and I needed to be put back on the medication. I did this because I was uninformed. It took several weeks to feel normal again. I later learned what I had experienced was called protracted withdrawal. I had not relapsed!
I then I found the support group on Facebook for Mirtazipine. I learned about the no-harm reduction taper. That’s when I found myself a Functional Medicine doctor, and I fired the psychiatrist. It took me 10 months to get off of Mirtazipine using a no-harm reduction taper.I had a compounding pharmacy make it into liquid so I could slowly titrate my reductions by 10% of the previous dose. With that taper I still experienced severe insomnia at times when I reduced my dose but if my dose was correct it would only last for four or five days, and then would stabilize.
Unfortunately majority of Doctors and psychiatrists have no problem getting people on these meds but are absolutely clueless and unaware of how to get their patients off. That’s where these online support groups online come in to fill the uninformed gap. I am currently still tapering my sertraline. This whole process has taken years of my life, and my husband and I had to put off having more children. I am 40 now and still tapering. This has been a nightmare.
Kerry N.
Boston
I had a horrible experience with Zoloft. I took it for 6 weeks. I stopped it because it was making me more depressed. When I stopped it for over a month I passed out dizzy and was more severely depressed. I had pains all over my body, flu symptoms, and a heart attack feeling!!!! Could not get out of bed. If I didnt know what was going on from my research I could have wanted to die!!!!! Awful medication. I wish I could give this information to someone. It needs to be taken off the market!!! I am traumitized and lost my memory!!!!
Arnold
Merritt island FL.
In January of 2013 my doctor took me off 8 mg of lorazapam in 6 weeks! 63 months later I am still getting worse ,not better! I have been unable to walk more than to the next room,head pressure is horrible,tinnitus too and this year I lost all my long term memory (short term is OK) so now I can’t daydream, I can’t talk to friends I have known for most of my life because I don’t know them anymore!
My neurologist told me he can’t help and even my wife who sees my uncontrollable muscle movements ans sees me cry out in agony can’t take me anymore and because my doctor said withdrawal can’t last over 3 years she believes him and tells me to ” GET OVER IT” and I am ready to give up! I don’t know what to do!
Wanda
Toronto
Anybody tried coming off metrazapine 30?
A
Washington, DC area
In Feb of 1996 I had an accident resulting in a large loss of blood and a compound fracture of the tib/fib of the left leg. I became very depressed. Prior to this I was an active adult, never having a psychiatric diagnosis. I worked out in the gym five days a week.
I was mis-managed (in the Washington, DC area) on psychiatric medication for 12 years, (1996 to 2008) resulting in a diagnosis of serotonin syndrome. I was put on antidepressants less than two months after the accident in 1996. In 2000 I was hospitalized for my first suicide attempt. Had a total of three suicide attempts requiring hospitalization. I was diagnosed bipolar after the first suicide attempt after being prescribed Prozac. Thereafter, I was prescribed Depakote with an antidepressant. I was given Xanax and then later Clonozepam to alleviate horrible anxiety symptoms from the antidepressants. My life was drastically altered because of Iatrogenic Depression (definitely relating to illness caused by medical examination or treatment).
Diagnosed with Serotonin Syndrome in December of 2008 by a GW University professor who is a neuro-pyscho pharmacologist. This was not the doctor that prescribed and managed my diagnosis of depression.
At this point I was hallucinating. I threatened suicide once again and my mother found the neuro-psycho-pharmacologist. It was suggested that I go into the hospital and be placed in a coma to detox. I refused.
I walked away from doctors that day.
It took me 8 months to detox off of antidepressants and 4 (four) YEARS to detox off of the benzodiazepines.
I detoxed on my own with the help of a doctor who prescribed medication as I tapered off the medication.
I can honestly say that I lost everything that I loved because of anti-depressant medications. I did not function normally, never leaving the house and had horrible body pain. In the year 2000 I separated from my husband because my personality completely changed and in 2001 divorced. All medications and doctor’s visits were self pay except for the time that I was married, from Feb 1996 until 2001 when I had insurance. The last two years that I was on the medication the cost of Cymbalta and Effexor was nearly $500.00 a month. It was the Cymbalta/Effexor combination that caused the Serotonin Syndrome.
I vowed to make my story known. I have been healing for the last ten years after detoxing off of all medication. I now try to do my best to eat good quality food, drink good quality water, eat very little meat, and take as few pills as possible.
I will do anything I can to help bring to light the devastating effects of psychiatric medication, specifically antidepressants, mood stabilizers and anti-anxiety medication.
Today I’m doing well, still with depression, but much happier than I ever was while on medication.
I recommend to everyone to look up SSRI Stories | Antidepressant Nightmares.
Ruth
Independence mo
I am taking Trazadone, and trying to wean myself off…but I can’t sleep…I had gotten down to 1/2 a tablet every 3rd night, but after several nights of not sleeping, had to go back to every other night…will try again, after I get some rest…if someone has a suggestion, I would appreciate all help…I also take clonazapam each night…been taking both, for several years…I am 77, and would like to get off at least the Trazadone…
Betty
North Carolina
I have been on Celexa for about 15 years. About 10 years ago I tried to wean myself off of it and turned into a person I didn’t know. Words would come out of my mouth that I had no control over and usually they were not nice. I was appalled and embarrassed that a mean streak had developed while weaning off this drug. I also had brain zaps. I went right back on the drug and refuse to wean off again because I am scared of becoming a raging b**** again.
Judy
Seattle, WA
I’ve been taking 50 MG Sertraline and 300 MG Buproprion HCL XL for years. With my doctor’s assistance I tried to get off first the Buproprion. She reduced it to 150 MG for a period then I went off it completely, still taking the Sertraline. EVERYTHING irritated me, and I became Super Bitch, biting off people’s heads for the smallest of irritants. I told my doctor I needed to get back on it because I must be a very angry person who needs the drug.
She never once told me it may be a side effect of getting off a drug. A year later I tried to get off the Sertraline, which she had me stop cold turkey. I had the same reaction, and Super Bitch reappeared. I again told her I needed to get back on that one too because, again, I believed I must be a very angry person. Now after reading this I realize these were withdrawal symptoms, that I am not just an angry person (what a relief).
However, it sounds like I need to keep taking these drugs for the rest of my life to avoid years of withdrawal temper tantrums. Is there any harm in taking these drugs for all of your life???? These are solid tablets so I don’t see how I can gradually get off of them.
Amanda
NZ
I had a nightmare getting of Effexor when I developed light and sound induced seizures from 7 months trial of the drug for migraine anxiety…never before having had seizures in my 56 years…
MY Israeli Doc prescribed them describing them as the best in his arsenal here in NZ.
I still have an involuntary body jolt triggered by certain triggers…and stopped the drug 7 months ago after a tapering program was devised by another Dr including treatments with Russian Scenar treatment and other suggestions…
If it had been spelled out to me this possibility of discontinuation syndrome …what that means … i would never have agreed and with my history of sensitivity to meds clearly documented in my medical notes feel it should not have been recommended…
WHY DO THE PHARMA COMPANIES ENJOY PROTECTION FROM THE FULL DISCLOSURE OF SIDE EFFECTS…IF fully informed consent is the bench mark for patient rights …they are corrupted at the outset.
I feel ripped off…and yet also lucky to be back with the loving support of a best friend I made it back from zombieland as my granddaughter described…to me…u turned into a zombie her words at 7 years
How can these drug companies get away with it? how come no one is made responsible…humans are being poisoned by the drug companies.
Judy
Winston Salem NC
What upset me was that, when you tried to go off one of these meds and had problems, they would use that to say “you see, you really need this”.
I feel so angry that all of these years these drugs were marketed as non-addictive and that doesn’t seem quite true.
Now they are bringing in these antipsychotic drugs (Abilify, Seroquel) which wreak havoc with the metabolism, causing insulin resistance, diabetes, weight gain and high cholesterol. Hmmm…. I wonder why they suddenly started prescribing anti-psychotics for depression? Sounds to me like the drug company’s needed to create a new market as they didn’t have enough people experiencing psychosis to pad their pockets.
ray
ga
I have took different antidepressants off and on for yrs. some are better than others but that is an individual thing which works best.a earlier post the shrink “fired” the patient for question her.if a dr thinks they know best and you can question them when you have side effects he is dr at low end of the scale. they suppose work with you. you pay them, so they work for you.
My decease dad once “fired” a dr at hospital.they put him in physo ward two days. My dad explain I am not paying you to peek your head in the door 2 mins just so you can get paid for $200 visit. Makes sense to me.
Lisa
NY
I survived a withdrawal after stopping Effexor after several years. First concern of my psychiatrist in putting me on Effexor, and she said this is applicable whenever a physician puts a patient on antidepressants, in cost-benefit and if the patient if is bad shape (sometimes suicidal) then obviously using meds is a no brainer.
I went off Effexor finally after extreme weight gain over the years. Withdrawal resulted in horrific vomiting, shaking, chills and what is commonly referred to as “brain zaps.” Brain zaps are flashes that feel like I was just hit with minor electrocution.
I saw my psychiatrist and described the horrible suffering and she said oh that’s from the sudden reduction in serotonin, so she put me on a minimal dose of plain old Prozac and instant relief!!
From there, I was able to slowly reduce my dose of Prozac until I was off it. I then opted for alternative medications that would not cause weight gain OR withdrawal upon ceasing to take it.
From my psychiatrist’s perspective, she has patients come in who are suicidal or unable to function, sometimes unable to get out of bed, and in tears begging for help, and she always starts with the most low level dose of the simplest antidepressant. But if that does not resolve the issue, she slowly goes to higher doses and/or other medications. At that point her last concern is withdrawal down the road. She saved my life, but I surely wish I had been fully informed from the start. Leaving a patient, especially an extremely depressed patient, to read and comprehend the manufacturers’ inserts that come with the medication is just not reasonable.
Glad that this has really come to the forefront and being discussed!
Sandra
Prozac has a long half-life and no withdrawal symptoms.
Carol
TX
This is the sort of thing that happens when healthcare becomes big business. Patients discover, too late, that someone decided profit was more important than their welfare. We need to start researching, on our own, every drug we’re thinking about taking. Don’t assume that your doctor knows or cares what the short- and long-term side effects are.
Lise
97303
I’ve been taking amitriptyline (tricyclic) for several years ranging from 75mg to 250 mg. I decided to cut back and now I am at 25mg. A big help to reduce was taking Phosphatidylcholine which also works for SSRIs.
https://www.verywellmind.com/how-to-stop-taking-ssri-antidepressants-safely-378683
Mike
Durham, NC
I had been prescribed Zoloft for anxiety and obsessive tendencies 20 years ago. Within a couple of weeks, I was much improved with less obsession than ever – not high but far less worried.
My psychiatrist and I worked to titrate my dosage as I felt that I’d like to discontinue do to moderate side effects, if possible. Accordingly, I titrated my dosage carefully over a full year. I felt fine for serval months thereafter, but when faced with a stressful experience, I soon developed what I can best described as pervasive dread. Whereas exercise, jogging, swimming for an hour, bicycling, had always improved my mood, it no longer helped at all.
I resumed the medication, but I did not feel any relief until 3 weeks had passed. Knowing that resumption of the benefits took so long has kept me from trying to stop again. To substitute another medication and then perhaps titrate from that is too much of a risk. ‘just hoping that, now in my 3rd decade of Zoloft usage, I continue to tolerate and benefit from it. Who knows?
Thank you for this article!!
Carol
Clinton Township, MI
Like a lot of post menopausal women, my doctor took me off my hormone replacement therapy and put me on Effexor. What a horrible thing the AMA recommends for women! I found a woman gynecologist who put me back on Prempro. So, when I went back to my doctor and with his guidance, weaned off Effexor, it was horrible. How many women were put on Effexor and not really need an anti depressant?
Maddie
United States
I was prescribed Effexor in the late 1990’s. No mention was made of any kind of withdrawal symptoms. My prescription was renewed year after year for over twenty years, even though, to my knowledge, there is no research to show that long-term use is safe.
In 2014, I suspected that the venlafaxine XR 75 mg I was taking was giving me unpleasant side effects as well as debilitating withdrawal symptoms if I missed by dose by as little as four hours – brain zaps, nausea, dizziness. One night I woke up and found that when I moved my eyeballs, I heard a distinct “click” with each movement – this happened over several months any time I was late taking my dose. I also didn’t think I needed an antidepressant any more.
I decided I would open up the capsule and take one less pellet every two weeks. I did this for over a year and finally reduced my dosage to 37.5 mg. After a couple of months stabilizing myself at the lower dosage, I started back reducing it by 1 pellet a week.
I ended up having withdrawal symptoms even with this tiny reduction. Now I’m stuck at that dosage. It makes me furious that a drug company can market a drug like this with no warning, and even with a denial that the drug is addictive. Of course it works well for them, since I’m still buying their poison pills!
Larry M
Raleigh, NC
I took Zoloft (sertraline) from 1995 to 1998 at which point I discovered that my symptoms were due to drinking way too much coffee each day.
Fortunately, the Zoloft had been prescribed by a prescient psychiatrist who had told me that if I decided to stop taking the medication, to taper off, not stop abruptly. He wasn’t specific, just “taper off.” I took half-tablets for a couple of weeks, then quarter-tablets. I didn’t have any withdrawal symptoms at all. After a few weeks with no coffee and no Zoloft, I was able to call and cancel future appointments.
Gerry
Maryland
I have been on Paxil since my 30s and am now 72. One time I was having a terrible week. Electrical shocks, depression, overall feeling horrible. I then realized I had forgotten to put my Paxil in my weekly pill holder. As soon as I restarted it all symptoms disappeared. I have since made sure I never do that again when doing my pills for the week. It was so horrible that to this day it scares me to think about it happening again. Paxil works for me and I plan on taking it til I die.
Joan
I took a small dose of Cymbalta for foot nerve pain- I decided after a year that it really didn’t work for that. I stopped taking and I literally cried for 6 weeks. Everything made me cry and I was not depressed. I had to go to work and try to avoid people or explain that there was nothing wrong with me. It was very embarrassing.
Sandy
Olympia WA
Due to a job loss, I knew I would no longer be able to afford Zoloft (this was prior to generic availability) AND my depression was gone). Knowing about the withdrawal issues, I did my own “step-down” plan similar to my husband’s Prednisone plan. In place of one tablet each day, I took alternate doses of one tablet and half a tablet for a few weeks; then one half table daily for a few weeks; then one half tablet on alternate days for a month; then one half tablet on alternate days for a month; then one half tablet two days each week; then I was able to stop the medication completely. Of course, this plan would not work if a person had no choice about stopping suddenly or did not have enough medication on hand to sustain such a step-down plan.
Judy
Seattle, WA
Thank you so much, Lynn, for sharing how you gradually took yourself off of Zoloft. I am going to try your method with one of my two antidepressants. Wish me luck!
Lynn
I have been on Zoloft for years and decided to wean myself off. I started by cutting my dose into quarters..100 mg to 75 to 50 to 25. I did this monthly. Once at 25mg, I skipped it every other day for a month, then every third day, 5th day and finally after 6 months I am done with it. The only side effect I have is I cry easily over everything sad. I can control that by telling myself to knock it off. Its better but I feel better without it. It was worth taking six months to do it.
Helen
New York
I had tried to get off Effexor a few years ago (venfelamine), and the results were typical. Agony, muscle aches, zaps, a depression worse than I had before taking this “Evil Drug”. About 6 months ago, thinking I had learned from experience, I crafted a foolproof plan. I reduced super gradually (counting little pills inside the capsule).
For 3 weeks, I was feeling fine! I was so proud of myself. At the end, I was down to 5 of the little pills. 2 days later I got a horrible dizzy spell. The symptoms increased, and I slid down the rabbit hole again – as if I had stopped suddenly (This was from 350 msg to nothing). After suffering for 2 weeks, I called my “pill doctor”. Unlike the first time, when he told me that I was being a hypochondriac. This time, he told me that “Some people can never quit Effexor.”! I wanted to sue him! Instead, I started taking half the dose.
I was literally “hooked”. These drugs should be discontinued. I know I will be forced to take it for the rest of my life.
mog
Illinois
When I decided to stop taking a different med altogether (Stelazine, for hallucinations) what worked for me was to reduce the med a fraction (I no longer remember the percentage, sorry). Then I waited, probably for 3-4 months, while my body got used to the reduction and the symptoms of withdrawal ceased.
Then I repeated the process, slowly and cautiously reducing the dosage. It probably took me 2-3 years to get off the Stuff entirely. I could tell, however, that my cognitive function was getting better with each reduction. I realize my experience is not with antidepressants, but the strategy for withdrawal may still be useful to others.
Virginia P.
Because I didn’t tolerate those antidepressants mentioned I was prescribed Bupropion. It was my miracle drug. But now that I have been on it for a couple of years my concern is that I have been experiencing symptoms mentioned for withdrawal. I’m not discontinuing my prescription so obviously, I will ask my doctor about a connection.
Because the symptoms can’t be explained at this point, tests have been ordered. Now that I see others are experiencing the same, but as withdrawal I now have something to take to my dr. Maybe there’s an explanation and I’m not losing my mind.
Cindy B
Seattle, WA
To “sell” a patient on the possible benefits of an Rx med while glossing over or ignoring the negatives (side effects and difficulty getting off it) is the same thing as an assault in my book. In some cases, it’s fodder for a lawsuit.
Meg
Albuquerque, NM
I have taken Lexapro, generic, for over 15 years. I have tried to stop taking it 3x. The first time was about 13 years ago. I stopped taking it “cold turkey” expecting, as with Prozac and other antidepressants I had taken, to feel a little hung over for a few days. It was horrible. It felt like a combination of the flu and the worst motion sickness EVER … dizziness, shakes, extreme achiness, extreme nausea, cold sweats, dizziness, vomiting and more.
The second time, I talked with my PCP, and I decreased the dose very slowly over a period of 3 months. Still had discontinuation syndrome (as I now know to call it) although a much milder case. Unfortunately, my mood plummeted. I began taking Lexapro again, feeling completely trapped on a drug I no longer wanted to take.
Recently, I read here on People’s Pharmacy about using Prozac to assist with getting off Effexor, Lexapro, and other SSRIs. I printed the information and talked with my doctor about it. Although she said she had only used this method to get patients off of Effexor, she agreed to the plan. I am still reducing the amount of Lexapro slowly, and this week I will go to 5 mg (1/2 pill) every other day with 1 Prozac.
I feel apprehensive but hopeful that this method may work, and I will finally be able to be free of Lexapro. No one should ever, ever be prescribed these powerful medications without informed consent about the weight gain and possible difficulty with discontinuation.