By Dr. David Woo - April 7, 2022

Antidepressants are considered the gold standard treatment for depression. However, while many people experience relief from depression symptoms with antidepressants, especially those with moderate to severe depression, many people either experience unpleasant side effects or find that medication doesn’t relieve their symptoms.(1)

While it can be tempting for someone to want to lower their dosage, or to stop taking an antidepressant altogether, this decision should only be made by the patient’s doctor.

Why Patients May Want to Stop Taking Antidepressants

Some people may wish to stop taking antidepressants if the side effects are intolerable, or if the medication doesn’t seem to be helping.

It’s normal for someone to have side effects from an antidepressant during the first few weeks of treatment.(2) Usually, these side effects subside as the body adjusts to the medication. At first, someone starting out on a new antidepressant may be willing to put up with side effects like insomnia, nausea, or sexual dysfunction if it means their depression symptoms will resolve. However, if these side effects do not subside after a few weeks, it can be tempting to want to reduce the dosage or even stop taking the medication. Never make this decision on your own. If you’re experiencing unwanted side effects, or if you don’t notice an improvement in your symptoms, talk to your doctor.

For some, antidepressants may not provide relief from their symptoms. Up to one-third of patients who try an antidepressant won’t find relief from depression symptoms.(3) If you’ve tried an antidepressant and don’t see a difference in your symptoms, talk to your doctor. Your doctor will recommend that you try a different antidepressant from a different class.(4) If you don’t see results with the first antidepressant that you try, this doesn’t mean your depression is incurable. It simply means that you and your doctor may need to try a different approach.

The Risks of Abruptly Stopping Antidepressants

Quitting antidepressants “cold turkey” increases one’s risk for:

• Depression relapse: Patients who stop taking antidepressants without a doctor’s supervision may experience an intense return of depression symptoms. This is referred to as relapse. These effects are worse when antidepressants are stopped suddenly, especially for patients who have been taking an antidepressant for a long time.
• Withdrawal symptoms: Also known as “antidepressant discontinuation syndrome.” Quitting a depression medication on your own may put you at risk for withdrawal symptoms, such as:
  • Flu-like symptoms
  • Nausea and vomiting
  • Sleep disturbances (insomnia or vivid dreams)
  • Impaired concentration
  • “Brain zaps” (electrical shock sensations)

How to Stop Taking Antidepressants Safely with Your Doctor

If you no longer want to continue taking antidepressants for any reason, talk to your doctor first. You should never make changes to your dosage or stop taking antidepressants on your own. Your doctor can help determine if a different treatment approach, like transcranial magnetic stimulation (TMS), is best for you moving forward.

In order to go off antidepressants safely, you need proper medical guidance and supervision. Your doctor will help you to slowly “taper off” your medication, which means reducing the dosage very slowly, over the course of several weeks.(5) Doing this reduces the potential for side effects and allows the drug to gradually leave your body.

The length of time you spend tapering off your antidepressants depends on how long it takes the drug to exit your system. Your doctor may also adjust this timeframe based on how you respond to each gradual reduction of your dose.

Are You a Candidate for Antidepressants?

Your doctor can help you understand if an antidepressant might help you find relief from depression symptoms. If you have any questions about whether antidepressants are right for you, or you would like to make an appointment, contact us online or call (212) 731-2033.

Resources:

1. Zwiebel S.J., Viguera A,C.. Discontinuing antidepressants: pearls and pitfalls.
   Cleveland Clinic Journal of Medicine. 2022;89(1):18-26. https://www.ccjm.org/content/89/1/18. Accessed March 9, 2022.
2. Depression: How effective are antidepressants? InformedHealth.org. Published January 28, 2015. Updated January 12, 2017. https://www.ncbi.nlm.nih.gov/books/NBK361016/. Accessed March 15, 2022.
3. Ionescu DF, Rosenbaum JF, Alpert JE. Pharmacological approaches to the challenge of treatment-resistant depression. Dialogues Clin Neurosci. 2015;17(2):111-126. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4518696/. Accessed March 15, 2022.
4. Voineskos D, Daskalakis ZJ, Blumberger DM. Management of treatment-resistant depression: challenges and Strategies. Neuropsychiatr Dis Treat. 2020;16:221-234. www.ncbi.nlm.nih.gov/pmc/articles/PMC6982454. Accessed March 9, 2022.
5. Ruhe HG, Horikx A, van Avendonk MJP, Groeneweg BF, Woutersen-Koch H. Tapering of SSRI treatment to mitigate withdrawal symptoms. Lancet Psychiatry. 2019 Jul;6(7):561-562. Accessed March 10, 2022.

Dr. David Woo

Dr. Woo has been seeing patients in private practice since 2002, always with the goals of combining evidence-based medicine with psychodynamic psychotherapy and collaborating with other mental health professionals to ensure the best possible outcomes for his patients. He has been certified to administer TMS at his practice since 2017. His greatest clinical interests include helping patients suffering from depression, anxiety, and obsessive compulsive disorder.