When patients have depression or anxiety disorders, their doctors may prescribe an antidepressant, which increases levels of certain mood neurotransmitters. For example, reuptake inhibitors, like serotonin reuptake inhibitors, prevent the targeted neurotransmitter from being recycled, leaving more for the brain to use, thus improving symptoms. When patients no longer need these medications, they may stop taking them, though some people may have withdrawal symptoms.
Prevalence
People who experience withdrawal symptoms from antidepressants have them after stopping the medication suddenly after at least six weeks of use. Antidepressants take six weeks to take effect and start helping with the symptoms of the mood or anxiety disorder. The authors of the article “Antidepressant Discontinuation Syndrome” published in the August 2006 issue of the journal "American Family Physician" point out that 20 percent of antidepressant users have withdrawal symptoms. These symptoms can last for one to two weeks.
Withdrawal Symptoms
Daniel K. Hall-Flavin, MD, a Mayo Clinic psychiatrist, explains that people who have antidepressant discontinuation syndrome, or antidepressant withdrawal, do have symptoms that can interfere in their lives. For example, people may have anxiety, sadness or mood swings after stopping their antidepressants suddenly. People may become irritable or agitated. Sleeping problems can occur, which include fatigue and insomnia. Other withdrawal symptoms include nausea, dizziness, headaches, stomach pain and tremors.
Withdrawal Symptoms of Antidepressants versus Addiction
Because a person has withdrawal symptoms does not mean that he is addicted to the antidepressant. Hall-Flavin explains that antidepressants are not considered an addictive substance. Antidepressants work by adjusting the patient's brain to a normal chemical balance, while addictive drugs elevate neurotransmitter levels that result in the high. People who use addictive drugs, such as heroin, have withdrawal symptoms because they develop tolerance and physical dependence. Antidepressants can cause withdrawal symptoms because people are just adjusting to the change.
Avoiding Withdrawal Symptoms
Antidepressant users can prevent withdrawal symptoms from occurring by tapering off their usage. Helpguide.org recommends that patients coming off an antidepressant should use the reduced dosage for one to two weeks before lowering it again. By doing so, antidepressant users come off the medication over several months instead of suddenly. When coming off an antidepressant, patients should do so under the guidance of their doctors.
Reemergence of Depression
Patients who take antidepressants for a depressive disorder, like major depression, have a risk of symptoms returning if they stop using the antidepressant. Hall-Flavin points out that it may be difficult to differentiate between returning depression symptoms and antidepressant withdrawal symptoms. In cases where the depression returns, patients may need to restart the antidepressant regimen.
References
- “American Family Physician”; Antidepressant Discontinuation Syndrome; Christopher H. Warner, Maj, MC, USA; William Bobo, LCDR, MC, USN; Carolynn Warner, Maj, MC, USA; Sara Reid, CPT, USAF, MC; and James Rachal, Maj, USAF, MC; August 2006
- MayoClinic: Antidepressant Withdrawal – Is There Such a Thing?
- Helpguide.org: Antidepressants – What You Need to Know About Depression Medications
