When antidepressant medication is stopped, risks for recurrence of depression and for physical and psychological reactions are possible. All types of antidepressants can cause these risks and reactions when stopped, according to Richard C. Shelton, M.D. in the August 1, 2001 issue of "Primary Care Companion to the Journal of Clinical Psychiatry." Antidepressant medication should never be stopped without the recommendation and supervision of a physician.
Antidepressant Discontinuation Syndrome
Antidepressant discontinuation syndrome is experienced by 20 percent of people that stop taking an antidepressant medication after at least six weeks of treatment, according to the August 1, 2006 issue of the journal "American Family Physician." Symptoms of the syndrome may include difficulty sleeping, nightmares, nausea and vomiting, diarrhea, dizziness, headache, fatigue, tremors, muscle jerks, irritability, nervousness and a low mood. Some patients report numbness, tingling, a rushing sensation in the head, blurred vision and "electric shock-like" sensations. While these symptoms are usually mild and resolve within a couple of weeks, they can cause significant distress. In rare cases, serious reactions involving severe agitation, significant mental impairment and psychosis requiring hospitalization have occurred.
Relapse or Recurrence
Antidepressant medication may be stopped when depression is in remission or when a patient experiences intolerable side effects. Relapse or recurrence of depression are possible. Recommendations from experts regarding the length of antidepressant treatment to prevent recurring depression varies, ranging from nine months to several years, or possibly continuing treatment for life in some cases, according to Dr. Shelton. One feature that distinguishes relapse of depression from antidepressant discontinuation syndrome is the absence of dizziness. Symptoms of discontinuation syndrome begin within a couple of days, and usually last a few weeks. A relapse of depression typically takes a few weeks to manifest, and common symptoms include difficulty sleeping and deepening depression, Dr. Shelton says.
Prevention and Treatment of Antidepressant Discontinuation Syndrome
After the decision has been made to stop antidepressant medication, it is important to gradually reduce the dose of the drug, according to Helpguide.org. Tapering the medication slowly may prevent symptoms of discontinuation syndrome. This gradual dose reduction should be supervised by a doctor and may take up to several months, Helpguide.org explains. Even with a slow tapering of medication, symptoms may still occur, according to Dr. Shelton. He advises that reassurance and education about the syndrome can suffice in mild cases. For more severe symptoms, the same or a similar antidepressant may need to be restarted, with a more gradual tapering of the dose. If that is not possible, medications to manage anxiety, difficulty sleeping and dizziness can be prescribed.
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