Antidepressants are prescription medications indicated for the treatment of major depression and bipolar depression. There are several classes of antidepressants; most boost serotonin levels, while some also work to increase dopamine and norepinephrine. When patients decide that it is time to stop taking their medication, they may experience withdrawal symptoms, clinically known as antidepressant discontinuation syndrome. The withdrawal symptoms can vary significantly depending on which class of antidepressants were taken, the dosage and duration of treatment. In addition, withdrawal symptoms also depend on whether the patient abruptly stops or tapers off in small increments.
Neuropsychiatric Symptoms
Patients experiencing antidepressant withdrawal may feel several neuropsychiatric symptoms. These effects can take place within a few days after stopping the medication and usually last an average of five days, but can last up to three weeks. In the November 2007 issue of "Advances in Psychiatric Treatment," Dr. Peter Haddad and Dr. Ian Anderson list several symptoms including irritability, anxiety, agitation, low mood and tearfulness. In addition, in the August 2006 issue of "American Family Physician," Dr. Christopher Warner and associates include several psychotic features associated with antidepressant withdrawal. Patients may experience visual and auditory hallucinations, delusions, confusion and severe muscle rigidity or looseness, known as catatonia. In their report, they state that psychotic symptoms are nearly exclusive to patients who have discontinued antidepressants that inhibit monoamine oxidase. This class of antidepressants is usually only used when safer antidepressants have failed to provide relief.
Movement and Sensory Symptoms
Withdrawal from antidepressants can also cause movement and sensory irregularities. In the study by Drs. Haddad and Anderson, they list several symptoms including numbness, tingling and stinging, electric shock-like sensations, rushing noises in the head, visual trails, light headedness, dizziness and vertigo. In addition, in the study by Dr. Christopher Warner and associates, they also list restlessness, uncontrolled muscle jerks, Parkinson's-like movements and tremor. These symptoms are most common in typical serotonin reuptake inhibitor antidepressants as well as the older class of antidepressants known as tricyclics.
Other Physical Symptoms
Patients who discontinue their antidepressants may also experience physical symptoms that affect sleep, digestion and other physical symptoms. In the study by Drs. Haddad and Anderson, they reported that patients may experience: nausea, vomiting, diarrhea, insomnia, nightmares, excessive dreaming, weakness and fatigue, headache, excess sweating and anorexia. In addition, in the study by Dr. Christopher Warner and associates, they also include flu-like symptoms, abdominal cramping and abdominal pain. Medications that affect serotonin, not only alter moods, but also affect the gastrointestinal system. Appetite, depression or state of well being are all affected by a person's level of serotonin. There are several medications that patients can take during their withdrawal period, but patients should consult their physician in case of the medications have habit forming potential.
References
- "Advances in Psychiatric Treatment"; Recognising and Managing Antidepressant Discontinuation Symptoms; Dr. Peter M. Haddad and Dr. Ian M. Anderson; November 2007
- "American Family Physician"; Antidepressant Discontinuation Syndrome; Dr. Christopher Warner et al.; August 2006
- IMS Health: TopTherapy Classes by U.S. Prescriptions in 2009
- "Primary Psychiatry"; Antidepressant Discontinuation Syndrome; Dr. Donal Robinson; October 2006
