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Antidepressant Withdrawal & Detox: Symptoms & Timeline

Antidepressant withdrawal is known as antidepressant discontinuation syndrome, and it involves symptoms like anxiety, insomnia, irritation, lethargy, nausea, and rapid heart rate, among others. It can largely be avoided by tapering off the use of antidepressants rather than stopping use suddenly.

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Antidepressants generally work by blocking the reuptake of neurotransmitters like serotonin into the synapses of nerve cells, which allows for greater flee-flowing availability of the chemical to regulate mood and affect. These drugs can produce significant neurochemical modifications in the brain when taken in large doses or for extended periods of time. As a result, discontinuing use can lead to withdrawal. 

What Is Antidepressant Withdrawal?

Antidepressant withdrawal refers to the symptoms that occur as the body works to rebalance itself after it has adapted to the presence of an antidepressant. When antidepressants are consumed, neurochemical changes begin to take effect that allow for them to have their clinical impact on depression symptoms. 

This can then lead to physical dependence, which is common in the case of antidepressants. It is actually this dependence on the medication that makes it effective. The removal of antidepressant medication will likely be accompanied by the presence of certain undesirable symptoms temporarily. 

What Causes Withdrawal From Antidepressants?

Withdrawal is caused by the sudden absence of a chemical that the body had adapted to, such as a selective serotonin reuptake inhibitor (SSRI). Without the presence of that chemical suddenly, excess serotonin is once again retaken into the synapses of nerve cells, and this may cause a range of symptoms, such as anxiety, sadness, and nervousness. 

Withdrawal from antidepressants can be particularly challenging and unpleasant for some people, which is why doctors recommend tapering off these medications rather than suddenly stopping use. A taper is a controlled, gradual, and progressive decline in the dosage and frequency of the consumption of a medication. 

Tapering can significantly reduce the severity of withdrawal symptoms. It also reduces the risk of relapse or the implementation of a maladaptive coping strategy, such as consuming excessive amounts of alcohol. 

What Are Common Symptoms of Antidepressant Withdrawal?

In most cases, doctors recommend gradually tapering off antidepressants instead of stopping use suddenly.

Some of the most commonly documented symptoms of antidepressant withdrawal include the following:

  • Anxiety 
  • Shakiness
  • Dizziness
  • Fatigue
  • Insomnia 
  • Agitation 
  • Flu-like symptoms, such as chills and fever

Which Factors Affect the Withdrawal Process?

The intensity of withdrawal symptoms can vary greatly based on factors like your age, sex, body size, and genetics. Two factors that apply universally for individuals discontinuing the use of antidepressants include the length of time the medication has been taken and how much has been taken

  • Length of time they have been used: Some people take antidepressants for several years and switch from one medication to another to continue to stimulate an antidepressant effect when tolerance has developed. As a general rule, taking antidepressants for longer periods of time provides more opportunity for the active ingredients in the medication to accumulate in your system. This will also make the withdrawal period more prolonged and the symptoms more severe in most cases.
  • Average dosage: Dosage also plays a key role in determining the intensity of withdrawal symptoms. As with duration, higher doses allow for more of the active ingredients in antidepressants to accumulate, leading to a longer withdrawal period and more intense withdrawal symptoms. 

How Long Does Withdrawal Last?

The duration of the withdrawal period differs based on the factors mentioned above. However, in the majority of cases, withdrawal symptoms usually appear within five days of discontinuation, which is due to the half-life of antidepressant medications, or the period of time needed for the concentration of the drug in the bloodstream to reduce by half. 

It takes approximately five half-lives for a drug to be completely eliminated from one’s system. Most antidepressants have half-lives of approximately one day or less. 

Withdrawal symptoms usually last up to one to two weeks following discontinuation, depending on the length of time you have taken the medication, the amount you have taken, genetic factors, and your tapering approach. In some cases, withdrawal symptoms can persist for months or even years.

Antidepressant Withdrawal Timeline

The timeline associated with antidepressant withdrawal is relatively linear and has not been linked with overt phases of symptom clusters. Symptoms typically begin to appear within one to three days following discontinuation and rarely beyond five. 

Symptoms then commonly last between one to three weeks. Peak symptoms of withdrawal typically occur within the first week of discontinuation. 

Most people report that symptoms are moderate and temporary, though they can be severe for some people. Taking antidepressants within the first 24 hours of discontinuation will relieve symptoms of withdrawal. 

Again, some people may experience symptoms that last for months or years, but these cases are less common. 

How to Detox From Antidepressants

In most cases, doctors recommend gradually tapering off antidepressants instead of stopping use suddenly. Your doctor will design the taper and prescribe you gradually declining doses of the antidepressant. Since your body will have a chance to adjust to the tapered doses, you are much less likely to experience withdrawal symptoms. 

There are not established guidelines on tapering dosage recommendations. The general advice is that a slower tapering schedule is preferred. Don’t attempt this on your own. Work with your doctor to determine the right tapering schedule.

Get Help for Addiction to Antidepressants

If you have been abusing antidepressants, on their own or in conjunction with other substances of abuse, help is available to help you stop. Any use of any medication outside of the parameters of a prescription is considered abuse. With comprehensive therapy and ongoing support, you can learn to stop misusing medications and build a healthy life in recovery.

Updated June 8, 2023
Resources
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  4. Antidepressant Discontinuation Syndrome. (May 2017). CMAJ.
  5. Serotonin and Brain Function: A Tale of Two Receptors. (September 2017). Journal of Psychopharmacology.
  6. Estimating Risk of Antidepressant Withdrawal From a Review of Published Data. (December 2022). CNS Drugs.
  7. Clinical Practice Guideline Recommendations on Tapering and Discontinuing Antidepressants for Depression: A Systematic Review. (February 2022). Therapeutic Advances in Psychopharmacology.
  8. Tapering Antidepressants: Why Do Tens of Thousands Turn to Facebook Groups for Support? (July 2021). British Journal of General Practice.
  9. Discontinuing Antidepressants: Pearls and Pitfalls. (January 2022). Cleveland Clinic Journal of Medicine.
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