Medical Edge Newspaper Column

Symptoms from Antidepressant Withdrawal Can Be Reduced by Tapering

Novemeber 20, 2009
Dear Mayo Clinic:
I'm taking an antidepressant and am concerned that when my doctor instructs me to quit taking it I'll go through withdrawal. Can this happen? What can I expect?

Answer:
It can happen, but when withdrawal symptoms occur, they're usually — but not always — mild and can often be reduced or avoided by tapering off the medication.

It's estimated that withdrawal symptoms can occur in about 10 to 20 percent of people who abruptly stop antidepressant therapy after taking it for longer than six weeks. In addition, it's more likely to occur with antidepressant medications that are more quickly metabolized, such as paroxetine (Paxil) and venlafaxine (Effexor). Withdrawal is less of a problem with longer-acting drugs such as fluoxetine (Prozac).

Symptoms of withdrawal usually occur within days of drug discontinuation. They may include flu-like signs and symptoms such as fatigue, aches, diarrhea and nausea, insomnia, a dizzy or off-balance feeling, sensations of electric shocks, anxiety, or agitation. It's thought that severe withdrawal symptoms may be related to factors other than withdrawal, such as a re-emergence of depression. More typically, if depression does recur, it returns gradually and takes many weeks to develop.

If your doctor feels that stopping your antidepressant drug is in your best interest, be sure to develop with your doctor a plan for tapering off.

Keep an open dialogue with your doctor regarding your signs and symptoms. Sometimes people mistake the physical symptoms of antidepressant withdrawal with a return of depression, and this can lead to unnecessary worry. Still, depression can recur, in which case your doctor may recommend resuming antidepressant therapy.

— Elliott Richelson, M.D., Psychiatry and Pharmacology, Mayo Clinic, Jacksonville, Fla.