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How to come off antidepressants

Dr Paul McLaren advises on best practice when it comes to easing yourself off depression medication.


By Dr Paul McLaren, Netdoctor

Battling depression is not easy, and many people have successfully recovered and improved their mental health thanks to medication. However, if for any reason you've been taking antidepressants and now want to stop, it's important to know what to expect.

Dr Paul McLaren, Medical Director at Priory Hospital Hayes Grove, outlines how to come off antidepressants safely:

Always speak to your GP before stopping taking any long-term medication.


How to stop taking antidepressants safely

How you stop depends on the reasons for coming off. If you are stopping at the end of a treatment episode, then you would do it more gradually than if you were stopping because of a lack of response or excessive side effects early in a treatment episode.
Your doctor should advise you on the sorts of symptoms which you might experience.

Make sure you talk to the prescriber before stopping. Your doctor should advise you on the sorts of discontinuation symptoms which you might experience, it is always easier if you know what to expect. A reasonable reduction regimen for coming off after completion of a treatment episode would be to reduce the dose by 50 per cent every two weeks until you get to the lowest dose pill available, which you stop after two weeks.

If you are stopping so that you can switch to an alternative, then your doctor will recommend a swapping regimen. With a few combinations you have to have a washout period, but with most changes you build the new one up while reducing the old one which reduces the risks of withdrawal.

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What side effects might you face?

Withdrawal symptoms usually last about 10 days to two weeks. They can be difficult to describe and include a general feeling of being unwell with dizziness or heaviness, like having flu, and unusual sensory experiences which are often described as 'head zaps' or ‘head shocks’. These can be unsettling if you have not been forewarned but they are not a sign of serious physical pathology.
You might experience flu like symptoms, dizziness or head zaps or head shocks.

It is important to have a relapse plan in place because even if you have been well on antidepressants for some time you could still relapse, so your doctor should talk to you about signs of relapse and work with you on a plan for what to do if they arise.


What to expect

  • Expect to feel different, even though you may not have discontinuation symptoms.
  • Plan ahead so that you can reduce the risk of additional stresses which will only add to your problems.
  • Be prepared to be flexible. It may be possible to stop more quickly than planned, or it may take a little longer.
  • Your doctor should give you options for getting in touch during the withdrawal process. Make sure to voice any concerns or worries you have, because internalising them will only worsen the situation.

Mental health support

If you are struggling to come off antidepressants and need help and support, try one of the following resources:
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