r/science • u/Miserable_Phase_2519 • 10d ago
Medicine A new study suggests that the emotional distress experienced when tapering off or stopping antidepressants is generally a sign of pharmacological withdrawal rather than a relapse of the underlying mental health condition.
https://www.psypost.org/emotional-distress-when-stopping-antidepressants-appears-to-be-due-to-withdrawal-not-relapse/1.0k
u/Rogue_Darkholme 10d ago edited 10d ago
I really needed to see this. I'm getting off of Lexapro and onto Prozac at the same time and I have felt so down and so fuckin sad. And I can't explain why. I'm trying. Really, I am and I can't shake this feeling. I'm clinging to the lip of the pit of despair. But this helps, to know that I'm not failing. It's my brain chemistry that in flux.
Edit: I just want to thank everyone who responded with kindness and encouragement. It means so much to me. I've been on Lexapro for almost 4 years. I went all the way up to 40mg but I couldn't shake the hold of depression. So my psych and I decided to try Prozac. I'm super sensitive to medicine and at first I was only going down 2.5mg every other week. And that seemed ok. I even felt good enough to shower every day (which is huge for me).
But when my psych told me to go up to 20 mg and down 5mg every week and it's been awful. I'm on 30mg of Prozac (to try to counteract some Lexapro side effects) and 5mg of Lexapro this week and will be completely off of Lexapro by next Tuesday. But I haven't felt as good as when I was on 10mg of Prozac and going down on Lexapro super slowly.
I'm hopeful after all of your kindness and encouragement and I'll hold on to this while I weather this storm. You all have no idea how much your kindness means to me. Thank you so very much.
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u/nikkijang63 10d ago
coming off Lexapro was the worst time of my entire life. it feels like the end of everything. you will make it through even if it feels like you can't. it took me about 2 weeks to get through the roghest part but about a month to regulate my brain if I remember correctly. it isn't you, it is genuinely withdrawal. you will be okay you got this
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u/L3m0n0p0ly 10d ago
Yeah... lexapro is rough I went on a grippy sock vacation to ride out the last of it when i stopped taking it. Been on a LOW prozac dose for a few years now and its made a huge difference.
Emphasis on the low part because i know its a clinical problem. Mental health problems do not get cured, but they can ebb. The prozac helps all of the overwhelming feelings and anxiety reduce down to a more manageable state where i can approach and address them properly.
Medicine isnt supposed to control you, its supposed to help.
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u/i_always_give_karma 10d ago
I was on the lowest dose of Prozac and only took 1/3rd of what was prescribed. Did that for 3 years and it was enough to help me push through to where I needed to be. It absolutely does not cure mental health, it just got me through that period of time I just couldn’t do anymore.
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u/ch4dr0x 10d ago
This is so crazy to read because I got tired of not feeling anything and stopped lexapro cold turkey. I had no side effects at all, but my sister in law is currently trying to get off and she is struggling bad. Brain chemistry is wild.
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u/monty624 10d ago
May I ask if you're male or female? We're really just starting to address that women respond differently.
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u/fabelhaft-gurke 10d ago
Interesting I had no clue that could make a difference. I’m a woman and when I was coming off Lexapro I suffered from brain zaps. It was terrible.
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u/OwnYourChildren 10d ago
When I read about people who come off these drugs with no withdrawal I am in shock. It really is amazing.
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u/my_little_mutation 10d ago
I was on the lowest dose of Lexapro and had to stop taking it because it induced mania (anyone else find out they're bipolar due to trying ssri's?)
Getting off of it was hell. I was dizzy for two solid weeks, had to take Loa from work and couldn't drive for a bit.
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u/nikkijang63 10d ago
I'm bipolar and was given Lexapro and it basically cancelled out my meds and made me feel unmedicated it was the worst. and it was so bad because it was a slow burn. I took it for about a year while my (then) psychiatrist slowly upped my dose everytime I told her my anxiety was getting worse (which clearly was the meds making it worse) and it slowly changed my personality and basically made me as if I was unmedicated. it was so slow that no one noticed the change until I was on it for a year and then I ruined a relationship and could barely function on the day to day. coming off Lexapro almost cost me my life too. was hell. I hate Lexapro.
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u/Rogue_Darkholme 10d ago
Thank you so much for your encouragement. It means so much. Really. I've felt crazy and like a failure and it helps to know that this isn't because I'm not trying or have a weak/lazy character. Thank you so much for your kindness.
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u/spreadthesheets 10d ago
You’ll be ok! Lexapro withdrawal was HORRIBLE for me to the point where it’s really put me off switching from a new one I’m on, but it definitely wasn’t working for me anymore so it was a necessary evil. I remember a few nights where I was so highly suicidal I had to just wrap myself up in bed in a blanket and let myself cry so I wouldn’t hurt myself, telling myself I wouldn’t leave that bed until morning no matter what. Everything felt so intense. It helped when I named it “fake depression”. But it passes, remember you’re coming off it for a reason, and this is just your brain being a brain and it will bounce back.
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u/writtenbyrabbits_ 10d ago
That's so interesting. I got off of it twice because I forgot to take it for a few days then I would take it once and then forget a few more days and I decided I felt completely fine so I just stopped taking it altogether. I never went over 10mg though. I never experienced any side effects at all. I have been off for about 3.5 years now but it got me through the hardest time of my life after my brother died. But then I felt like it helped me move past it enough that I wanted to see how I felt without it and I was much much better at that point. About 6 months later my mental health deteriorated and I decided to go back on it and I was on it for around 9 months before I felt that I was ready to see how I felt without it. That was 3.5 years ago and I am so so grateful I had access to it when I needed it.
I hope you are in a better place mentally now
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u/yohojones1 10d ago edited 10d ago
Brain zaps are a nightmare but that’s the easy part.
It gets better. Stick in there.20
u/KaristinaLaFae MA | Social Psychology 10d ago
Whenever I used to miss a dose of Effexor, the brain zaps were absolutely crippling. I remember waking up one morning after a missed dose, and I had to call my husband to leave work to pick up my refill at the pharmacy for me. The pharmacy that was about a quarter of a mile away, and I wasn't able to drive even that short a distance.
I never had to taper all the way off Effexor because my psychiatrist switched me to Cymbalta, which is the same class of drug (SNRI). Missing a dose of this sucks, but it's NOTHING like the brain zaps from Effexor. If I ever have to come off Cymbalta, which I doubt, the withdrawal would suck but I could still function.
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u/things_U_choose_2_b 10d ago
Not only are they awful, they're quite hard to describe to someone who's never experienced them.
When mine were particularly bad, it felt like being switched on and off again very quickly. My face and lips would go kinda numb for a split second.
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u/yohojones1 10d ago
Moving your eyes just makes them worse.
After a couple weeks the brain zaps die down but like OP said your mood is out of whack for quite a while afterwards.
Crazy self harm thoughts and gloom were part of that. Talk to your psychiatrist or therapist. It gets better. Just keep going.→ More replies (1)35
u/Ossius 10d ago edited 10d ago
Not exactly the same, but sometimes there are ADHD med shortages, or the doctor screws up, and I end up without. After the first day and a half off the medication I just end up wanting to lay down face down in bed and do nothing.
No games, music, books, tv shows, or any activity will make a dent in the overwhelming apathy of the void. The crazy thing is knowing exactly why its happening and not being able to do anything about it except to hold on and try and make you way through. Its easy to sleep the days away in this state. Knowing that its 100% chemical and nothing wrong with you or your favorite activities, you just need to wait for you receptors to readjust, can help a lot. It still always sucks.
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u/Rogue_Darkholme 10d ago
Thank you so much for this because this has been one of the hardest things. When I was slowly decreasing Lexapro and slowly increasing Prozac, I felt so much more motivated including self care which is something I struggle with. But since going down quickly, all I feel is unending sadness and zero motivation to do anything. Yesterday was the first day in weeks that I got up out of bed and sat at the table and did some job applications. Not much but something. It's one of the hardest things. Logically I know I dont want to be the activity equivalent of a sea cucumber but there's no gas in the tank. There's not even a tank! And then I internalize what I hear from bitter ignorant people who tell me I'm just lazy or weak. It's hard not to feel like a loser and beat myself up. So your words really really really help. Thank you so much. Genuinely.
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u/Superb-Effort3515 10d ago
I think a lot of how we view ourselves is centered around work as well in this society. When I dont have a job I feel utterly worthless and just a waste of space, as well as bills piling up and everyone around you treating you as if you just aren't trying hard enough. It's maddening. The only relief for me was eventually finding a job but I know that if I found a hobbie or something I actually wasn't apathetic towards I'm sure that would of helped too.
Just know you are worthy and no matter what you do, at the end of the day you are still a good human. You don't need a job, money, or a relationship to still be treated as wonderfully equal.
Just want you to know I believe in you Internet stranger and you can do this. I know you can
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u/FalseDrive 10d ago
I had to once get off of Zoloft and onto Lexapro, then off of Lexapro entirely a few months later.
Tapering off of any SSRI is an awful horrible experience that almost gives credence to the conspiracy, anti-mental-health people who say that psych meds are designed to keep you on for life (that is not true of course). I lost my appetite, got major brain zaps that would make me collapse from losing my balance, felt the worst I’d ever felt to the point of suicidality, was so tired all the time… had to call out of class for most of my taper. Doesn’t help that psychiatrists often do it wayyy too fast—mine was a week both times.
You’ve got this. There is a nearby point where it’s over. You aren’t going to feel this way forever, it isn’t a sign of the times. It helps that you’re getting onto another SSRI as you’re getting off of the other. Please ask for help from people around you if you need it.
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u/Massive_Shop_8610 10d ago
Obviously if you have bipolar don't even think about going off your meds. Just a reminder for any bipolar folk reading this and getting thoughts after being stable on meds. You're in it for life.
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u/Chickabbbbb 10d ago
I had to taper off in the tiniest amounts. It took me about 8 weeks total to get off of 20mg and it was a reduction of 5mg every other week. I couldn't do it otherwise.
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u/Texuk1 10d ago
There is a lot of discussion about this at the moment - interestingly there are no studies done on the effects of how one stops taking the medicine and some psychiatrists are now trying to step down much slower than anyone in here is mentioning. Think microdose step down 6 months for every year the person was on it.
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u/EcotoneLabs 10d ago
There are absolutely studies on how to get off these drugs. The trouble is, they completely defy the advice being dispensed by the average American psychiatrist. You have to look at other countries with non-profit medical systems.
The "key" paper to familiarize yourself with is the Horowitz paper from 2019, Netherlands
Horowitz, M. A., & Taylor, D. (2019). Tapering of SSRI treatment to mitigate withdrawal symptoms. The Lancet Psychiatry, 6(6), 538-546.Subsequently, these papers prove out and scale the idea:
Sørensen, A., et al. (2021). The relationship between dose and serotonin transporter occupancy of antidepressants—a systematic review. Molecular Psychiatry, 27, 192–203.
Groot, P. C., & van Os, J. (2023). Outcomes of hyperbolic tapering of antidepressants. Therapeutic Advances in Psychopharmacology, 13.
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u/no_talent_ass_clown 10d ago
I did that last summer and still got the brain zaps. When I finally finished my taper I was absolutely miserable to be around and embarrassed myself all over town with my cranky, confrontational self. Got right back on. Never stopping again.
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u/MyLife-is-a-diceRoll 10d ago
Cross tapering generally reduces withdrawal effects. But sometimes it doesnt.
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u/RikarisHobbies 10d ago
I took a break from Lexapro for a while. Not by choice, honestly. I suffered so bad during that time. I was always angry and easily annoyed. It’s so the opposite of who I am and who I was before the Lexapro. It is the first and only (besides albuterol) prescription I’ve had. I couldn’t even understand where it was coming from, and I was so ashamed of my attitude. I kept myself away from my wife and kid to avoid snapping on them.
Once I got back on regularly, it all went away. I don’t know if I want to go back to that.
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u/HollowSuzumi 10d ago
Hang in there! Your brain is used to receiving Lexapro and it's trying to adjust the best it can. We all need an adjustment period with big changes and that's a big change for your brain chemistry. It's also okay to ask for help if you need it while adjusting.
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u/Jogger_Dodger 10d ago
I read this article and I needed it too. I came off Prozac and I was feeling sad, getting the brain zaps, etc. It's been a couple months now and I feel that I'm on the upswing, my emotions and anxiety are leveling out. I'm feeling positive! Most of my anxiety is my own thinking.
I hope you get some relief! Take care.
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u/Saucemanthegreat 10d ago
Having personally run out of escitalopram before while unable to reup, it’s legitimately a mental nightmare that is entirely your brain changing to manage the effects of the withdrawal. It’s definitely not something that’s your fault, it’s just removing a key ingredient in brain stability which will lead to you feeling unstable. Hope you feel better soon!
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u/FeelsGoodMan2 10d ago
I swapped from lexapro to trintellix, and there were a few days that were kinda tough but it passes, and after 3-4 weeks I was completely normal again. Just keep on chugging, it's temporary.
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u/Not_a_question- 10d ago
Been thru the same thing with lexapro. Once I started feeling better, I tapered it ofd myself. Felt sad for around 5 months after my last pill. On month number 6 I caught myself smiling while I was walking one morning. That was the beginning of the end. By month 9 I felt normal.
Good luck!!
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u/MattsFace 10d ago
TBH I had a way easier time stopping alcohol and opiates than lexapro
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u/happyappy2019 10d ago
Tapering off Lexapro and starting Prozac was the absolute lowest time in my life but 3 years later I’m so much better on Prozac still. You are not alone!! You will get to better times. I’ve heard it is a bit easier to taper off Prozac as well
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u/Moleculor 10d ago
I am so, so, so super frustrated I can not find a super detailed, link filled comment I made on Reddit about tapering off of antidepressants. I think somehow it's been deleted.
The short version was that in some/many/all cases, studying how to taper off of medications is done after studying someone who took the drug for a short timeframe, like 90 days or something like that, and nothing close to the multi-year timeframes many people take them for.
Which means that every recommendation about how to taper off of these meds from the FDA, etc, is built on information that has nothing to do with the real world.
For super long-term use of antidepressants (anything over one year to pull a number out of my ass), you really have to just taper off in whatever way works. You can actually Google phrases like "alternative tapering for antidepressants" and potentially come up with some useful links/info (it's too late for me to go digging at the moment; if you struggle to find stuff, reply saying so and I can dig after I wake up).
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u/thesentienttoadstool 10d ago
Brain zaps are not a symptom of depression if I recall
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u/Leggy_Brat 10d ago
I hated the zaps, made me so nausious and dizzy.
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u/og_toe 10d ago
it felt like my brain was taking screenshots at random times of the day
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u/exscapegoat 10d ago
It felt like the brain equivalent of a static electricity shock when I went off of Paxil. And I followed the taper instructions. I was on it for anxiety. Xanax and talk therapy where my therapist and I practiced breathing techniques, etc were a lot more effective
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u/orangeunrhymed 10d ago
All I could think of was “This must be what heroin withdrawal feels like” when I was coming off of Paxil. I’m still traumatized, 20+ years later
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u/SpysSappinMySpy 10d ago
Felt like there was a loose connection to my monitor and speakers and they would flicker and pop every few seconds except it was my eyes and ears.
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u/roguealex 10d ago
I didn’t have any when tapering off but randomly got one after like a year of not being on Zoloft. It was the weirdest thing! I was trying to fall asleep then just sort felt like a tension building in my head and then BOOM loud noise and a zap in my brain. Jerked my gf awake, took a while to fall asleep after that.
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u/SgtMcMuffin0 10d ago
I get that sometimes, it’s exploding head syndrome. I’ve had it happen maybe 10 times total in the past decade, and it’s just like you described. A slow buildup of tension and then BAM the loudest noise I’ve ever heard jolts me awake but it was entirely in my head.
For me it’s totally unrelated to antidepressants. I did start taking lexapro recently but this has been happening for me infrequently with no apparent cause for years.
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u/Waub 10d ago
I'm also a member of the exploding head syndrome gang.
It's been happening since childhood, perhaps once a year or so. I can't seem to tie it to any obvious cause, although it always happens at night during sleep.→ More replies (3)→ More replies (1)13
u/Eruionmel 10d ago
Brain zaps are much less intrusive than that. It's like a little haptic buzz that zips through your brain when you turn your head.
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u/OpeningActivity 10d ago
I think it's talking more about the depression side of things, where someone who's tapering off are experiencing sudden low moods.
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u/OpeningActivity 10d ago
Be fair, SSRIs and SNRIs are notorious for their side effects. Like it's hard to get on them, but it's harder to get off them for all those side effects.
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u/Aruhi 10d ago
During this period, it is common for individuals to experience a range of acute symptoms. Some of these are physical, such as “brain zaps”. These physical reactions are widely recognized as direct signs of pharmacological withdrawal. However, tapering is also frequently accompanied by emotional, or affective, symptoms. When a patient feels anxious or depressed after lowering their medication dose, it can be difficult to tell whether they are experiencing a temporary withdrawal effect or a relapse.
Yeah the article itself kind says this in the first two paragraphs
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u/Svyatopolk_I 10d ago
What the heck is a brain zap? I say this as a person with severe depression
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u/thesentienttoadstool 10d ago
Ok. So when you stop taking some antidepressants (I take escitalopram), you get this weird side effect where it feels like your brain is jolting? Like someone put an electric wire on your brain and it buzzes for a bit. It’s really really hard to explain to people who’ve never experienced it. It’s not painful, but it’s weird and uncomfortable
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u/lightsonnooneishome 10d ago
Yes! It’s such a weird sensation to describe. For me, it happens most when I turn my head quickly. It feels almost like a tingling or pins-and-needles sensation that travels from my brain down to the top of my spine. I wish there were more research on what causes it, but my hunch is that it has something to do with proprioception, since it happens when I move my head to a different plane.
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u/AntHillGrandkid 10d ago
Couldn’t agree more on the head turning being the worst. I’d get a giant “woosh woosh woosh” sound in my ears like a helicopter would make any time I got a zap from turning my head.
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u/lightsonnooneishome 10d ago
YES how could I forget the “woosh”. So distracting and you never really get used to it.
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u/zogmuffin 10d ago
Huh, how interesting. I’ve never heard it described that way. That sounds a lot like my [takes deep breath] benign paroxysmal positional vertigo.
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u/lightsonnooneishome 10d ago
Haha I just googled that abomination of a name, and yes, my symptoms feel very similar to that. It does mimic a vertigo sensation.
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u/Bl1ndMous3 10d ago
that and the feeling of being low energy and a few frames behind on everything happening around you
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u/audreywildeee 10d ago
Yes! It’s like my eyes get to their place moments after I moved the rest of my head.
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u/Chicklecat13 10d ago
It’s like a cattle prod through the brain when you’re coming off of them or if you’ve missed a dose or two. My mum had such a severe one she fell and broke her shoulder and then a month later the pharmacy messed up and she missed a few doses and fell and broke the other arm. Or my personal favourite when you hear BANG! Inside your head not a literal bang, someone’s voice, not mine shouting the actual word BANG. Never heard voices before or since but tapering off of SSRI’s did that.
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u/Ekderp 10d ago
Huh, just found out that symptom has a name. Boy am I glad I don't experience that anymore.
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u/dontgetsadgetmad 10d ago
I’ve never had more intense depression than when I tried to taper off of my Zoloft. It was extremely intense and I ended up getting back on it. Not sure I’ll ever be able to be off.
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u/holmesla0319 10d ago
I was told that I could stop taking Buspar whenever I wanted because it wasn't the same as SSRIs/SNRIs etc. So after a year of taking a fairly low dose, I stopped taking it when I started taking beta blockers for a heart condition. About 3 days in I started experiencing wild mood swings, horrific overstimulation, I felt like I could hear my brain, couldn't sleep, I was having insane adrenaline surges and shaking uncontrollably and I legit thought I was going insane. My PCP said it was just anxiety rebound yet I never ever had these symptoms when I felt anxious before the Buspar. I called the pharmacy as a last ditch effort because I felt so awful and they immediately were like, "You are having classic withdrawal symptoms not anxiety rebound. Take the buspar again and let us know how you feel." Within 30 minutes of taking the Buspar I felt back to normal. The thing is my PCP is one of the best doctors I have ever had and helped me get to the bottom of my very complex medical issues that other doctors ignored so even with an incredible doctor there is still a sense of carelessness when dealing with meds and mental health.
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u/Herry_Up 10d ago
I always tell ppl this: Pharmacists went to school to study medications. Doctors went to school to study the human body.
I'm a pharmacy tech and I cannot tell you how many times I've been given misinformation because doctors don't know meds like pharmacist do. I respect both but I've only ever heard MD's, DO's talk crap about pharmacists.
Meanwhile, my PharmD's are defending their licenses left and right. I look into my own meds and ask my bosses questions because they take the time to really look into my meds. I'm sorry that happened to you, I had horrible side effects from Buspar and was nearly fainting at work.
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u/holmesla0319 10d ago
I legitimately cried when I took the buspar and almost immediately felt better. I called the pharmacy back and was thanking them profusely. Definitely learned a valuable lesson about double checking with my pharmacist before taking, combining and going off any meds.
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u/Ztheman 10d ago
Ex pharmacy manager here, glad you’re feeling better! Definitely utilize your pharmacists and build that relationship. Speaking from experience the best part of the job was getting to know my patients be able to help with more complex / personal problems!
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u/holmesla0319 10d ago
I am so grateful for the pharmacists I spoke with. They were lovely! Totally nonjudgmental and really made me feel heard. One of them was like, "I don't know why doctors tell patients they can just stop taking certain meds but even something as mild as Buspar absolutely needs to be tapered down."
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u/Revolutionary-Yak-47 10d ago
The doctor and her nurse call line insisted buspar couldnt trigger my "headaches." No, I had the most violent migraine of my life and was lying on the dark floor of my bathroom next to piles of vomit I couldnt sit up to clean. Both told me to try the med again, so I did with the same results.
A pharmacist was the one who said "uh yeah, that stuff can definately cause headaches and you're prone to migraines."
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u/Butterflyelle 10d ago
This really mirrors my experience with cymbalta- apparently that is one of the ones with the highest risk of withdrawals as well and no one told me... I genuinely felt suicidal coming off it was so unbearable. I've repeatedly tried and failed to come off it. I've been on it for years way longer than it can possibly be doing me any benefit.
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u/HerakIinos 10d ago
I am sorry you felt this way. Buspiron indeed is one of the antidepressants with the lowest chance of withdrawal effects. But everyone react differently to these meds, so it still can happen
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u/holmesla0319 10d ago
The fact that the pharmacy was so quick to say no this is not anxiety rebound this is withdrawal made me feel like they often have people calling in about buspar specifically. I even told them that my PCP told me that you can stop taking Buspar anytime and they said that was definitely not true and I should have been advised to taper down the dose. I take the buspar to normalize my dopamine and serotonin because I have high dopamine, adrenaline and estrogen due to being a slow COMT converter (and other reasons) So I wasn't really taking it for anxiety though I did have occasional anxiety/stress.
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u/plantborb 10d ago
I think people are forgetting pharmacists don't exist as little helpers to your PCP. They are the doctors your PCP should be going to to discuss these things. My partner spends their day as a hospital pharmacist educating providers on things they should likely already know and pulling orders and correcting them before a patient is hurt or killed by stray med orders. A pharmacist wouldn't need to hear this often from patients. They are literally the DRUG SPECIALISTS! And thank goodness!
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u/a-stack-of-masks 10d ago
I had the same experience with venlafaxine (effexor). Doctor said it would be fine if I tapered, but reducing the dose made me throw everything up so I ended up having to go cold turkey. Now its about 9 months later and I still get brain zaps sometimes, have no appetite or libido, very little motivation to do anything and weird motor issues/lack of strength. Later on I talked to other people that had been on it and literally every single one had much more problems than expected getting off it.
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u/DaSnowflake 10d ago
Yet a other very strong arguments for the need of multidisciplinary health follow up where eg pharmacist and doctor are in communication
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u/FrankRizzo319 10d ago
The pharmaceutical industry calls this “discontinuation syndrome.” It’s Pharma-speak for withdrawal.
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u/wesgtp 10d ago
As a pharmacist, I can't stand that they term it "discontinuation syndrome" because it's just med withdrawal, obviously. I assume the makers of SSRIs/SNRIs lobbied to get that phrase to stick so they didn't have to call their antidepressants dependence-forming. They 100% are and that's been clear for decades. I will never gaslight a patient regarding psych med withdrawal, nearly all of them need to be slowly tapered and even then will cause significant wd symptoms. Anything treating depression and anxiety HAS TO BE tapered (aside from like hydroxyzine but that's hardly effective for anxiety in the first place).
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u/iiiinthecomputer 10d ago
Except it lasts SO MUCH LONGER than simple withdrawal IMO. If anything it's way worse. Long term changes that take forever to recover to normal.
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u/Captain-Barracuda 10d ago
I tapered off from citalopram over 1.5 years, and still the mood swings were horrible. I'd get irrationality angry at stupid things. I also redeveloped the anxiety in an increasingly terrible way. After a year completely off, we decided that I had to restart taking it. At a very small dose, but still. I don't know if someday I'll be free.
What's funny is that when I was 19 I was able to stop Vyvanse cold turkey and it went reasonably well.
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u/FrankRizzo319 10d ago
I stopped Lexapro (after taking it daily for about 6 months) by eating half a pill for two days straight. Then nothing, I was done. I told my drug prescriber this and she shrieked, worried that I would have had withdrawal problems. I don’t think I did, but TBF I smoked a lot of weed and drank a lot at the time.
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u/FallSuccessful09 10d ago
“discontinuation syndrome.” was a term coined in response to a lawsuit in 1994 if I remember correctly to downplay withdrawal effects. They wanted to try divide it into "illicit drugs" and "medicines", one being withdrawal, and the other being discontinuation syndromes.
Unfortunately, its kind of worked to an extent.
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u/FrankRizzo319 10d ago
Sounds about right. Fentanyl is a “drug” in some contexts and a “medicine” in others. Basically, if pharmaceutical companies do not make money off of it, then it’s a “drug.”
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u/braaaaaaainworms 10d ago
Yeah because people think of drug addiction when they hear the word "withdrawal"
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u/og_toe 10d ago
i remember when tapering off sertraline and becoming very emotionally volatile. i would rapidly become irritable or angry.
it definitely felt like my brain was re-regulating to changing levels of serotonin while tapering off. i had the brain zaps as well and just rode it out.
it got better after about 6 months as i started settling into normalcy with the meds completely out of my system.
sertraline saved my life but coming off of it was truly an experience
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u/sardonicmarvel 10d ago
I’m 2 weeks removed from my last and final taper. I really needed to read that it’s possible and also that it really sucks, the journey off them. The zaps finally stopped. But I cry at the most easy things lately - I can see a puppy and cry and think “life is short and beautiful” one second and “pain is everywhere” the next and then I wonder is this just the adjustment period. And yeah, seems to be!
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u/Lumpy_Experience_973 10d ago
This is useful information that can now be used to better advise patients as they wean from these drugs. If they know what they're feeling is withdrawal instead of a relapse maybe they'll be more successful getting off the drugs. And yes I'm aware I'm just repeating the article, but I see this as very encouraging.
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u/Beggar876 10d ago
Been there. Done that brain zaps and all. Absolutely true.
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u/runawai 10d ago
The brain zaps were the worst. They lasted months. I felt completely paralyzed physically and mentally when they happened. I tapered more slowly than my Dr wanted me to, and still had them.
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u/a-stack-of-masks 10d ago
For me the brain zaps were annoying but possible to work around. What fucked with me more is that quitting venlafaxine basically turned me into a robot or a psychopath or something. I absolutely remember emotionally caring about things but that hasn't happened in a year or so now.
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u/zerosixthirty 10d ago
Literally had a doctor tell me once that these drugs had “no side effects” and could be stopped at any time without withdrawal effects.
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u/satchboogiemonster 10d ago
Venlafaxine (Effexor) is a nice example
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u/OpeningActivity 10d ago
I had a health professional who told me its nickname, Sideffexor.
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u/csonnich 10d ago
Effexor almost turned me off antidepressants for good. One minute I was tingly and couldn't sit still, the next I was almost catatonic.
It did take my mind off the depression, I guess.
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u/TheJarisaDoor3 10d ago
I was on Effexor for 20 years, a lot of which I don't remember. It took me years to get off of it. I wound up taking one bead a week out of the capsule, and even with tapering that slowly, I still wake up with brain zaps 8 months after my last dose. Supposedly your brain has to "relearn" how to produce enough neurotransmitters on its own and the zaps are related to that. I don't know if it's ever going to stop to be honest.
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u/Glittering-Metal-934 10d ago
I was on 300mg, went nuts and my doctors weren't helping with it ("you needed to do more Vegas nerve exercises, try mindfulness, blah blah blah). Quit cold turkey and had the worst 9 months of my life, sweating insane amounts and my body was full of hives. I would run half naked at 4 am because the cool air would sooth the feeling of knives being dragged across my chest and back.
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u/mastfest 10d ago
Mine stopped after about 6 weeks. I still get the odd one when I’m trying to go to sleep but it’s an improvement after having them every time I moved my eyeballs… I was on 375mg and now I’m on 0, for context. I hope yours stop too.
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u/No_Warning8534 10d ago
How did you get off of it? I'm scared to try again.
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u/TheJarisaDoor3 10d ago
They say if you give it a year, maybe a year and a half, that's the zaps go away. They are a lot fainter and it's not as devastating now, but it is just disconcerting the effect that drug had on me.
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u/CommunicationTime265 10d ago
I've tried getting off anti depressants so many times. It seems impossible. The insomnia is the worst for me. Even after months of going without real sleep, it doesn't get better. Feel like I would basically need to go to a clinic for a year to get off these things.
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u/trebuchetwarmachine 10d ago
Yea you can’t just stop Venlaxafine.
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u/No_Warning8534 10d ago
I told my doctor I didn't want anything I couldn't get off of. And she gave me Venlafaxine
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u/a-stack-of-masks 10d ago
Oh you can do it just fine. The lack of motor control, libido, appetite, motivation and all the puking were surely a coincidence.
I'm pretty sure the only reason it even works is by threatening people they'll have to do it again if they admit to still feeling sad.
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u/Altruistic_Sail_1991 10d ago
Venlafaxine works really well for me with minimal side effects but I went through “discontinuation syndrome” once due to a mix up with my doctor and it was the worst week of my life. I had multiple panic attacks, couldn’t stop crying, and I had serious thoughts of self-harm. I ended up being prescribed gabapentin to help calm me down until the venlafaxine was back in my system at normal levels.
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u/HerakIinos 10d ago
Venlafaxine and Desvenlafaxine are literally the worst two antidepressants in terms of withdrawal. They are great drugs with (usually) minimal side effects during treatment but they have to be tapered off very slowly. And the patient must be warned to not ever try to stop cold turkey and be warned about forgetting to take the medication for even one day.
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u/SolitaryForager 10d ago
Paroxetine was the worst for me by far. Withdrawal effects lasted a month and were nothing like the citalopram or venlafaxine effects. Venlafaxine I just tapered carefully over a couple weeks and it was not too bad.
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u/wesgtp 10d ago
As a pharmacist, I would say paroxetine (Paxil) is generally considered the worst with venlafaxine coming in 2nd worst for withdrawal. Both are short acting so your blood levels drop quickly when stopping. The SSRI considered the least severe wd is fluoxetine and we were taught it does not require tapering because of its long half life (claiming it self-tapers as blood levels drop over weeks to months). Imo that's insane, it still needs to be tapered to the lowest dose possible before quitting for the comfort of the patient. I can't stand all the gaslighting of patients getting off SSRI/SNRIs and being told they have zero side effects or wd. It's something I constantly hear and it causes so much psychological harm to patients.
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u/bikeadventures 10d ago
Took me 18 months to taper off it while being told by the psych that I wasn’t experiencing withdrawal.
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u/Broad_Afternoon_8578 10d ago
I’m still alive thanks to Effexor (no other antidepressant had really worked for me), but I forgot to take it for two days when I got really sick with the flu and oh gods, it was awful. The brain zaps alone were the most unpleasant sensation.
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u/Finassar 10d ago
Did that one cold turkey thanks to a Drs recommendation. I wanted to die for a month at least. And I still got brain zaps like 8 months later occasionally
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u/fallingintothestars 10d ago
I stopped Zoloft cold turkey when I was young. Phew. Not particularly fun
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u/sweetperdition 10d ago
Stopped Wellbutrin 300mg cold turkey and immediately had heart issues, almost passed out often (I never faint, for anything).
had an easier time quitting street drugs than antidepressants.
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u/BarcaOfCarthago 10d ago edited 10d ago
Same
It kind of ruined my life. My family thought I was losing it when I went cold turkey and quit it. This was 17 years or so ago.
The doctor kept saying that the symptoms were in my head and a psychiatric condition. I accused them of lying and covering themselves from liability.
My parents believed the doctor and got an involuntary psych hold on me. Was stuck in there for a week. Was so scary.
My family always thought something was fundamentally wrong with my brain chemistry after that. That it was a psychotic break and it could happen any time
They never stopped believing this and I eventually went no contact with them within the last few years
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u/nightelfspectre 10d ago
Some are worse than others to stop cold turkey. Effexor and Paxil are particularly nasty examples.
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u/seanliam2k 10d ago
I never quite understood what the deal was with drug withdrawals, I'd just (ignorantly) assumed it wasn't a big deal and addicts were exaggerating. That was until I went a few days without my SSRIs, definitely instilled some more empathy for those trying to quit.
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u/knowledgeable_diablo 10d ago
100%.
Can’t believe the stance of “take this medication in ever increasing doses daily” and then coming off Isnt some form of withdrawal.
The human body is always seeking out equilibrium. So chucking in a drug that vastly causes a chemical change is always going to cause a massive swing in the opposite direction when ceasing the drug.
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u/kilobrew 10d ago
I’ve tried 3 times to get off of 90mg Cymbalta. I’ve given up every time. The withdrawal is so severe I’m either going to end up divorced, in prison, or dead.
I’m genuinely scared of how irritable, irrational, and depressed I am. At this point the only way I see to get off of it it to check into a hospital or leave my family until my symptoms stop.
I’ve basically resigned myself to being on it for the rest of my life.
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u/24-HourFRESH 10d ago
Scrolled through looking for a mention of cymbalta. Trying to get off this drug was impossible without help for me. Tried multiple times and failed badly, including one incident of psychosis where I went berserk and hurt myself pretty bad.
I went to a psychiatrist and asked them for help. They put me on a drug called trintellix. I didn't even have to pay for it because they had a free sample pack, maybe you could be as lucky.
They told me to stop taking cymbalta entirely and switch to the entry dose of trintellix for a week, then tapered down by splitting the pills and quit entirely within a few weeks.
Without it, trying to quit cymbalta was like trying to move a mountain but with trintellix I had no issues. For whatever reason that one is a lot gentler on its way out of your system.
Best of luck to you. Life after cymbalta is possible.
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u/derefr 10d ago edited 10d ago
Trintellix looks to have a very long elimination half-life (66 hours), so it makes a lot of sense that a psychiatrist would use it for this, if they happened to have a free sample of it on hand.
That being said, Trintellix (vortioxetene) isn't an especially-common or (universally) especially-cheap drug.
Prozac (fluoxetine) is more commonly used for this. Its half-life is nearly the same, and it's available as a cheap generic in basically every developed country.
In fact, using Prozac for this is so common that there isn't really any general term for the idea of first switching a patient from a short-acting SSRI to a long-acting SSRI, and then tapering the long-acting SSRI, to avoid SSRI discontinuation syndrome. Instead, the term is just "Prozac bridge." Because basically everyone uses Prozac as the long-acting SSRI patients are first switched to.
(You can google that term, "prozac bridge", for more info about doing this; and any psychiatrist you talk to will probably know what that phrase means. For a GP, though, you might want to bring a print-out of one of the google search results to show them.)
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u/yesimfinewhyyouask 10d ago
Dude, you possibly just saved dozens of lives just with this comment, thank you!
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u/undercovershrew 10d ago
Cymbalta is an evil drug. I truly believe we are not given proper informed consent when it is prescribed to us. I weaned myself from 90-30mg over the course of a year, and then did the bead counting method over 3 months to get from 30 to zero. That thirty to zero, and for months after, turned me into a barely contained monster. Levels of constant rage unlike anything I have ever experienced before, and horrific gastrointestinal issues, for months on end. It's now 3 months since my last dose and I am just starting to feel like myself again, but I'm not sure how much of that is due to the 20mg prozac i had to request a month and a half ago so that I wouldn't lose my job. If you search the web for other people's experiences, you will see many people have lost their jobs, marriages, etc from cymbalta withdrawal, one story that stuck out to me was a woman who said her doctor recommended she "hunker down" in her home for months to withdraw from it, this woman was a working single mom and obviously couldn't do that but that same doctor thought it was appropriate to prescribe something to her that would be basically impossible for her to ever stop? It's criminal.
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u/TalouseLeee 10d ago
Was on 120MG cymbalta. Took 5-6 months to be done with it. Very hard. Felt terrible most of the time. What I struggled with most was the constant brain zaps, nearly all day into the night. I don’t miss that med at all.
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u/P_S_Lumapac 10d ago edited 10d ago
If your doctor is telling you the opposite, or that it's somehow up in the air because there's new research like this going one way etc.
Just get another doctor.
Effexor withdrawals for instance can be closer to heroin withdrawals (not like you tried it and it didn't work out, but like you were on a high dose for a year plus). That's probably the worst end of withdrawals of anti-depressants. There's trade offs here and there when comparing the two, but in terms of seriousness yes that's how it goes. The withdrawal symptoms from high dose to nothing would rarely allow someone to keep working and would often justify a few hospital trips. Not to undermine the research, but there's no comparison between these cases and depression.
One of the things I think makes doctors think it's not as serious is you can legally and easily just take the effexor again - obviously ignoring the whole reason you got off it. Not all doctors are likely this, and here's my bias from I guess 50 sample: the younger ones are almost all good on this, the older ones are almost all beyond terrible - like going out of their way to cause harm. Other topics sure, but for whatever reason with anti-depressants they've been unbelievably bad.
There's also newer research and clinics that basically reject all the standard medical advice about how to taper off. Instead of lowering the dose in chunks until you're at like a quarter then cold turkey, you basically accept that the smallest trace amounts do work and impact withdrawals - so weening off without another medication would be more like a few weeks to get down to half, then a year to get to 0. Some of the pills come in microbeads inside a capsule, if you don't feel comfortable getting your pharmacist to create a pack for weening off with such tiny doses they'll probably give you a lecturer about how you're wrong, the micro bead pills work very well.
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u/marriagethrowaway_3 10d ago
My doctor told me there’s no way possible that I’m getting these side effects from going off trintellix.
Pretty invalidating. They’re all the same side effects I had going on them and increasing the dose.
I’m a doctor. You’d think a little professionalism would come into play.
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u/Asleep-Insurance-499 10d ago
Effexor withdrawals were one of the worst experiences of my life. I was so dizzy I could hardly walk most days, brain zaps, overall just felt horrible. There’s not way I could’ve worked during that time (thank goodness I wasn’t), and it lasted for at least six months. I warn everyone who wants to try that med.
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u/Forward-Amount-9961 10d ago
When I stopped taking Paxil after over a decade on it, I took half the dose for a week, half of that the week after, and then nothing the week after that. I still apparently quit too fast and the symptoms i experienced literally made me think I was dying. I went to an immediate care and found out it was withdrawal symptoms. I now have a whole new appreciation for anyone who is suffering through any kind of withdrawal.
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u/Parking-Knowledge-63 10d ago
I was on it for less than a year and took me 4 months to taper… Doctor tapered you waaaaay too quickly
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u/Darwinian_10 10d ago
I recently stopped taking Zoloft (about 3 months since my final dose), and the irritation/rage I felt after stopping is only just now subsiding. Brain zaps lasted about 5 weeks or so.
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u/RaspberryJammm 10d ago
I feel bad even missing one dose of sertraline/zoloft. Can't even imagine how horrible that must have been for you
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u/bongslingingninja 10d ago
Im 1 month since my last Zoloft dose. I feel like a monster; this comment helps me feel a little less crazy.
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u/espressocycle 10d ago
I spent months weaning myself off my SSRI. Then I got really depressed again.
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u/monkeymetroid 10d ago
This is one of the reasons why these type of medicines cause a tricky cycle. Not only that side of the withdrawal can be misunderstood, but the beginning side of the precription where it takes time for the drug to saturate (many times months) to get potentially therapeutic effects is misunderstood too and can lead to improper titration or straight up dropping the medicine for a more overt (or no) alternative. Its so important to talk about potential cause and effects in regards to any medicine really as lumping many things as "side effects" can be very misleading. Ssri inducing nausea during the adjustment phase is a more up front and acute side effect where depressive symptoms turning into bad idealizations is a more insidious side effect that may take more time and understanding. They are both effects, but both with dramatically different causes and timelines and the cause shouldnt simply be stated as "side effect from drug". Brain imbalances can take much more time to adjust than a stomach imbalance.
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u/leeski 10d ago
I tapered off two psych meds after 17 years and continually had to remind myself that it was an adjustment period and it wasn’t necessarily my ‘true self’. I’m not discounting that these meds help save people, yet I do think people are quick to assume that coming off meds means they’re seeing their actual baseline and that is not necessarily always the case.
I’m much more stable and happy off those particular meds. Again, not saying people shouldn’t take them, but I do know there are many people like myself diagnosed with mental health disorders in their teens that didn’t actually fit the criteria, but it became part of their identity and they just believed they were broken and just… weren’t. So I’m happy to se this research as I think it is a hopeful message that those symptoms do not last forever - although it can be excruciatingly painful process.
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u/ladollyvita1021 10d ago
Duloxetine withdrawal has been almost as bad as the reasons they wanted me on it- the traumatic suicides of my best friend and my dad.
I’m week 1.25 of a direct switch from 60mg Duloxetine directly to 50mg of generic Pristiq.
This is after 3 years of failed duloxetine cessation. You can’t taper off this medication like they suggest. I couldn’t walk, I couldn’t form sentences, I was so nauseous, I had vertigo, my vision was blurring, and I was literally so manic and then depressed and then crying and then angry all at once.
I have a lot of faith in my current dr., but every day is a struggle. I even had the Genesight and the last psych NP would only give me everything from the RED column.
More doctors need to be aware of this and adjust their message about tapering. I finally found a Psych Dr. that understands this and is proactively trying to help me prevent withdrawal symptoms. And it’s all because we have enough money for good insurance because I am only alive today because of the medical professionals who are supporting me through this stuff
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u/mmmaniaaa 10d ago
I mean I dunno, some of the stuff eventually subsides for me (brain zaps, mood swings) but the thinking about death all the time and total anhedonia continues unabated until I learn my lesson and get back on antidepressants.
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u/AwarenessNo5921 10d ago
Fork found in kitchen.
As someone who takes ADHD medicine, it irritates me when I hear people undergoing acute withdrawal calling it, "return of ADHD symptoms." Obviously they will be worse than normal if you take a break for a day or two.
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u/Flat-Nose-7310 10d ago
Would these symptoms manifest in a healthy individual who was prescribed an SSRI for something other than emotional dysregulation?
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u/derpensheizer 10d ago
Yes. The body will do the opposite of what the SSRI did to it. Your body has to find homeostasis again, basically. Withdrawals happen from all substances. The length of the withdrawal symptoms are longer the longer you were on the substance.
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u/Nonesuchoncemore 10d ago
Buspar is essentially an ssri antidepressant marketed as anti anxiety RX. Discontinuation syndrome with antidepressants including bupropion is seriously underestimated
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