Stopping an antidepressant suddenly can cause discontinuation symptoms: dizziness, flu-like aches, nausea, trouble sleeping, vivid dreams, irritability and the electric "brain zap" sensations many people describe. They usually start within a few days of stopping or lowering the dose. They are not a sign of addiction, but they can be very uncomfortable, and they are largely preventable with a gradual plan.
Some medicines are harder to stop
Medicines that leave the body quickly, such as paroxetine (Paxil) and venlafaxine (Effexor XR), tend to cause stronger symptoms. Duloxetine (Cymbalta) also leaves quickly and, like venlafaxine, often needs a slow taper. Fluoxetine (Prozac) leaves the body slowly and causes fewer. Escitalopram (Lexapro) and sertraline (Zoloft) fall in between.
Why there is no one-size schedule
A safe taper depends on the medicine, the dose, how long you have taken it, and how you have responded to dose changes before. Many people do well tapering over several weeks; others need months, with smaller steps at the lowest doses, where symptoms tend to be strongest. Your prescriber builds the schedule with you and adjusts it as you go.
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Primary care, mental health, and addiction medicine in one practice. New patients are often able to be scheduled within a week of requesting an appointment.
Discontinuation or relapse?
Discontinuation symptoms come on within days and usually fade within a few weeks, but for some people they last longer, sometimes months. A return of depression or anxiety usually comes on more slowly, weeks to months later, and needs a different response. Telling them apart is one of the most important parts of follow-up.
Good times and bad times to stop
The best time is when you have been well for at least six to twelve months and life is relatively stable, not in the middle of a move, a loss or a stressful season at work.
Get help from Hope Integrative Medicine
If you are thinking about coming off an antidepressant, we can build a taper plan with you and follow you closely through it. Our mental health team sees patients in person in West Ashley and by telehealth across South Carolina, alongside our primary care providers, and new patients are often able to be scheduled within a week of requesting an appointment. Request an appointment.
This article is general health information and does not replace advice from your own provider. Never start, stop or change a medication without talking with your prescriber. If you are having thoughts of harming yourself, call or text 988 or call 911.
Frequently Asked Questions
Discontinuation symptoms such as brain zaps usually start within a few days of stopping or lowering the dose and fade within a few weeks, though for some people they last months. A slower taper with smaller steps usually prevents or shortens them.
Paroxetine (Paxil) and venlafaxine (Effexor XR) leave the body quickly and tend to cause the strongest discontinuation symptoms. Fluoxetine (Prozac) leaves slowly and causes the fewest.
Discontinuation symptoms come on within days and usually fade within weeks, though some people have them for months, and often include dizziness, flu-like aches and brain zaps. A return of depression or anxiety usually builds more slowly, weeks to months later.