It's usually recommended that a course of SSRIs continues for at least 6 months after you feel better, to prevent your condition coming back when you stop. However, if you've experienced previous episodes of depression, a 2-year course may be recommended.
Clinicians generally recommend staying on the medication for six to nine months before considering going off it. If you've had three or more recurrences of depression, make that at least two years.
Antidepressants, specifically SSRIs, which are considered the most tolerable and are, therefore, the most prescribed, are generally safe to take long-term.
It's important that you do not stop taking antidepressants suddenly. A dose of antidepressants should be slowly reduced, normally over 4 weeks, but sometimes longer. This is to prevent any withdrawal symptoms you might get as a reaction to coming off antidepressants suddenly.
Guidance from the National Institute of Health and Care Excellence recommends that antidepressants are used as 'maintenance' treatment for up to 2 years to prevent their depression returning (relapse). It also recommends cognitive-behavioural therapy to change habits of thought and behaviour.
Take your time.
Clinicians generally recommend staying on the medication for six to nine months before considering going off antidepressants. If you've had three or more recurrences of depression, make that at least two years.
For people with chronic or severe depression, medication may be needed on a long-term basis. In these cases, antidepressants are often taken indefinitely. That is, in part, because depression is not an illness that can be cured.
From the 14 studies that provided usable data, they calculated that 56% of antidepressant users experienced withdrawal symptoms when they discontinued the medication. Just four studies looked at the question of severity, they found, but of those, 46% of people experienced severe symptoms.
You are feeling better, and you and the doctor agree that it is time to stop. You have been taking the medicine for at least 6 months after you feel better. You are having counselling to help you cope with problems and help change how you think and feel. You are not worried about the depression coming back.
It's usually recommended that a course of antidepressants continues for at least 6 months after you feel better, to prevent your condition recurring when you stop. Some people with recurrent illness are advised to carry on taking medicine indefinitely.
During long-term SSRI therapy, the most troubling adverse effects are sexual dysfunction, weight gain, and sleep disturbance.
Two recent reviews of research in this area concluded that discontinuation effects, sexual dysfunction, weight gain, and sleep disturbance (multiple long-wake periods) are adverse effects of long-term SSRI use.
If you have been feeling better for 6 months or more, your doctor may suggest coming off escitalopram. Your doctor will probably recommend reducing your dose gradually over several weeks, or longer if you have been taking escitalopram for a long time.
“Emotional blunting is a common side effect of SSRI antidepressants. In a way, this may be in part how they work–they take away some of the emotional pain that people who experience depression feel, but, unfortunately, it seems that they also take away some of the enjoyment.
Lexapro is prescribed long-term, allowing it to create neuroadaptation in the CNS, brain, and body. Long-term effects of Lexapro may develop making continuing treatment untenable. Lexapro is not a cure.
Fluoxetine, which has the longest half-life of the SSRIs (see Table 1), appears to produce the fewest withdrawal symptoms, while paroxetine, which has the shortest half-life, produces the most pronounced discontinuation effects.
Perhaps the most recognizable among them is Prozac (fluoxetine). It's still the best option for many people, but since it was approved by the Food and Drug Administration (FDA) in 1987, Prozac has been joined by a variety of other antidepressant medications.
When treatment is eventually stopped, there will be fewer receptors than before and a short-term deficiency of serotonin activity. The body will typically correct this, but there will be a period of adjustment until the system normalizes.
About 28% of patients stop taking their antidepressant within 1 month, and 44% within 3 months. Such a high early discontinuation rate is a major obstacle for effective treatment of MDD.
Although this is beneficial for someone who's depressed, for someone who does not have depression, taking antidepressant medication can cause serotonin to build up in the body, resulting in serotonin syndrome. When serotonin levels are too high, the person may experience symptoms like: Agitation or restlessness.
Antidepressants interfere with serotonin, the neurotransmitter that regulates anxiety and mood while also controlling appetite. In particular, these changes may increase cravings for carbohydrate-rich foods, such as bread, pasta, and desserts.”