If you don't want to be on antidepressants forever, you'll need to work with your doctor to create a gradual tapering plan, as stopping abruptly can cause Antidepressant Discontinuation Syndrome (withdrawal) with flu-like symptoms, dizziness, anxiety, or brain zaps, and a risk of depressive relapse, but with careful management, many people successfully stop or reduce medication, often combining it with therapy like CBT. The process involves slowly lowering the dose over weeks or months, as symptoms can mimic depression but usually resolve, while true relapse persists and may worsen.
Long-Term Treatment – For those with severe, recurrent depression or treatment-resistant depression, antidepressants may be used for several years or indefinitely. The decision to remain on long-term medication depends on how well the medication controls symptoms and the patient's mental health history.
TL;DR: After stopping antidepressants, the brain can gradually adjust back to its pre-medication state, but this process and its outcomes can vary significantly between individuals. Some people may return to their previous mental state, while others may experience lasting changes or improvements.
Most people can gradually stop taking their antidepressants over a few weeks or months, by taking smaller doses and then stopping completely. This is called 'tapering'. This can reduce the risk of you getting withdrawal symptoms, or mean that any symptoms you have are less severe.
It's important to be aware of any emotional or physical shifts that occur during the process and discuss them with your doctor. With the right treatment plan, antidepressants can be safely and easily discontinued without compromising mental health or quality of life.
You may be tempted to stop taking antidepressants as soon as your symptoms ease, but depression can return if you quit too soon. Clinicians generally recommend staying on the medication for six to nine months before considering going off antidepressants.
If you take antidepressants for a long time (several years or more) you may be at an increased risk of type 2 diabetes. This is more likely if you are over the age of 30 and are taking either SSRI or tricyclic antidepressants.
The hardest antidepressants to come off are typically those with short half-lives, meaning they leave the body quickly, leading to more intense withdrawal (discontinuation syndrome); prominent examples include Paroxetine (Paxil), Venlafaxine (Effexor), and Fluvoxamine (Luvox), with Venlafaxine often cited for particularly severe withdrawal. In contrast, Fluoxetine (Prozac), with its long half-life, is generally considered the easiest to stop due to its gradual exit from the body.
However, when compared with antidepressants, a recent 2022 network meta-analysis of randomized controlled trials found no difference between exercise and pharmacological interventions in reducing depressive symptoms in adults with nonsevere depression.
Suicidal feelings
There is a possibility that taking an antidepressant could make you feel suicidal. It may happen even if you didn't experience suicidal feelings before. This side effect is mainly with SSRI antidepressants. But it is a risk with all antidepressants.
What are the alternatives to antidepressants?
However, some positive effects of withdrawal were also reported, such as people feeling like their emotions were returning to normal (rather than being 'blunted' by their medication). Some participants reported positive changes in their thinking patterns and found it easier to recall positive memories.
Antidepressants are thought to work by increasing neurotransmitters like serotonin and noradrenaline. These are chemicals in the brain which can improve mood and emotion. But this process isn't fully understood. Increasing levels of neurotransmitters can also disrupt pain signals sent by nerves.
Avoid driving or operating machinery. Avoid caffeine, tobacco and alcohol. Drink plenty of fluids. Take your antidepressant at bedtime if your doctor approves.
For many, SSRIs have been profoundly helpful in managing their health and continue to have an important place in care. However, use of SSRIs has not been far from controversy and criticism. In 2004, the FDA issued a black box warning about a possible increased risk of suicidality in young adults taking an SSRI.
The typical length of treatment is 6 to 12 months, but some people may stay on antidepressants for much longer.
Although depression may occur only once during your life, people typically have multiple episodes. During these episodes, symptoms occur most of the day, nearly every day and may include: Feelings of sadness, tearfulness, emptiness or hopelessness. Angry outbursts, irritability or frustration, even over small matters.
Many people report feeling emotions more fully or feeling more like themselves after they stop taking antidepressants. Some people report positive changes in their thinking and cognitive abilities after stopping antidepressants. This can include improved memory, focus, and mental clarity.
141 patients with depression and/or anxiety disorder participated in this study. Running therapy and antidepressant medication had similar effects on mental health (remission and response rates). Running therapy outperformed antidepressant medication on physical health variables.
Escitalopram and sertraline stand out.
Bupropion, citalopram, escitalopram, and sertraline were better tolerated than the other antidepressants. Escitalopram and sertraline were found to have the best combination of efficacy and acceptability.
Of the 310 respondents who had ever tried to stop an antidepressant, 37.9 % reported having been unable to do so despite trying one or multiple times, 8.3 % were currently in the process of trying to do so, and 53.8 % reported having been able to stop (Table 2).
Sertraline requires special attention to the risks associated with neurologic, psychiatric, and congenital disorders in clinical use. In addition to common AEs such as nausea, and tremor, newly identified adverse reactions such as genital anaesthesia, bruxism, and microscopic colitis should be guarded against.
In time, the brain returns to a normal state after stopping antidepressants. If depressive symptoms do arise and gradually worsen, it's best to consult a psychiatrist or doctor if they don't improve within a few weeks or if they become severe.
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.
Antidepressants may not be fully researched or clinically tested on people under 18 years old. This means there is less information available about the possible benefits and risks. If you are under 18 and your doctor prescribes you an antidepressant, they should be very careful about the dose.