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- Can I Become Dependent on My Medication?
- Who Develops Withdrawal Symptoms?
- How Is Antidepressant Withdrawal Treated?
- What If I'm Also an Addict?
Antidepressant withdrawal is rarely life-threatening, and the symptoms don’t usually last more than a week or two. But the withdrawal process can be unpleasant, which is why most experts recommend tapering off these medications to avoid any risks.
Antidepressants are medications used to treat symptoms of depression. Different antidepressants may be used in the management of anxiety and panic attacks, obsessive-compulsive disorders, some chronic pain syndromes, eating disorders, and post-traumatic stress disorder.1
Many people take antidepressants for at least 6 months. People with a history of depression may take the medication for 2 years. Use of the medication for even longer may be appropriate for those with a history of recurrent episodes of depression.2
Can I Become Dependent on My Medication?
Antidepressants are not considered addictive;1 however, people who take them can develop some degree of physical dependence (their body becomes accustomed to having the medication in its system and begins to rely on it to feel and function normally). In these people, a distinct withdrawal syndrome may emerge when they stop taking their antidepressant.
Even though physical dependence is one of the clinical criteria for addiction, dependence in and of itself is not addiction. People who take antidepressants don’t crave them if they stop taking them—a characteristic sign of addiction.1 People who are addicted to a substance will compulsively abuse the substance even though it causes negative consequences in their life, such as the loss of a job or a damaged relationship. Known clinically as a substance use disorder, addiction involves much more than physical dependence and is significantly more likely to occur with a benzodiazepine like Xanax, which has a known addictive potential.
Even though antidepressant withdrawal symptoms can be uncomfortable, they are rarely severe enough to require hospitalization.3 The benefits of antidepressants often outweigh any risks or inconvenience presented by the occasional withdrawal symptom, as about 50% to 65% of people who take antidepressants experience a significant improvement in their depression.1
Users typically begin to develop symptoms within 3 days of stopping antidepressants, though some individuals may begin to experience them within just hours.3 These symptoms may last for about 1-2 weeks, though some can last up to 2 months. For most people, the effects are mild.1,3
The symptoms of antidepressant withdrawal can vary based on the drug.
|Withdrawal Symptoms by Antidepressant Type3|
|Selective serotonin reuptake inhibitors (SSRI)||Tricyclic antidepressants||Monoamine oxidase inhibitors (MAOI)*|
*MAOIs are rarely prescribed anymore, due to their potential for adverse food and drug interactions, serotonin syndrome, and hypertensive crises.
Who Develops Withdrawal Symptoms?
Experts estimate that about 20% of people who take antidepressants for at least 6 weeks will develop withdrawal symptoms should they stop taking the medication.3 Other sources claim that about 1/3 of the people who use SSRI and serotonin and noradrenaline reuptake inhibitor (SNRI) antidepressants will experience antidepressant-related withdrawal symptoms.1Antidepressants most commonly associated with withdrawal are paroxetine (Paxil) and venlafaxine (Effexor).1
Note: Benzodiazepines, like antidepressants, are sometimes prescribed for anxiety and panic symptoms. These drugs have some similar withdrawal symptoms to those experienced with antidepressants, but they can be much more serious.
How Is Antidepressant Withdrawal Treated?
Many practitioners will recommend tapering the dose of antidepressants to prevent any unpleasant withdrawal symptoms.3 Tapering means you gradually take increasingly smaller doses of the medication until you’re completely off of it.4 The process may take anywhere from 6 to 8 weeks.3
Most tapering schedules will be monitored on an outpatient basis through the doctor who prescribed the medication or through another healthcare provider. In some cases, withdrawal symptoms may arise even during a taper; your doctor can discuss any issues with you and adjust your tapering plan as necessary; for example, they may substitute a longer-acting antidepressant for a shorter-acting one.3,4
Some people who experience withdrawal from antidepressants may also need psychological counseling. In rare instances, people may need to check into a hospital or clinic for assistance in managing severe symptoms.3
It is not recommended to stop an antidepressant without working with a doctor. Most people need to be gradually tapered off antidepressants, which requires the assistance of a medical professional.4
Although usually mild, withdrawal symptoms may be unpleasant enough to prompt school absences, missed work, and other similar psychosocial issues; rarely, withdrawal symptom severity may require hospitalization.3
What If I'm Also an Addict?
People who are depressed—and who take antidepressants—may also, like many other people, abuse drugs and alcohol. In 2016, 21.2% had a past-year addiction that involved illegal drugs or alcohol, and about 3.8% of people with a past-year major depressive episode had a past-year addiction that involved both illegal drugs and alcohol.5
Mixing an antidepressant with another substance is a risky decision. Antidepressants can interact badly with alcohol and other drugs:6,11
- People who drink alcohol while they are taking tricyclic antidepressants or MAOIs may become dizzy or drowsy.
- Alcohol can worsen depressive symptoms.
- Alcohol may reduce the efficacy of your antidepressant, meaning it may lessen its ability to manage your symptoms.
- Using drugs such as marijuana, amphetamines, cocaine, heroin, and ketamine can cause uncomfortable and unpredictable side effects.
If you are depressed and abusing drugs or alcohol, talk to your doctor. You may be tempted to quit your antidepressants because you think they aren't working, but, as shown above, substances can alter the efficacy of the medication. If you talk to your doctor, they can recommend treatment options that can help treat both your addiction and your depression. A person who suffers from both conditions is said to have a dual diagnosis—a situation that benefits from a specialized treatment approach that addresses both conditions at the same time.
Types of treatment programs for addiction include outpatient and inpatient rehab programs.
- Outpatient programs operate on a part-time schedule, where the person attends treatment for a set amount of time on certain days and returns home after treatment ends.
- Inpatient programs are live-in centers where the person stays at the facility for the duration of their treatment.
Because of the setting, inpatient programs are able to provide more comprehensive care that includes medical supervision, but it usually costs more. Both types of programs may offer treatment for co-occurring or dual diagnosis conditions, but it’s best to check before enrolling.
A common misconception is that a person who wants to get sober has to quit all the drugs they’re taking, including non-addictive drugs such as antidepressants. Keep in mind that suddenly quitting antidepressants can bring on withdrawal and may leave you vulnerable to the symptoms that the antidepressant was prescribed to manage.1 Also, because the withdrawal syndromes of many drugs include anxiety and symptoms of depression, stopping use of your antidepressant can be especially psychologically distressing and may result in the return of depressive symptoms such as thoughts of self-harm or suicide.12
|Antidepressant Information at a Glance|
|Form, Intake and Dosage||Interactions and Complications|
|Effects and Adverse Reactions||Substance Abuse|
|Physiological Problem Signs and Symptoms||Dependence|
|Legal Schedules and Ratings|
- Royal College of Psychiatrists. (2018). Antidepressants.
- National Health Service. (2015). Antidepressants.
- Warner, C., Bobo, W., Warner, C., Reid, S., and Rachal, J. (2006). Antidepressant Discontinuation Syndrome. American Family Physician, 74(3), 449-456.
- Government of Alberta. (2017). Antidepressant Withdrawal.
- Substance Abuse and Mental Health Services Administration. (2017). Results From the 2016 National Survey on Drug Use and Health: Detailed Tables.
- National Health Service. (2015). Antidepressants: Cautions.
- National Health Service. (2015). Antidepressants: Side Effects.
- U.S. National Library of Medicine: Medline Plus. (2018). Prescription Drug Abuse.
- National Institute on Drug Abuse. (2018). Is there a difference between physical dependence and addiction?
- Hawton, K., Bergen, H., Simkin, S. (2010). Toxicity of antidepressants: rates of suicide relative to prescribing and non-fatal overdose. The British Journal of Psychiatry, 196(5), 354-358.
- National Alliance on Mental Illness. (n.d.). Frequently Asked Questions.
- Keks, N., Hope, J., & Keogh, S. (2016). Switching and stopping antidepressants. Australian Prescriber, 39(3), 76–83.