Antidepressants and Discontinuation Syndrome

Tips For Getting Relief From Discontinuation Syndrome

For someone dealing with major depression, an antidepressant truly can be a life-saver, figuratively and literally. It's important to take this type of medication exactly as prescribed and to not stop taking it without talking to your doctor first: Depending on the specific medication, antidepressants can cause symptoms of discontinuation syndrome if there are major fluctuations in the amount of drug in your system or if you stop taking it altogether cold turkey.

Discontinuation syndrome can cause flu-like symptoms, nausea, problems with balance, sensory disturbances, and agitation. For some people, it can feel as if they're depression or anxiety is coming back. Usually, the symptoms are mild and last only a week or two, but there's no reason to experience them at all if you don't have to. These tips will help you avoid discontinuation syndrome and to get relief if it happens anyway. 

1
Ask To Try Prozac

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Prozac (fluoxetine) is in the class of selective serotonin reuptake inhibitors, or SSRIs, along with medications like Zoloft (sertraline) and Lexapro (escitalopram). This popular antidepressant has a very long half-life, meaning that after you stop taking it it leaves your body more slowly than most other SSRIs. For this reason, you're unlikely to have extreme withdrawal symptoms with Prozac. Keep this in mind when you and your doctor are discussing which antidepressant you should try.  

2
Taper Off Slowly

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If you and your doctor have decided it's time for you to stop taking your antidepressant, it's possible to avoid discontinuation syndrome altogether. Even if you're tempted to, the key is to not quit cold turkey, but instead to taper off your medication. This means gradually decreasing your dose over an extended period of time. How you'll do this will depend on how long you've been taking the drug, how high your dose is (if you're on a low dose you'll be able to taper off more quickly), and any other factors your doctor wants to consider.

3
Medications For Treating Discontinuation Syndrome

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Sometimes, even if you are slow and deliberate when weaning yourself off an antidepressant, you still may experience symptoms of discontinuation syndrome. One possible way to get relief is to take a single 20 milligram (mg) dose of Prozac. Your symptoms will likely go away within a few hours. And because of Prozac's long half-life you won't have withdrawal symptoms after taking that one capsule.

If you were on a very high dose of the SSRI Paxil (paroxetine) or Effexor (venlafaxine), which is a selective serotonin-norepinephrine reuptake inhibitor (SNRI) you may need to take a second 20-milligram dose of Prozac. Benadryl (diphenhydramine) is an over-the-counter allergy medication that has been reported to help with discontinuation symptoms.

4
Stick To Your Schedule

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Certain antidepressants, such as Effexor (venlafaxine), are just the opposite of Prozac (fluoxetine): They leave the system quickly and therefore can cause withdrawal symptoms. This can happen even you're simply a little late taking your regular dose. If you happen to forget your antidepressant it's OK to go ahead and take it as soon as you realize you missed it. The exception is if it's close to time for you to take your next scheduled dose; in that case, wait until then and get back on track. 

5
Make a Smart Switch

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Let's say you're taking a selective serotonin reuptake inhibitor (SSRI) but it isn't working very well for you, or it's causing side effects that you can't live with. You should be able to go directly from your current medication to another SSRI without triggering discontinuation syndrome: You won't need to wean yourself from the first drug before starting the second. The same is true of switching from an SSRI to a selective serotonin-norepinephrine reuptake inhibitor (SNRI) such as Effexor (venlafaxine). And you should be able to easily go straight from Prozac (fluoxetine) to any other antidepressant except for one in the class of monoamine oxidase inhibitors (MAOIs)—the first type of antidepressant developed. These medications aren't as safe and have more side effects than the newer drugs, so it's unlikely your doctor would put you on one unless you truly haven't been able to take any of the SSRIs or SNRIs. 

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