Antidepressants: Starting and stopping antidepressants

How long should I take antidepressants?

When you start a new antidepressant, the first step is to decide whether you can tolerate the side-effects; this should become clear within a few weeks. The next step is to decide whether the drug helps with your depression or anxiety; for this, you will need to take it at full dose for at least six weeks.

If the medication does work for you, your doctor will advise you to continue taking it for at least six months after you start to feel its beneficial effects. People who stop taking antidepressants too soon risk having the symptoms of their depression or anxiety problem return. Most people who take antidepressants need to take them for at least a year. People who experience depression that keeps coming back may need to take them for a longer term.

Are antidepressants addictive?

Drugs that are addictive produce a feeling of euphoria, a strong desire to continue using the drug, and a need to increase the amount used to achieve the same effect. Antidepressants do not have these effects.

Antidepressants do, however, have one thing in common with some addictive drugs—they can cause withdrawal effects when you stop taking them. When you take antidepressants for months or years, your body adjusts to the presence of the drug. If you then stop using it, especially if you stop suddenly, you may experience withdrawal effects such as muscle aches, electric-shock-like sensations, dizziness, headache, nausea, chills and diarrhea. These effects are most commonly reported with paroxetine (Paxil) and venlafaxine (Effexor); however, they can occur with any antidepressant. Some people find these effects distressing and have difficulty withdrawing from these drugs.

How do I cut down or stop taking antidepressants?

Whether you want to cut down your dose or stop taking a medication, the same rule applies: go slowly. Sudden changes in your dose can greatly increase your risk of having another mood episode.

The first step is to ask yourself if this is the right time. Are you feeling well? Is the level of stress in your life manageable? Do you feel supported by your family and friends?

If you think you’re ready, talk to your doctor. If your doctor doesn’t agree, find out why. If you are not satisfied with his or her reasons, you may want to see another doctor for a second opinion.

If your doctor does agree, he or she will advise you not to skip doses but to reduce your dose gradually—usually by about 10 per cent at a time—with at least two to three weeks between each reduction. This process of cutting back can take several months. Using a pill cutter can help you to cut your dose down in small amounts.

If you want to stop taking more than one medication, your doctor will usually suggest that you lower the dose of one drug at a time.

As you cut down, if you start to feel unwell, let your doctor know. He or she can help you determine whether you are experiencing withdrawal effects or signs that symptoms are returning. Don’t be afraid to go back up with your dose. Find the dose that works best for you.

Contents

• Introduction
• Do I need treatment?
• What do antidepressants do?
• Side-effects
• Types of antidepressants
• Starting and stopping antidepressants
• Antidepressants, other drugs and driving
• Antidepressants, sexuality and pregnancy
• Is age an issue?
• Where can I get more information about antidepressants?
• How can I find treatment or a support group?

• Print
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