David Baxter PhD
Late Founder
Health checkup: Stopping antidepressants
July 5, 2006
by Jane Sundberg
Abruptly stopping the use of antidepressants ? by missing a dose, forgetting to get a prescription refilled or deciding on your own to stop the medication ? may trigger unpleasant physical and psychological symptoms. This can happen with the newer classes of selective serotonin reuptake inhibitors and selective norepinephrine reuptake inhibitors, and the older class of tricyclic antidepressants.
Clinical depression affects 10 million to 14 million Americans annually. Many of these individuals are treated with antidepressants, which boost the levels of brain chemicals. Antidepressants also are used to treat social phobia, premenstrual syndrome, panic attacks and obsessive-compulsive disorder.
But suddenly stopping the medication can lead to a constellation of symptoms.
Patients most typically experience gastrointestional distress; headaches or lethargy; sleep disturbances such as insomnia and excessive dreaming or nightmares; and anxiety, agitation and low mood.
Studies have shown that discontinuation symptoms are common among users of tricyclic antidepressants. About 55 percent of patients who stop Tofranil, 80 percent who stop Elavil and 33 percent who discontinue Anafranil will experience these symptoms.
In addition, patients who suddenly stop taking SSRIs (Zoloft, Paxil, Celexa, Lexapro and Luvox) or SNRIs (Cymbalta and Effexor) can experience balance and sensory abnormalities. Dizziness and a feeling of disorientation can sometimes impair coordination to the point where a person can't drive.
Sensory abnormalities include numbness and the unusual sensation of electric shocks, particularly in the head, neck and upper limbs.
The acronym FINISH may help you identify the symptoms: flulike, insomnia, nausea, imbalance, sensory disturbances and hyperarousal.
These reactions usually start within a day after stopping any antidepressant therapy and are more common with longer courses of treatment.
The symptoms usually go away in a couple of weeks, but if therapy is resumed, the symptoms will stop almost immediately. However, when people are off their medication, their initial illness is likely to resurface.
To avoid these symptoms or a relapse of depression, never abruptly stop taking your medication.
Consult with your health care provider about whether you should discontinue these drugs and if so, how to proceed.
Jane Sundberg, doctor of pharmacy, is a psychiatric clinical pharmacist at Strong Health's department of pharmacy.
Caution:
As this article explains, antidepressants should never be stopped 'cold-turkey' but weaned off gradually. Dr. Richard S. Shelton's article Discontinuation of Antidepressant Therapy (pdf, 45KB) is a good guide to minimizing the side effects of discontinuation. Do not stop taking medications without first consulting the prescribing doctor.
July 5, 2006
by Jane Sundberg
Abruptly stopping the use of antidepressants ? by missing a dose, forgetting to get a prescription refilled or deciding on your own to stop the medication ? may trigger unpleasant physical and psychological symptoms. This can happen with the newer classes of selective serotonin reuptake inhibitors and selective norepinephrine reuptake inhibitors, and the older class of tricyclic antidepressants.
Clinical depression affects 10 million to 14 million Americans annually. Many of these individuals are treated with antidepressants, which boost the levels of brain chemicals. Antidepressants also are used to treat social phobia, premenstrual syndrome, panic attacks and obsessive-compulsive disorder.
But suddenly stopping the medication can lead to a constellation of symptoms.
Patients most typically experience gastrointestional distress; headaches or lethargy; sleep disturbances such as insomnia and excessive dreaming or nightmares; and anxiety, agitation and low mood.
Studies have shown that discontinuation symptoms are common among users of tricyclic antidepressants. About 55 percent of patients who stop Tofranil, 80 percent who stop Elavil and 33 percent who discontinue Anafranil will experience these symptoms.
In addition, patients who suddenly stop taking SSRIs (Zoloft, Paxil, Celexa, Lexapro and Luvox) or SNRIs (Cymbalta and Effexor) can experience balance and sensory abnormalities. Dizziness and a feeling of disorientation can sometimes impair coordination to the point where a person can't drive.
Sensory abnormalities include numbness and the unusual sensation of electric shocks, particularly in the head, neck and upper limbs.
The acronym FINISH may help you identify the symptoms: flulike, insomnia, nausea, imbalance, sensory disturbances and hyperarousal.
These reactions usually start within a day after stopping any antidepressant therapy and are more common with longer courses of treatment.
The symptoms usually go away in a couple of weeks, but if therapy is resumed, the symptoms will stop almost immediately. However, when people are off their medication, their initial illness is likely to resurface.
To avoid these symptoms or a relapse of depression, never abruptly stop taking your medication.
Consult with your health care provider about whether you should discontinue these drugs and if so, how to proceed.
Jane Sundberg, doctor of pharmacy, is a psychiatric clinical pharmacist at Strong Health's department of pharmacy.
Caution:
As this article explains, antidepressants should never be stopped 'cold-turkey' but weaned off gradually. Dr. Richard S. Shelton's article Discontinuation of Antidepressant Therapy (pdf, 45KB) is a good guide to minimizing the side effects of discontinuation. Do not stop taking medications without first consulting the prescribing doctor.
