When and How To Come Off Your Antidepressant

It is normal to want to come off your antidepressant when you start to feel well. But it is best if you keep on it for at least 6 months after you feel better. You should take a 6 month course of antidepressants even if you start to feel well. It is a bit like a course of antibiotics. If you finish the course, you have a better chance of staying well.

When might the course be longer than 6 months? 

If you are over 65
If you have had depression in the past. It can help to take your antidepressants for 1-2 years after you feel better
If you have had depression that keeps coming back. In this case, your GP might suggest you take antidepressants for more than 2 years

Don’t just stop taking your antidepressant. Below is some help on how to start coming off.

If you are thinking of stopping your antidepressant please discuss this with your GP and develop a plan of how you are going to reduce and stop.

How Easy Is It To Come Off Anti-Depressants?

Many people find it easy to stop. But about a third can find it hard.

This is not the same as addiction or tolerance:

We don’t crave or seek out antidepressants, the way we might if we had an addiction.
Over time, we don’t need to take more of them to get the same effect.

Instead, our body has just got used to them. So it needs to be weaned off.

Common Problems When Stopping Antidepressants

These often happen within 1-5 days of cutting down or not taking them.

The symptoms are often mild. They tend to get better within a few days to a few weeks. So don’t worry if you start to notice these. By cutting down slowly, it is less likely you will get them.

Here are some of the more common ones:

SSRIs	TCAs
Flu-like symptoms (chills, muscle pain, sweating, headaches, feeling sick) Sleep problems Dreaming more Having more vivid dreams Feeling dizzy Feeling tired “Electric shock” sensations Feeling more irritable and restless Having a sore stomach Diarrhoea	Flu-like symptoms (chills, muscle pain, sweating, headaches, feeling sick) Sleep problems Dreaming more Feeling tired Diarrhoea Having a sore stomach Having headaches Restlessness Feeling sick

These are more common when taking:

Paroxetine
Amitriptyline
Imipramine
Venlafaxine

With these anti-depressants, you may feel symptoms just one day after not taking them.

Problems are also more likely if:

You have been taking an antidepressant for a long time
You stop them quickly
You have had problems stopping before

How Do I Get Over These Problems?

Below is some help on how to deal with these problems. The best advice is to reduce your dose of antidepressant slowly.

You can reduce your antidepressant by:

Cutting down your dose. You can do this by taking one tablet rather than two, or half a tablet rather than one. This can work well if you are taking tablets like Paroxetine
or
Alternate day dosing. This means taking your tablet one day, then not taking it the next. This can work well if you are taking tablets like Fluoxetine or Citalopram.

How slowly you do this depends on how long you have been on your antidepressant:

Short-Term Use (Around 6-12 months)

You should reduce how much you take, and how often you take it, slowly over 6-8 weeks.

Long-Term Use (1-2 years and above)

You should reduce how much you take, and how often you take it, slowly over six months. You should cut your dose by one quarter every 4-6 weeks. Your GP will be able to help with this.

I took the course for around 6 months, going down to half a tablet per day during the last month or two. Twelve years on, I’ve never needed them since.

Jim, Glasgow

If you have been using antidepressants for a while, coming off may lead to more symptoms. Agreeing a plan with your GP will help to reduce side effects. If you notice lots of side effects, you should reduce your dose more slowly. Your GP might be able to change you to a new tablet or give you it in a liquid form to help.

It’s normal to feel tense about coming off your antidepressant. You may feel it has helped a lot to make you feel better. You might be worried that coming off will make you feel worse.
But
Many people come off antidepressants without any problems.
For those who have symptoms, these are often mild and pass quickly.

What Else Can I Do To Help Me?

Challenge Your Worry About Coming Off Your Antidepressant

Think about how good you might feel once you have come off. Keep in mind what you might gain.

It may be that some of the things that got you down have now got better. This might help reassure you when coming off your antidepressant.

Ask yourself – what is the worst that could happen?

Bear in mind that it is normal to notice some changes when coming off. This doesn’t mean anything’s wrong, and it doesn’t have to mean your problems are coming back. These symptoms do tend to pass.

Use Other Ways To Feel Good

What else have you done that has helped with your problems? These things will also help you come off your antidepressant.

Here are some great ideas to help:

Exercise
Talk to people about how you feel
Set yourself small goals
Build up your confidence by facing your fears
Don’t put too much pressure on yourself

Once You Have Come Off Your Antidepressant

Bear in mind that life is full of ups and downs. There will always be times when you feel unhappy and stressed. This doesn’t always mean your problems are coming back. Use the tips on other ways to cope at these hard times.

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