Antidepressant withdrawal can last from days to over a year, depending on the medication, dosage, duration, and tapering method.
Antidepressant withdrawal, or withdrawal syndrome, can be a challenging experience, with symptoms such as dizziness, brain “zaps,” mood shifts, and trouble concentrating.
The duration varies widely, depending on the medication, dosage, and individual factors. While some people experience symptoms for days or weeks, others may face longer-lasting effects.
About 30% to 50% of people stopping antidepressants are affected by withdrawal symptoms, underscoring the need to understand the withdrawal process.
Antidepressant withdrawal can last for different lengths of time, depending on the individual, the medication, and the dosage. While some people recover within a few days, others may experience symptoms for weeks, months, or even more than a year.
Studies show withdrawal often lasts longer than the two weeks suggested by U.S. guidelines, with reported durations ranging anywhere from 5 days to 79 weeks (or a year and a half).
Protracted withdrawal
Protracted withdrawal refers to symptoms that persist for months or years after stopping a medication. It likely results from changes in brain chemistry that take time to stabilize.
The risk of protracted withdrawal is thought to be higher with long-term use, abrupt discontinuation, or inadequate tapering of certain medications.
A study reviewed 69 cases of protracted withdrawal syndrome (PWS) from antidepressants. Participants had taken antidepressants for 6 to 278 months (about 23 years), averaging 96 months (8 years).
Withdrawal symptoms lasted between 5 and 166 months (nearly 14 years), with an average duration of 37 months (a little more than 3 years).
The findings suggest that long-term antidepressant use may impact multiple body systems.
The most common symptoms included:
- Emotional symptoms: These were reported by 81% of participants. Symptoms could include anxiety, depression, agitation, or suicidal thoughts.
- Physical symptoms: These were reported by 75%. Symptoms could include headaches, fatigue, dizziness, brain zaps, visual changes, muscle aches, tremors, diarrhea, or nausea.
- Sleep issues: These were reported by 44%.
- Cognitive difficulties: These were reported by 32%.
Another study surveyed 1,148 people from online support groups for antidepressant withdrawal. The results revealed that 40% of participants experienced withdrawal symptoms lasting over 2 years, and 80% were moderately to severely affected. About 1 in 4 had trouble discontinuing their antidepressants.
Withdrawal caused various issues, including work difficulties, job loss, sick leave, and relationship breakdowns.
Here are key factors affecting the duration of antidepressant withdrawal:
- Type of antidepressant: Different classes (SSRIs, SNRIs, TCAs) have varying withdrawal timelines.
- Dosage: Higher doses may lead to more prolonged withdrawal.
- Length of use: Longer use of the medication may result in a longer withdrawal period.
- Tapering process: Gradual tapering versus abrupt discontinuation may affect withdrawal duration.
- Individual sensitivity: Each person’s body reacts differently to medication changes.
- Physical health: Overall health, including liver function and metabolism, may impact withdrawal.
- Psychological factors: Anxiety, depression, or other mental health conditions may influence withdrawal intensity and duration.
- Polydrug use: Taking multiple medications simultaneously may complicate and prolong withdrawal.
Discontinuation method
Your discontinuation method can significantly affect withdrawal duration and severity.
Abrupt discontinuation (stopping suddenly) often leads to intense and prolonged withdrawal symptoms.
In contrast, gradual tapering (slowly reducing the dose over weeks or months) allows the body to adjust, typically reducing the severity and duration of symptoms.
Other methods, like micro-tapering (tiny dose reductions) or switching to a longer-acting medication before tapering, may further ease withdrawal.
Treatment duration
The length of time you’ve been on antidepressants can impact how long withdrawal symptoms last. If you’ve taken them for years, your body and brain may have adapted more to the medication, leading to longer and more intense withdrawal.
Shorter use often results in milder and briefer symptoms since your body hasn’t had as much time to adjust. However, the specific medication and your unique response also play a role.
Drug half-life
The half-life of a drug is the time it takes for half of the medication to leave your body.
Antidepressants with a short half-life leave your system quickly, which can lead to more intense and immediate withdrawal symptoms. Medications with a long half-life exit more gradually, often resulting in milder and slower-onset withdrawal.
One study analyzed reports of antidepressant withdrawal from a large global database and compared the risk between short- and long-half-life antidepressants.
The findings suggest:
- Withdrawal risk was notably higher for short half-life antidepressants, such as paroxetine, desvenlafaxine, venlafaxine, and duloxetine. These were more difficult to discontinue.
- Longer half-life antidepressants, such as agomelatine and vortioxetine, were associated with a lower risk of withdrawal, potentially making them easier to stop.
- dizziness or lightheadedness
- flu-like symptoms (chills, fatigue, muscle aches)
- nausea or vomiting
- headaches
- sweating
- tremors or muscle spasms
- electric shock sensations (“brain zaps”)
- diarrhea
- insomnia
- increased anxiety or restlessness
- irritability or mood shifts
- depression or worsening mood
- confusion or difficulty concentrating
- emotional blunting or inability to cry
- agitation
- tingling, numbness, or heightened sensitivity
- visual disturbances
- hyperarousal
- hallucinations (rare cases)
Managing antidepressant withdrawal symptoms involves thoughtful planning, support, and self-care.
Here are key strategies:
- Slow tapering: Gradually reducing the dose of antidepressants under the guidance of a healthcare professional helps minimize withdrawal symptoms.
- Supportive therapies: Cognitive behavioral therapy (CBT), acupressure, and massage therapy may help manage anxiety, physical discomfort, and emotional disturbances.
- Hydration and nutrition: Staying hydrated and maintaining a balanced diet with plenty of fruits, vegetables, and whole grains can support overall well-being during withdrawal.
- Physical activity: Gentle exercise like walking, swimming, or yoga can alleviate physical tension, improve mood, and reduce stress.
- Mindfulness and relaxation: Practicing mindfulness, meditation, and deep breathing exercises can reduce anxiety, improve emotional regulation, and support overall mental health.
- Herbs and supplements: Omega-3 fatty acids, L-theanine, B vitamins, ashwagandha, and valerian root may help manage withdrawal symptoms such as anxiety, fatigue, mood changes, and sleep disturbances. Always consult a doctor before using herbs or supplements.
Antidepressant withdrawal can be difficult, with symptoms ranging from mild to severe. They can last anywhere from a few days to over a year, depending on factors like the medication, dosage, and how you stop taking it. Gradually reducing the dose under a doctor’s guidance can help ease the process.
If you’re thinking about stopping antidepressants, it’s important to work closely with your doctor to manage the withdrawal effectively.