Antidepressants Withdrawal and Detox

When you suffer from depression, physicians may recommend antidepressant drugs as treatment, to correct chemical imbalances in the brain. Antidepressants function by balancing the chemicals in the brain responsible for sadness, anxiety and other emotions. However, if you take antidepressants for more than six weeks , there is a high chance that you’ll experience withdrawal symptoms if you stop taking them.

Withdrawal from antidepressants is often referred to by medical professionals as ‘discontinuation syndrome’ instead of the more common ‘withdrawal syndrome’. This is because antidepressants are considered non-addictive, whereas withdrawal syndrome implies an addiction is present. However, both terms describe the same effects, including the range of antidepressant withdrawal symptoms that result from quitting antidepressants.

It is never recommended for you to stop taking antidepressants ‘cold turkey’. Abrupt cessation can throw your brain into a state of imbalance, accompanied by physical and psychological consequences that could be worse than your initial symptoms. The safest way to quit antidepressants is to undergo a medically supervised withdrawal and detox. A medical detox can help to reduce any withdrawal symptoms that may occur.

Medical detox from antidepressants does not need to be a lonely or uncomfortable experience. So, whether it’s your first or hundredth attempt to quit, it’s never too late to turn your life around.

Antidepressant withdrawal and detox

Suddenly quitting antidepressants can lead to restlessness, fatigue and in some cases, crying spells. Your depression can even feel worse in some cases, leading you to take more doses of antidepressant medication. This means that instead of getting rid of the drugs in your system, you only add more. If this happens, you may need to seek help from an antidepressant detox centre.

Some of the withdrawal symptoms that can occur during withdrawal may include symptoms similar to the flu, aggression, tremors, suicidal thoughts, abdominal pain and cramping, dizziness and confusion, vertigo, nausea, confusion, sexual dysfunction, increased depression, sensations similar to an electric shock, insomnia and profuse sweating.

The first step towards finally being free from antidepressant usage is to overcome the fear of withdrawal and ask for help from medical professionals. Although you may not experience the full range of symptoms, it is crucial to be prepared for anything when you’re ready to stop taking antidepressants, as withdrawal can be unpleasant and fairly severe. Fortunately, there are top-rated residential facilities that provide medically trained staff, who can ensure your safety and comfort during withdrawal.

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What is antidepressant withdrawal?

Antidepressant withdrawal is also referred to as Antidepressant Discontinuation Syndrome (ADS). It comprises a group of physical and mental symptoms that occur when you suddenly stop taking your antidepressant medication. According to research, the time it takes for the body to become dependent on antidepressants is around six weeks of consistent usage. After this initial period, it’s possible to experience withdrawal symptoms when you try to significantly reduce your dosage.

Quitting completely after this period can also result in uncomfortable withdrawal symptoms. While antidepressant withdrawal is challenging, it is usually not life-threatening. Still, it is recommended to quit antidepressants only under close medical supervision to avoid suicidal ideation or other behaviours that could cause self-harm due to irritability, anxiety, rebound depression and other symptoms.

Antidepressant withdrawal could also result in a phenomenon known as ‘brain zaps’, which you may or may not experience. These refer to electric, shock-like sensations occurring in the brain. Teenagers especially may be prone to suicidal thoughts and actions when quitting antidepressants. If you or someone you know is taking antidepressants and are trying to quit, it is essential to talk to a doctor.

Causes of antidepressant withdrawal

The major causes of antidepressants withdrawal are related to the changes the drugs have caused to both your brain and body. Antidepressants work by changing the levels of neurotransmitters that the neurons in the brain become adapted to. When you suddenly quit, the change that occurs happens too fast, leading to withdrawal symptoms that range from mild to distressing.

After using antidepressants for a while, your body also adapts to the substance in your system as a way to create balance. If you severely decrease or stop your dosage, you can throw your system into shock and out of the balance it has created for itself. All the initial symptoms for which the antidepressants were being used will resurface during the process of withdrawal.

Therefore, antidepressant withdrawal is caused as your brain and body struggle to regain normal functioning. It is a way of physically manifesting the chemical consequences occurring inside you when you withdraw from antidepressants. In addition, many of the symptoms you may experience during this period are similar to your initial ones like depression, mood changes and anxiety.

Phases of antidepressant withdrawal

When trying to quit antidepressants, you may experience a range of withdrawal symptoms that can be categorised into two main phases. The initial phase lasts for about six weeks, and includes new symptoms and a reoccurrence or intensifying of symptoms you had before taking the medication. The withdrawal stage is known to involve symptoms such as headaches, insomnia, nausea, agitation and irritability.

During this stage, you may also experience electric zapping sensations washing across your entire body that feel like riding a roller coaster. The second stage may begin six weeks after you stopped using antidepressants. The withdrawal symptoms you may experience at this period rarely disappear on their own. In some cases, they could be so severe that they lead to a relapse.

Some of the symptoms at this second stage last for years, and may include mood swings, disturbed mood, irritability, bipolar illness, persistent insomnia, impaired memory, impaired concentration, poor stress tolerance, major depression and anxiety disorders.

Antidepressant withdrawal symptoms: What to expect

Generally, antidepressant withdrawal symptoms occur when about 90% of the substance has been eliminated from your body. If you know the half-life of your specific antidepressant medication, you can calculate the time your withdrawal effects may begin. Popular antidepressants and their approximate half-life include:

  • Prozac (fluoxetine) – 5 days
  • Lexapro (escitalopram) – 30 hours
  • Effexor (venlafaxine) – 6 hours
  • Celexa (citalopram) – 36 hours
  • Zoloft (sertraline) – 24 hours
  • Paxil (paroxetine) – 29 hours

However, the length of time you can expect withdrawal to last will depend on different factors, including: your age, metabolism rate, level of tolerance, frequency of antidepressants use, longevity of usage and the existence of any co-occurring mental disorders.

In addition, certain antidepressants have a more significant risk of causing negative withdrawal symptoms. If you’re using Paxil or Effexor for instance, your withdrawal symptoms may be quite intense. This is because both drugs have short half-lives and are flushed out of the body faster than those with long half-lives, such as Prozac and Celexa.

Common symptoms of withdrawal include:

  • Nausea
  • Uncontrollable seizures
  • Hand tremors
  • Dizziness
  • Headaches
  • Mental disorientation
  • Paranoia
  • Hallucinations

You may also experience a rebound of symptoms associated with depression.

Timeline of antidepressant withdrawal

The beginning and duration of withdrawal can differ markedly from one person to the next. For instance, you might not experience any symptoms until several weeks after you’ve quit your medication. For some people,  withdrawal may almost be completed within the same period. The key factor when it comes to the timeline for antidepressants withdrawal is how long you’ve been taking these drugs. If you’ve been on this medication for six months, your symptoms will significantly differ from someone who has been on antidepressants for two years.

The antidepressant withdrawal timeline may follow this outline:

Days 1 to 3: Depending on the medication used, you may begin to experience the initial withdrawal symptoms in the first few days after you quit. Mild symptoms can also appear, even if you taper off.

Days 4 to 5: Withdrawal symptoms increase in intensity, before starting to fade. During this time, you may experience fever, dizziness, nausea and shakiness.

Weeks 1 to 3: If you stop taking your antidepressants, symptoms might disappear after three weeks. Generally, the symptoms persist for up to three weeks, and gradually begin to fade away.

Weeks 4+: Different factors will determine how long your withdrawal lasts, and if you will experience symptoms that linger for months afterwards.

What is antidepressant detoxification?

Antidepressant detoxification is the process of allowing these drugs to leave to your body. It involves gradually lowering doses until you can safely stop using the medication. Medical detox can help to prevent or limit withdrawal symptoms. The ideal way to approach antidepressant detoxification depends on your general state of health, how much and how often you use, as well as your personal preferences and treatment goals.

During detoxification, your doctor can work with you to determine the most suitable pace at which you can be tapered off antidepressants. They will also administer remedies or suggest helpful over-the-counter medications to help manage your symptoms in the short-term. A successful taper needs to be carried out slowly. It can therefore take about six weeks to two months to complete.

There are no rules when it comes to tapering your antidepressant dosage. It may be initially cut in half and then reduced by quarters. It could also be tapered down in as little as one month or over several months. Generally, a slower or more gradual tapering can improve your comfort and reduce withdrawal symptoms. Your doctor will therefore need to track and make necessary adjustments to your doses, according to your individual needs.

Antidepressant detox process

When you’re looking for a rehab programme, it is essential to carefully research your options and be prepared for what happens during the antidepressant detox process. In general, the process within a medical setting will begin with assessment and evaluation. Your medical history – in addition to your results from a physical exam – will be assessed to ensure you’re in good physical and mental health, and can begin treatment. Monitoring and support is the next stage of the process, where a tapering schedule can be created for you.

Your supervising physician will create a tapering schedule, and provide round-the-clock medical monitoring to manage any extreme withdrawal symptoms that may occur. During this period, it is also important to have the support of your friends and family.

Your doctor could switch you to a longer-acting antidepressant or provide medications which specifically address your discontinuation symptoms. If you’ve been engaging in polydrug use or abusing alcohol with your medications, you can benefit from therapies such as talk therapy or Cognitive Behavioural Therapy (CBT) after the detox process.

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Home detox

Home detox – or trying to stop using antidepressants without the help of medical professionals – can be challenging. In some cases, it can even worsen your depression. If you’re thinking about a home detox, there are some things to take into consideration:

  • You could become sick during home detox because of antidepressant discontinuation syndrome or antidepressant withdrawal. This occurs when you suddenly stop taking your medication, and you might feel like you have a stomach bug or the flu.
  • You could set back your treatment goals, because you have no professional help. Home detox can actually worsen your symptoms or significantly increase the length of time it takes to feel better.
  • There is also the risk of contemplating suicide, as the possibility of suicidal thoughts can occur during detox. Detoxing at home could increase the risk of you acting out these negative thoughts.
  • Other symptoms associated with your depression such as insomnia, pains or headaches might worsen. In addition, depression can also make it difficult to manage other health problems, especially when left untreated.

Why detoxification at home can be harmful

After deciding to quit antidepressants, you may attempt self-detox. This kind of decision is not ideal, as in certain situations, self-detoxification can be dangerous. There are many different reasons why you should not consider undergoing detoxification at home. It’s quite common to give up and return to using drugs when detoxing from antidepressants and other substances.

Even though alcohol is the most dangerous substance from which to self-detox, other drugs can be risky too. You may think that detoxing from a medication on which you’ve become dependent is a simple and easy process. Sadly, this is quite far from the truth. No matter the drug, there are always going to be risks involved when detoxing. It is therefore best to choose inpatient or outpatient treatment for detox. This form of care provides the assistance of qualified caregivers, and reduces the chances of severe side effects.

Trying to detox from the comfort of your own home almost always results in negative consequences. Unlike simple diets to remove toxins from the body, detoxing from drugs like antidepressants should always be carried out with the approval and supervision of an addiction specialist.

Medically supervised antidepressant withdrawal detox

Medically supervised withdrawal detox involves the administration of medication to reduce the severity of side effects that occur when you stop using antidepressants. Such medication may be used to treat side effects such as insomnia and headaches. However, there is no medication specially designed to treat antidepressant withdrawal.

The main goal of medically-supervised withdrawal is to help you safely and successfully transition into medication-assisted treatment for antidepressant dependence. However, supervised withdrawal alone cannot provide the long-term abstinence from antidepressants you desire. Also, it doesn’t address the underlying physical and psychological reasons for using the drugs.

If you or someone you know is in need of antidepressant withdrawal detox treatment, you may want to explore the available options. Going ‘cold turkey’ on your own is never the answer and can be unsafe. A more intensive medically supervised withdrawal is essential, whereby you can have specialised professionals help you begin your recovery today.

Medications used during antidepressant detox

Antidepressant detox and the associated symptoms are not usually life-threatening. However, when you experience psychological symptoms of withdrawal such as depression, there is the possibility of self-harm. This can occur either intentionally or unintentionally, as the result of an accident or bad judgment. This is why it is strongly recommended to stop using antidepressant medications with the help of a doctor.

While there are no approved drugs to address antidepressant withdrawal, doctors utilise two strategies that have proven to be effective. Since discontinuation symptoms occur because of an abrupt cessation of your medication, a tapering strategy involving slowly reducing your antidepressant dosage is applied. In most cases, lowering dosage in successive intervals is effective in avoiding withdrawal symptoms.

Besides tapering, your physician may switch you to a different antidepressant with a longer half-life. This strategy is commonly used if you are still experiencing symptoms whilst tapering. The new antidepressant is then tapered down slowly to avoid the symptoms of antidepressant withdrawal.

Certain psychiatrists prescribe Fluoxetine in a single 20mg tablet, after the last dose of a shorter-acting antidepressant medication. The aim is to ease the final washout of the medication from your body.

It is essential to check-in with your doctor a month after you quit taking antidepressants altogether. During this follow-up meeting, your physician will check to ensure your discontinuation symptoms have disappeared, and there are no signs of rebound depression.

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Withdrawing from antidepressants: Treatment methods and options

If you’ve been using antidepressants for a long time, withdrawal should be carried out gradually and under the close supervision of a medical team. In some situations, your dosage may be tapered off or another medication may be used to reduce the symptoms of withdrawal, but this generally lengthens the process.

If you’re withdrawing from antidepressants, psychological counselling may also be needed to help you identify and deal with your fear of living without antidepressants. This type of psychological dependence can be treated using methods such as individual or group counselling. Generally, withdrawal from antidepressants is treated on an outpatient basis. However, you might be required to check into a clinic or hospital to be monitored for signs of depression or suicidal thoughts.

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Guided antidepressant therapy

Your doctor may make the decision to put you on guided antidepressant therapy. Normally, you will be under the care of a psychiatrist. If you’ve had two or more previous (serious) episodes of depressive illness over a period of five years, this form of therapy may be required. It is considered a very effective method for treating cases of highly recurrent depression.

Sometimes, you may feel confident about ending your therapy or treatment, even when you have remained on maintenance therapy for a long time. However, the difficult decision to end guided therapy will depend on factors such as the difficulty of treatment for former depression episodes, the subsequent effects on your career, personal and family life, and if a future episode may involve the risk of suicide.

You, your doctor and a family member will need to consider these factors, in order to decide whether to continue with guided antidepressants therapy or if it can be safely discontinued. If the drug is withdrawn, you will need follow up, as this is the most efficient way to determine whether drug treatment needs to be continued.

Live a drug-free life again

If you’re abusing antidepressants or have developed a dependence on them, don’t delay seeking substance abuse treatment. In addition, you may be feeling better and think it’s time to stop using your medication. In such cases, the medication is usually responsible for such feelings, making you think that you no longer need antidepressants. It is always best to talk with your doctor to create a plan of action to help you adjust to living without the drugs. It is also essential to follow your doctor’s prescribed treatment.

Curiosity, pleasure and trying to deal with day-to-day stress are some of the different reasons to start abusing antidepressants. No matter why you started abusing antidepressants, it doesn’t have to stop you from getting better. If you’re willing to live a drug-free life again, you don’t have to go through withdrawal and treatment by yourself. There are qualified professionals who can help with the struggles you face. Dot let fear keep you from the treatment you deserve. It’s better to seek withdrawal at a professional treatment centre.

Preventing relapse

Roughly four out of five people with depression will relapse at one time or another. With careful handling, you can withdraw from your antidepressant medication and avoid the disturbing side effects that could result in a relapse. According to studies, Mindfulness-Based Cognitive Therapy (MBCT) provides the same results in relapse prevention as antidepressants. MBCT blends the teachings of CBT with mindfulness-based stress reduction techniques (such as meditation).

Typically, Mindfulness-Based Cognitive Therapy is a group intervention provided in a standardised manner. The focus is mainly on identifying and addressing certain thought patterns and influence the re-occurrence of depressive episodes. This therapy is meant to be implemented whilst in a state of remission, and not during actively depressed moments. MBCT studies have also shown the promise of the technique in reducing depression relapse rates in high risk patients and the chronically depressed.

Tips for handling cravings

Cravings for antidepressants can be handled by practicing healthy habits. By maintaining a positive mindset, you improve at resisting the temptation to return to antidepressants. There are a number of healthy practices to effectively handle cravings. Some of them are:

  • Exercise: This stimulates mental processes and keeps cravings at bay. Swimming, walking, running and weight lifting are helpful activities for a positive mindset. According to studies, walking about 20 to 40 minutes, three times a week can relieve some depressive symptoms.
  • Sleep: Unhealthy sleeping habits can result in giving in to cravings and relapsing into depression. Ideally, you should go to sleep at the same time each night, and aim for around eight hours of sleep per night.
  • Eat healthily: Food can significantly affect the way you feel. Unhealthy food can lower your energy and contribute to a negative mood.
  • Maintain healthy relationships: During difficult times, it is crucial to have a strong support network of family and friends. You should therefore make a conscious effort to have people around you who care about you and about your happiness. The people you socialise with should be positive-thinking individuals.
  • Relaxation techniques: Frustration and stress can be powerful triggers for depression, and could cause cravings as well. Relaxation techniques which can effectively help you alleviate stress or frustration include yoga and meditation.

FAQs

What is antidepressant withdrawal?

Antidepressant withdrawal occurs when you suddenly quit using antidepressants – especially after you’ve taken them for around six weeks or more. The symptoms of antidepressant withdrawal are often referred to as antidepressant syndrome, and usually linger for a few weeks. These symptoms may include anxiety, headaches, irritability, dizziness, tiredness, insomnia or vivid dreams.

Is Antidepressant withdrawal dangerous?

An abrupt withdrawal from antidepressants can lead to the appearance of withdrawal symptoms, but it can also cause a rapid reoccurrence of your original disorder. This is one of the reasons doctors do not recommend quitting on your own, as you should be slowly tapered off over time.

How long does antidepressant withdrawal last?

There are different factors that determine how long withdrawal symptoms last. The duration for antidepressants withdrawal will depend on the specific drug you’re taking, your current dose, how long you’ve been taking it and the symptoms you’re experiencing. Typically, withdrawal symptoms can linger for up to three weeks, during which your symptoms gradually fade away.

How long does it take to detox from antidepressants?

Factors that contribute to the duration of antidepressants detox include the amount of antidepressants in your system, the length of time you’ve been using them and the type of antidepressants you are taking. Fortunately, there are a wide variety of options available to undergo a safe and successful detox.

Are there ways to prevent or reduce withdrawal symptoms?

If you wish to prevent or reduce withdrawal symptoms, you should see your doctor before stopping your medication. They may recommend a gradual reduction of your regular dose for a period of a few weeks or more, to help your body adjust to the absence of the drugs. This method of tapering your medication under medical supervision can contribute to experiencing fewer withdrawal symptoms.

How do you care for someone going through withdrawal?

The first step to care for someone going through withdrawal is to get them into a treatment programme. Outside a hospital or inpatient setting, you can provide help by continuing to support their recovery, and ensuring that they stick to their treatment plan. This might include keeping the environment calm and quiet, regulating temperature and administering outpatient medications. Emotional support is also a key factor in providing an environment that promotes recovery, and should be provided as much as possible.

Can medication help?

Generally, there are no medications approved for the specific treatment of antidepressant withdrawal. Antidepressant withdrawal symptoms can appear as flu-like symptoms, such as nausea, headache and dizziness. Physicians therefore treat these symptoms with the same types of medications they would use to treat someone who is suffering from flu. In addition, insomnia and other related ailments can be treated using sedatives.

Are there any home remedies for getting clean safely?

Because of the intensity of antidepressant withdrawal symptoms, using any form of home remedy or alternative medications is not advisable. Instead, you should seek help from a professional to relieve your symptoms. You may consider a detox or rehabilitation centre, or talk to a medical professional about your options.

Can I find help?

If you’ve decided to stop taking your antidepressant medication because of the side effects you’re experiencing, then you need to find the right treatment. Therefore, don’t stop taking the medicine until you’ve discussed this with your doctor. Even if you feel like you don’t need the medication anymore, quitting without help can cause a return of the original symptoms.

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