You take it regularly Antidepressants one and want to get away from it? Then the following applies: Do not do this alone, as serious problems can arise! The reason: as the body gets used to the medication, withdrawal symptoms are possible if you stop taking it.
The following applies as a guide: Anyone taking antidepressants for more than eight weeks must take into account the risk.
What can happen if you stop taking your medication?
The following symptoms, among others, may occur when you stop taking an antidepressant:
- dizziness‘Dizziness
- Nausea, vomiting
- sleep disordersNightmares
- Flu-like symptoms
- Headache
- irritability
- anxiety
- Sensations similar to electric shock.
Symptoms usually appear about one to four days after stopping and usually disappear within two to six weeks. Sometimes they persist for months.
Antidepressants: the different groups of active ingredients
Against depressions Several active ingredients are used, many of which we have a special on antidepressants evaluated. Some of them are grouped into larger groups based on their characteristics:
- SSRI: Selective serotonin reuptake inhibitors
(English: It iselective It iserotonin Rcapture Iinhibitor), - IRSN: Selective serotonin-norepinephrine reuptake inhibitors
(English: It iserotonin noradrenaline Rcapture Iinhibitor), - HAND-inhibitors: MYesTheminOoxidase inhibitors.
Others, on the other hand, are grouped into a group of active ingredients based on their chemical structure, such as:
- Tricyclic antidepressants, also known as tricyclics
- Tetracyclic antidepressants
How often do withdrawal symptoms occur?
Around a third of people who stop antidepressant therapy experience withdrawal symptoms, shows a meta-analysis carried out by researchers from Charité Berlin and the University of Cologne, which will be published in the specialist journal in 2024 Lancet Psychiatry appeared. Data from 79 studies with about 21 thousand participants were included in the analysis.
What are the causes of the symptoms?
In part, this is probably due to the different durations of action of antidepressants in the body. Fluoxetine, an SSRI, works for a long time. Discontinuation problems with this substance are rare, as the new review confirms. Some antidepressants therefore appear to cause more frequent or more severe withdrawal symptoms than others – notably some tricyclic antidepressants such as imipramine, SSRIs such as paroxetine or SNRIs such as venlafaxine.
According to the meta-analysis, both psychological and physical causes can play a role. 4,470 participants were given a dummy drug (placebo) instead of an antidepressant – and 17% of them also experienced withdrawal symptoms. This may be partly due to fear of withdrawal. Nevertheless, patients should take the problem seriously and take important preventive measures.
From suitable to not very suitable: drugs under test
- High blood pressure, enlarged prostate, irritable bowel syndrome – Stiftung Warentest regularly evaluates the benefits and risks of various drugs based on analyses by pharmaceutical experts and taking into account the results of current studies. All tests are grouped together on our website Medication Topic Page.
- Our book provides information about the different forms and causes of depression, as well as treatment options. Help with depression.
- You can find an overview of the benefits of psychotherapy for mental distress and psychotherapy procedures funded by health insurance companies in a separate article on the topic. psychotherapy. There we also give tips for finding a therapy location.
How can I prevent withdrawal symptoms?
To ensure that the end of depression therapy isn’t overshadowed by withdrawal symptoms, experts recommend “tapering” medications, which is taking smaller and smaller doses over a longer period of time. This is helpful for another reason: If antidepressants are stopped abruptly after taking them for a long time, depression can reappear. Tapering counteracts this.
According to the updated 2022 National guidelines for the treatment of depression Antidepressants should be tapered off gradually at the end of long-term therapy over a period of at least eight to twelve weeks. For example, it may help to use progressively lower doses of tablets or to initially switch patients to an antidepressant in liquid form and then reduce it drop by drop. If the antidepressant has been used for less than eight weeks or needs to be changed urgently due to side effects, the guidelines state that it can be stopped quickly.
Important: Never stop taking antidepressants on your own and do not reduce the dose on your own, but discuss the procedure with your doctor. If you experience withdrawal symptoms, contact the clinic. Then the dose will probably have to be increased again and then reduced in even smaller steps.
Elderly people cannot tolerate all antidepressants
Several antidepressants and several other medications are on the so-called Priscus list – which means they can potentially harm older people. You can find out more about these active ingredients and how they can be replaced in a separate Contribution to the Priscus list.
Relapse or withdrawal symptom?
Will a treatment with a antidepressant If medication is stopped and symptoms later recur, it is not always clear whether the problems arise from stopping the medication or whether the depression has returned. A mnemonic (FINISH) is used to try to summarize the typical withdrawal symptoms:
The typical signs of depression are not always easy to distinguish. Depression, lack of motivation and strength can also occur with depression, as well as loss of appetite, insomnia or physical complaints.
Clue to differentiate: Discontinuation symptoms usually appear very quickly – about one to four days after the end of treatment or dose reduction. The symptoms usually disappear within two to six weeks; rarely they last for several months; affected people usually only notice a relapse much later. Even so, it is important to contact your doctor to get the right help.