what is ssri discontinuation syndrome treatment

You can treat the symptoms of SSRI discontinuation syndrome by resuming the original dosage of the SSRI or lowering it appropriately over a longer period of time. Either way, this is also something that your doctor should decide depending on your specific case. Preventing this type of situation is also extremely important.

Full Answer

How to stop taking SSRI antidepressants safely?

• You think it's taking too long. Doctors list impatience as one of the main reasons their patients stop taking their antidepressant medications. ...
• You are experiencing unwanted side effects. ...
• You cannot afford the medications anymore. ...

Can SSRI antidepressants permanently damage you?

Long-term use of antidepressants could cause PERMANENT DAMAGE, doctors warn. Image:Antidepressants are meant to be taken for nine months for a first episode of depression. Long-term antidepressant users are risking permanent damage to their bodies, according to leading medical experts. Dr Tony Kendrick, a professor of primary care at the University of Southampton, says more urgent action needs to be taken to encourage and support long-term users to come off the medication.

Does SSRI treat lack of concentration caused by depression?

SSRI’s help improve the sadness, and often many other symptoms of depression, which may include improving concentration Sometimes, while increasing the levels of serotonin, the levels of dopamine and norepinephrine decease, causing a decrease in concentration.

How to deal with antidepressant discontinuation syndrome?

What supplements are useful for getting off antidepressants?

• Activated charcoal. ...
• Fish Oil or Krill Oil. ...
• Glutathione (GSH) Glutathione is a potent antioxidant in the body, and every cell has it to reduce the build of toxin and prevent inflammation.
• Melatonin. ...
• Magnesium. ...
• Vitamin B Complex. ...
• Himalayan Salt or Sea Salt. ...
• Other supplements. ...

How do you fight discontinuation syndrome?

When experiencing withdrawal symptoms or antidepressant discontinuation syndrome, increasing physical exercise or changing the diet to include more fresh food may help ease symptoms by making a person feel reinvigorated and less lethargic.

How long does it take for discontinuation syndrome to go away?

Discontinuation symptoms may occur in either case, especially if a drug is stopped abruptly. Symptoms usually start two to four days after stopping the medicine. They usually go away after four to six weeks. In rare cases, they may last as long as a year.

How long do SSRI discontinuation symptoms last?

Typical symptoms of antidepressant discontinuation syndrome include flu-like symptoms, insomnia, nausea, imbalance, sensory disturbances, and hyperarousal. These symptoms usually are mild, last one to two weeks, and are rapidly extinguished with reinstitution of antidepressant medication.

Is SSRI discontinuation syndrome permanent?

In weeks one to three, the symptoms will gradually fade. Few people may see any withdrawal symptoms that last longer than four weeks, though some may have symptoms lasting for several months. Some people who take SSRIs will stay on them indefinitely while others are able to stop taking it after a few weeks or months.

Does your brain go back to normal after antidepressants?

If the symptoms develop later or gradually, they may constitute a relapse of the depression. Ultimately, these withdrawal symptoms will improve with time, but they can be unpleasant for days and possibly even weeks. In time, the brain readjusts and people should experience a return to their normal state.

How common is SSRI discontinuation syndrome?

Antidepressant discontinuation syndrome occurs in approximately 20 percent of patients after abrupt discontinuation of an antidepressant medication that was taken for at least six weeks.

Is discontinuation syndrome permanent?

Most cases of discontinuation syndrome may last between one and four weeks and resolve on their own. Occasionally symptoms can last up to one year. They typically resolve within a day of restoring the medication.

What are severe SSRI withdrawal symptoms?

Quitting an antidepressant suddenly may cause symptoms within a day or two, such as:Anxiety.Insomnia or vivid dreams.Headaches.Dizziness.Tiredness.Irritability.Flu-like symptoms, including achy muscles and chills.Nausea.More items...

Which SSRI is most likely to cause discontinuation syndrome?

Prevention of SSRI Discontinuation Syndrome Around 20% of people taking Paxil, Zoloft, Celexa, or Lexapro will experience some degree of withdrawal following termination of treatment, lasting anywhere from one to three weeks. 4 For those who have been on SSRIs for many years, the symptoms may persist for longer.

Do SSRIs cause long-term damage?

Two recent reviews of research in this area concluded that discontinuation effects, sexual dysfunction, weight gain, and sleep disturbance (multiple long-wake periods) are adverse effects of long-term SSRI use.

Does brain fog from antidepressants go away?

These symptoms of brain fog may be short-term or ongoing as you take these medications. While antidepressants are generally intended to help with brain fog, some can cause brain fog as a side effect, depending on the medication and your unique response to it.

Does Benadryl help antidepressant withdrawal?

While antidepressants like Prozac (fluoxetine) have a longer half-life, they may still cause symptoms of withdrawal. 11 If you need support in managing your antidepressant withdrawal symptoms, over-the-counter antihistamines or sleep aids can help minimize some of that discomfort.

What is SSRI discontinuation syndrome?

SSRI discontinuation syndrome is a specific type of substance withdrawal that can occur when ceasing the use of antidepressant drugs. Antidepressants are very commonly prescribed for depression, chronic anxiety and a range of other mental health conditions. They’re known to be very effective.

Why do people stop taking SSRIs?

People stop taking these drugs abruptly because they don’t think there’s a risk. Then they’re surprised when they feel physically sick without the chemical in their system.

How long should I take SSRIs?

Originally, SSRIs were formulated to be used for no more than a few months. Now, the recommendation is that when a person is feeling better for six months, SSRI use should be gradually discontinued.

Is it safe to take SSRIs?

Selective serotonin reuptake inhibitors — or SSRIs — can be an incredible help for people diagnosed with depression. They’re also considered very safe, with little potential for abuse because of their long-term effects. But while this is true, just like with other drugs, taking SSRIs isn’t completely risk-free. When a person stops taking the drugs, they may experience a sort of withdrawal called SSRI discontinuation syndrome.

When to use tapering regimen?

Use a tapering regimen when you discontinue medication. Especially when you’ve used a certain medication for more than just a few weeks, you shouldn’t stop using it abruptly. Your system may be more reliant on it than you realize.

Do SSRIs help with mental health?

But this represents a misunderstanding of how most medications are supposed to work. SSRIs and other drugs formulated to help treat mental health conditions are not fixing the condition. Instead, they’re repairing underlying deficiencies in the brain’s ability to regulate crucial chemicals like serotonin and dopamine.

Can you use SSRIs without a prescription?

If you or a loved one are abusing SSRIs — using them without a prescription or not as prescribed — you need to get help. Contrary to what you may have been told about these drugs, you can become dependent on them. This is what causes SSRI discontinuation syndrome, and withdrawal may be more severe if you’ve abused these medications.

How to stop SSRIs?

Discontinue slowly. One of the best ways to minimize discontinuation syndrome is by reducing doses of medicines, including SSRIs, slowly. Together, you and your doctor should decide how to reduce, then stop, the dose. Based on his and others’ clinical research, Baldessarini said that reducing the dose of an SSRI to zero gradually over two weeks or longer is prudent. Even slower discontinuation may be required if you’ve taken high doses for a long time.

How long does it take to reduce SSRI?

Based on his and others’ clinical research, Baldessarini said that reducing the dose of an SSRI to zero gradually over two weeks or longer is prudent. Even slower discontinuation may be required if you’ve taken high doses for a long time. Practice healthy habits.

What happens if you stop taking SSRI?

SSRI Discontinuation or Withdrawal Syndrome. After some people stop taking a type of antidepressant known as a selective serotonin reuptake inhibitor (SSRI), they experience a variety of symptoms. According to Dr. Ross J. Baldessarini, professor of psychiatry and neuroscience at Harvard Medical School and director of the psychopharmacology program ...

What happens if you stop taking antidepressants?

If you’re experiencing these symptoms soon after stopping an antidepressant, then the reaction likely is discontinuation syndrome. However, as Banov noted, symptoms such as mood swings, anxiety and depression can make it tricky to distinguish between discontinuation reactions and depression.

What are the drugs that inhibit the inactivation of serotonin?

Inhibitors of inactivation of both norepinephrine and serotonin (SNRIs). These include chlompramine (Anafranil), venlafaxine (Effexor) and desvenlafaxine (Pristiq). Such drugs are prescribed more often for depression or severe anxiety disorders, so the withdrawal phenomenon is more common.

How long does Prozac last?

For instance, Prozac, which has about a five-week half-life, appears to cause discontinuation much less often than drugs with shorter half-lives, such as Paxil. If discontinuation symptoms last more than a week or two, call your doctor. You may be in the early stages of a relapse.

How many people discontinue antidepressants?

About 20 percent of people experience discontinuation symptoms, according to Dr. Michael D. Banov, medical director of Northwest Behavioral Medicine and Research Center in Atlanta, and author of Taking Antidepressants: Your Comprehensive Guide To Starting, Staying On and Safely Quitting. About 15 percent experience mild to moderately bothersome symptoms while fewer than five percent experience more severe symptoms, he said.

How to reduce SSRI?

Together, your physician and you need to decide how to reduce, and then stop, the dose. Decreasing the dosage of an SSRI to zero slowly over two (2) weeks or even longer is most prudent. Even a slower discontinuation might be needed if high doses have been taken for a long time.

Can you have symptoms after only missing one dose of a drug?

In frequent cases, symptoms can occur even after only missing one dose. Often the symptoms are quite bad but go away almost immediately after the resumption of the drugs. There are individuals who are so miserable when attempting to end these drugs that they feel an obligation to keep taking it in order to avoid these brutal symptoms being experienced.

Is discontinuation syndrome reversible?

In summary, this discontinuation syndrome is found to be a condition that is reversible. But it is always suggested that these drugs only be used under the very strict supervision of a primary care physician and this applies to stopping the medication as well.

Is Prozac a short acting SSRI?

For instance, Prozac is a SSRI that is longer-acting while Paxil, Zoloft, Effexor and Luvox are short acting. The SSRIs that are short acting, when stopped or the dose is lowered, creates what is known as “anticholinergic rebound” and is a break in the creation of the main neurotransmitter acetylcholine. Acetylcholine is the neurotransmitter created most when a person is under extreme stress.

What are the symptoms of SSRI discontinuation syndrome?

For example, SSRI discontinuation syndrome symptoms are dizziness, gastrointestinal upset, lethargy, anxiety, low mood, sleep problems, and headaches.

What is discontinuation syndrome?

Discontinuation syndrome is a physical reaction to stopping an antidepressant medication abruptly. This syndrome can cause changes in your body and brain that cause you to feel unwell physically and mentally. Doctors typically take you off an antidepressant gradually to avoid or minimize discontinuation syndrome.

How long does it take for an antidepressant to stop?

You can deal with this, and your doctor is there to help. The most common symptoms are mild. In most cases, it will pass within a week or two without you doing anything about it.

How long does it take for a symtom to go away from antidepressants?

These antidepressant discontinuation syndrome symptoms, however, are usually mild and will only last one to two weeks. These antidepressant discontinuation symptoms can be quickly stopped by beginning to take antidepressant medications again. The management of antidepressant medications is extremely important for the body and following a providers instructions should always be done to avoid imbalance sensory disturbances, insomnia nausea imbalance, or general flu like symptoms.

What happens when you stop taking medication?

When the medication is no longer there, the neural natural processes must take back over the job completely. This can happen gradually and relatively painlessly when your doctor tapers down the dose, or it can happen abruptly, which causes the symptoms of discontinuation syndrome.

Why is discontinuation syndrome called discontinuation syndrome?

The reason for the change is that what happens is different from the withdrawal effect you have from an addictive drug. Antidepressants aren't addictive. People who are on them don't engage in drug-seeking behaviors.

Can SSRI cause nausea?

The most common reported symptoms for SSRI antidepressant discontinuation syndrome, also known as select ive serotine reuptake inhibitors, are: flu like symptoms, insomnia nausea imbalance, nausea vomiting, cognitive impairment, fatigue, headaches, and more. Systematic review agrees that taking selective serotonin reuptake inhibitors at the rate a doctor prescribes should always be done. If you are having adverse effects or side effects due to antidepressant discontinuation syndrome or medication itself, reach out to your health care provider immediately. Avoiding the signs and symptoms of ssri discontinuation such as nausea imbalance or general imbalance sensory disturbances should be done as soon as possible. Prevention and management of these flu like symptoms is possible and antidepressant withdrawal is a matter that should be discussed with your doctor.

Why is antidepressant discontinuation syndrome needed to be done on an individual basis?

Management of antidepressant discontinuation syndrome needs to be done on an individual basis because of a lack of specific treatment data (Box 1).2,3,5

What are the symptoms of antidepressant discontinuation syndrome?

The mnemonic FINISH summarizes the symptoms of antidepressant discontinuation syndrome: Flu-like symptoms (lethargy, fatigue, headache, achiness, sweating), Insomnia (with vivid dreams or nightmares), Nausea (sometimes vomiting), Imbalance (dizziness, vertigo, light-headedness), Sensory disturbances (“burning,” “tingling,” “electric-like” or “shock-like” sensations) and Hyperarousal (an xiety, irritability, agitation, aggression, mania, jerkiness).3

Can you stop antidepressants during pregnancy?

Physicians should be vigilant at times when patients may consider stopping an antidepressant (e.g., during pregnancy). Because not all formulations of the same drug are bioequivalent, there may be an unintended reduction in drug concentration if an antidepressant is switched to another formulation. To minimize risk of the syndrome, patients should be encouraged to consult their physician before stopping an antidepressant. Prescribing an antidepressant with a longer half-life or tapering the medication over six to eight weeks may reduce the risk.4

Does stopping antidepressants cause relapse?

Cessation of antidepressant therapy may increase the risk of relapse of depression or anxiety. Unlike the symptoms of antidepressant discontinuation syndrome, symptoms of relapse usually take more than a few days to appear and to disappear following reintroduction of the antidepressant.4

Do antidepressants have to be tapered?

Antidepressants with short half-lives need to be tapered gradually; however, gradual tapering may not prevent the syndrome in all cases.

Can you switch to fluoxetine when stopping another antidepressant?

Switching to fluoxetine when considering stopping another antidepressant may be helpful in some cases.

How to manage withdrawal symptoms of SSRI?

Your first step is to be fully aware of your mood, but you also must be able to manage your mood.

How long does it take for SSRI to stop?

However, as a general rule, symptoms of withdrawal become apparent within one week of stopping the medication.

How long does it take for SSRI withdrawal symptoms to go away?

Studies have also found that SSRI withdrawal symptoms typically resolve within 48 hours of restarting medication treatment. Also, switching to a different antidepressant may limit the adverse effects of discontinuing SSRI drugs. Dysregulation of serotonin is thought to be the cause behind the withdrawal symptoms.

How common is SSRI withdrawal syndrome?

Source: commons.wikimedia.org. SSRI withdrawal syndrome is extremely common, regardless of which SSRI drug is taken or how long medication therapy has been utlizied. Studies have shown that many people who discontinue SSRI drugs have at least two or more symptoms of withdrawal.

What are the symptoms of SSRI withdrawal?

You may experience several symptoms, including: Anxiety. Insomnia. Irritability. Suicidal thoughts. How to manage the physical and mental symptoms of SSRI withdrawal will be addressed in the last paragraphs of this article.

How long does it take to stop taking SSRIs?

Depending on the dose of SSRI drug you are on, weaning off of the drug may take several weeks.

Does paroxetine have a longer half life than other SSRIs?

This is thought to be because it has a shorter half-life, meaning it does not stay in the system as long as other SSRIs.

How long does it take to stop psychiatric medication?

Discontinuation syndrome, therefore, can be relatively easy to minimize or prevent altogether in many people. The key to discontinuing many psychiatric medications is to do so under a doctor’s supervision in a slow and gradual tapering process over weeks’ time. For some people, the process may take many months in order to successfully discontinue a psychiatric medication.

What is the purpose of antidepressants?

Grohol, Psy.D. on May 17, 2016. Psychiatric drugs, such as antidepressants and antipsychotics, are commonly prescribed to treat a wide variety of mental disorders, such as depression, bipolar disorder or schizophrenia.

Can you stop taking medication without consulting?

In some cases, a person may try and discontinue their medication without consulting their prescribing physician. One should never stop taking any medication prescribed by a doctor until one has talked to their doctor about stopping.

Is discontinuation syndrome real?

Discontinuation syndrome is a very real phenomenon, and has been well-documented in the research literature. Doctors and patients should be aware of the potential negative impact of discontinuing a psychiatric medication too quickly or on their own.

How to manage SSRI discontinuation?

Discontinuation symptoms can be managed by both prevention and treatment strategies. Preventive strategies include steps to be taken prior to onset of discontinuation symptoms. These include patient education regarding the need to continue antidepressant treatment and maintain adherence. Additionally, patients should be advised that inadvertently missing SSRI doses for a few days, especially with paroxetine, can result in discontinuation symptoms. As changes in ongoing SSRI treatment may be necessitated by partial response, nonresponse, tachyphylaxis, or intolerable side effects, the steps to minimize the risk of discontinuation symptoms include 1) increasing the dosage of the current SSRI to the maximal tolerated dosage; 2) switching to another SSRI or an SNRI; 3) using fluoxetine as a bridge to a nonserotonergic antidepressant, such as bupropion; 4) augmenting the SSRI with an atypical antipsychotic, lithium, buspirone, or liothyronine; 5) adding psychotherapy, light therapy, and/or exercise; and/or 6) consideration of treatments that are specific to treatment-resistant depression—repetitive transcranial magnetic stimulation, vagus nerve stimulation, electroconvulsive therapy, and intravenous ketamine. However, as depression is a chronic disorder, we recommend continued, potentially indefinite, treatment to reduce the risk of relapse or recurrence in patients whose depression is highly recurrent or chronic, is difficult to treat, and is comorbid with other psychiatric and medical conditions ( 2, 4 ). Adverse events may also be reduced or mitigated by use of alternative treatments (bupropion for sexual dysfunction, sedatives or cognitive-behavioral therapy for insomnia, exercise and diet modification for weight gain). Use of pretreatment biomarkers such as C-reactive protein may enable personalized selection of an initial antidepressant medication ( 76, 77 ). Further studies are needed to demonstrate the utility of biomarkers in reducing the need to switch treatments, which would diminish the risk of discontinuation symptoms. Combinatorial pharmacogenomic kits that test for genetic variants of several pharmacokinetic genes are available and have shown some promise in predicting treatment-emergent side effects ( 78 ). However, their utility in predicting risk of discontinuation symptoms remains unclear.

How long do you have to take SSRIs before discontinuing?

Any patient who either discontinues or markedly reduces the antidepressant medication dosage is at risk of discontinuation symptoms. Antidepressant medications may need to be taken for at least 4–6 weeks before the development of discontinuation symptoms is of concern. In patients with premenstrual dysphoric disorder, discontinuation of SSRIs after up to 2 weeks of daily dosing was not associated with any increased symptoms compared with placebo ( 71 ). Patients who are taking the SSRI with the shortest half-life—paroxetine—are at the highest risk of discontinuation symptoms ( 52, 57 ). Factors associated with higher likelihood of discontinuation symptoms include earlier age at onset of depression ( 57 ), comorbid conditions such as panic disorder ( 25 ), and a past history of discontinuation symptoms. Factors not shown to predict development of discontinuation symptoms include duration of SSRI therapy beyond 4–6 weeks prior to discontinuation ( 52) and length of medication taper ( 49, 52 ).

What does SSRI mean in medical terms?

a SSRI=selective serotonin reuptake inhibitor; SNRI=serotonin-norepinephrine reuptake inhibitor. Symptoms commonly associated with depression in patients with major depressive disorder include irritability, anxiety, panic, and mania or hypomania.

What is the most commonly prescribed class of antidepressants?

Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed class of antidepressant ( 1) and are recommended as one of the first-line treatments ( 2 – 4) for major depressive disorder, an often chronic or recurrent disorder that affects one in six adults during their lifetime ( 5 ).

How long does it take for a patient to stop a relapse?

Clinicians may also recommend discontinuation of treatment for patients with no or few risk factors for relapse or recurrence or upon patient request, consistent with treatment guidelines of 6 to 9 months of continuation-phase treatment after symptomatic remission ( 2 – 4 ).

Does SSRI discontinuation affect dopamine?

Discontinuation of SSRIs has also been postulated to affect dopamine neurotransmission as well as the hypothalamic-pituitary-adrenal axis ( 67, 73 ).

Does SSRI cause symptoms after discontinuation?

A greater prevalence of symptoms after discontinuation of SSRIs with shorter half-lives suggests a role for reduced availability of serotonin in the central nervous system with decreasing levels of SSRIs ( 67 ). Across multiple SSRIs, Michelson et al. ( 53) found that greater reduction in serum levels of SSRIs and their active metabolites on discontinuation was associated with higher rates of discontinuation symptoms. Henry et al. ( 68) found that higher levels of paroxetine in the brain prior to discontinuation (despite the same oral dosage of 20 mg/day; N=4) were associated with higher levels of symptoms after discontinuation; no such association was seen for fluoxetine. In preclinical studies, chronic but not acute use of SSRIs has been associated with down-regulation of autoreceptors and serotonin transporter that may be sustained for weeks after discontinuation ( 69, 70 ). The modulation of serotonin receptors and transporters over several weeks of SSRI treatment may account for why symptoms do not emerge after discontinuing SSRIs taken for just 1–2 weeks ( 71 ).

Symptoms

Naming

Results

Treatment

• Whether you experience discontinuation syndrome after stopping an SSRI depends on several factors. These include the amount of time youve taken the medication, your dosage level, and the pills half-life (how quickly it is eliminated from your body). For instance, Prozac, which has about a five-week half-life, appears to cause discontinuation much l...

See more on psychcentral.com

Prevention

Risks

Prognosis

What Is Ssri Discontinuation Syndrome?

• “Selective-serotonin reuptake inhibitors” or SSRIs are a drug family used in treating anxiety as well as depression conditions. Individuals who suffer from attacks of panic and other complaints are believed to have a low quantity of serotonin in their brains. This serotonin is vital in the conduction of messages from one neuron to another. SSRI med...

See more on syndrome.org

Symptoms

Causes

Treatment

Ssri Discontinuation Syndrome Duration