Reducing or ceasing your antidepressants

Antidepressant medications, such as serotonin reuptake inhibitors (SSRIs) and serotonin and noradrenaline reuptake inhibitors (SNRIs), are used to help patients treat mental health disorders such as anxiety and depression.

Although not addictive, these medications can cause a form of physical dependence because your body gets used to taking them.

This means that if you reduce the medication or stop taking it altogether, you might experience withdrawal symptoms. These withdrawal symptoms are usually mild, but can be prolonged or severe, and they might affect how you function in your daily life.

This is why we recommend that if you want to reduce or stop taking your antidepressants, you discuss it with your doctor, who will be able to make a plan with you to slowly reduce your dose so that you minimise the effects of withdrawal.¹

Some people are able to stop their antidepressant medicines easily, but other people experience significant side effects. It is hard for doctors to predict who will find it easy to stop their antidepressant medicines and who will find it difficult, so as a precaution we suggest that everyone reducing their dose does so slowly.

If you stop taking your antidepressants abruptly, you may experience symptoms, such as:

• flu-like symptoms, such as sweating, fatigue, headaches and feeling unwell
• sensations that feel like electric shocks
• rushing noises, blurred vision and dizziness
• mood disturbances
• stomach upsets
• sleep problems.

In most people the symptoms are usually mild; however, they can be so severe in others that they affect a person’s ability to work and function.¹

If I have severe withdrawal symptoms after reducing the dose, what can I do?
Discuss your symptoms with your GP, who may suggest staying at the same dose (rather than continuing to reduce the dose) or even increasing the dose slightly until the symptoms settle.
 
After the symptoms settle, you can resume reducing the dose, perhaps even more slowly, so the withdrawal symptoms are kept to a minimum.
Talk to your GP about a plan to help you manage the withdrawal symptoms.¹
 
Who is more likely to have withdrawal symptoms?
Some patients have withdrawal symptoms and others don’t, and we don’t know exactly why. Your risk of experiencing withdrawal symptoms is higher if:

• you have been on antidepressant medications for more than 12 months
• you have previously experienced withdrawal symptoms
• you are on a high dose
• you are on a certain type of antidepressant.¹ 

Could my withdrawal symptoms actually be my depression or anxiety returning?
It can sometimes be hard to know if the symptoms you’re experiencing are because you’ve reduced your dose or if it’s your depression or anxiety returning. This is why you need to discuss your symptoms with your GP and any other mental health providers you have.

Usually, withdrawal symptoms include some physical symptoms (eg sweating, blurred vision, stomach upsets) that go away if the dose is increased,¹ so your GP might suggest a higher dose, or a slower dose reduction, and that you continue to monitor your symptoms.

Important: if you are experiencing suicidal thoughts or feel at risk of significant harm, please call Lifeline on 131 114 or seek emergency care.

While you are reducing your antidepressant medication, the following non-medication treatments might help to reduce the risk of relapse while also helping your mood symptoms:

• avoid significant life changes
• stay informed about your condition and the medications you are taking and, where possible, avoid medications that worsen your mood
• have an action plan so you know what to do if your symptoms get worse
• regularly get together with friends and family members who support you, so that you improve your social connections and support network
• seek help from a psychologist who can work with you to improve your mental health strategies and thinking patterns
• adjust your routines so that you have a good sleep each night, a nutritious diet and regular exercise.

• General Practice Mental Health Standards Collaboration and Lived Experience Australia, Tips for getting the most out of your GP appointment
• University of Queensland, RELEASE resources (Redressing REdressing Long-tErm Antidepressant uSE)
• Royal College of Psychiatrists, Stopping antidepressants
• Healthdirect, Antidepressants
• Better Health Channel, Depression – treatment and management
• Black Dog Institute
• NPS Medicinewise, Information for Aboriginal and Torres Strait Islander people, About depression medicines: what you need to know about your antidepressant
• Bond University, Considering going off antidepressants? Here’s what to think about first
• Royal College of Psychiatrists, Stopping antidepressants

If you still want to stop taking your antidepressants without reducing the dose slowly, make an appointment with your GP to discuss your individual situation.

Medical author: Dr Arella Keir, RACGP Senior Medical Educator and GP in Hobart/Nipaluna

Writer: Lyn Yeowart