Therapy can run alongside the medical care you get from your GP or prescriber, not instead of it.
What this covers
Antidepressants such as sertraline, citalopram, escitalopram, fluoxetine (Prozac), paroxetine, venlafaxine, duloxetine, mirtazapine and amitriptyline help many people with depression and anxiety, and nothing here suggests you should come off them. However, some people do worry about coming off them, and some find it hard when they try. Your GP or prescriber normally looks after the medical side: prescribing, reviewing how the medicine is working, and agreeing any change with you. I am not a medical service and cannot prescribe, advise on doses or manage a reduction. What I can offer is support with what you are feeling and thinking while you and your prescriber make those decisions.
What coming off can feel like
- Headaches, sweating, or feeling dizzy or unsteady when a dose is reduced or missed
- Unusual body sensations that people often call brain zaps
- Trouble sleeping, strange dreams, or feeling tired
- Feeling restless, irritable, anxious or tearful
- Feeling low or emotionally numb
- Not being sure whether what you feel is the medicine wearing off or your low mood or anxiety coming back
Coming off antidepressants: read this
The NHS says not to stop taking an antidepressant suddenly or without talking to your doctor first, and that your doctor will agree a plan to lower the dose gradually, usually over several weeks or months.
- The NHS says most people get some withdrawal symptoms when coming off an antidepressant, although some get none. They usually start within a few days and last a few weeks, but for some people they are severe or last months or longer.
- If symptoms are hard to manage, speak to your doctor; the NHS says they can change the plan.
- The NHS lists feeling low or suicidal among possible withdrawal symptoms. If that happens, speak to your doctor straight away.
- I cannot tell you how fast to reduce, or whether to. That is a decision for you and your prescriber.
Support you can get alongside therapy
Your GP or prescriber can review how your medicine is working, and the NHS says adults newly prescribed one of the most commonly used antidepressants can get extra pharmacist support through the New Medicine Service. For low mood or anxiety, you can also refer yourself to NHS Talking Therapies.
What therapy can offer
- Support with anxiety or low mood that returns, or that you worry will return
- Practical ways to cope with sleep problems, restlessness and tearfulness while symptoms last
- Working out what the medication does for you, and what else could help alongside it
- Support with the decisions you make with your prescriber, including changing your mind
Confidentiality
Worried about your job or your driving licence? What I report, and what stays between us.
If it is someone you love
It can be worrying to watch someone you love find it hard to come off an antidepressant, and you can have support of your own whether or not they get help. Support for families and loved ones.
Short answers to common questions
Are antidepressants addictive?
Whether antidepressants should be called addictive is contested. The government’s prescribed medicines review says they are not addictive but that some people have problems coming off them, and many people do experience withdrawal symptoms, which the NHS describes in detail. Whatever the label, finding it hard to come off one is common and nothing to be ashamed of. See the review summary.
How long do antidepressant withdrawal symptoms last?
The NHS says they usually start within a few days and last a few weeks. For some people they are severe, start weeks or months later, and last months or longer, which is more likely the longer you have taken the medicine or the higher your dose. Speak to your doctor if symptoms are severe or long-lasting.
How do I know if it is withdrawal or my depression coming back?
It can be hard to tell, and the NHS says some withdrawal symptoms may feel like your condition coming back. NICE tells clinicians that withdrawal is more likely when symptoms start quickly after a reduction, or feel new or different. Please do not try to judge this alone; your prescriber can help you work it out.
Can therapy help while I am coming off antidepressants?
Yes, alongside your prescriber’s care. NICE says support should be available throughout withdrawal, and symptoms can be physical or mental. I cannot prescribe or manage a reduction. I can help with anxiety, low mood, sleep worries and the uncertainty that often comes with it.
Who should I speak to first about coming off antidepressants?
Speak to the doctor who prescribes them. The NHS says to talk to your doctor if you want to stop, and the government’s review says to tell your doctor if you have problems, so they can offer more support or refer you on. Please do not stop on your own.