Medication

Many people experience withdrawal symptoms when they try to stop antidepressants. So how can you stop safely?

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About one in seven Australians take antidepressants. The decision to start is often made during a crisis, with the idea that they can help for a while and then stop. Most people do not start antidepressants thinking they will take them for the rest of their lives.

Clinical guidelines recommend only six to 12 months of antidepressant treatment for a single episode of moderate to severe depression.

However, about half of people who take antidepressants have been using them for longer than 12 months. People can experience unpleasant withdrawal symptoms when they try stopping antidepressants, which causes them to start or continue antidepressants.

A recent review organized by The Lancet about 1 in 6 to 7 people experience withdrawal symptoms when they stop antidepressants. This may be an understatement, as many of the people included in the studies had only been taking antidepressants for a few months.

What did the researchers find?

The Lancet The review, which included 79 studies and 21,000 people, found that 15% of antidepressant users experienced withdrawal symptoms after they stopped taking the drug. Common symptoms included dizziness, headache, nausea, insomnia and irritability.

Withdrawal symptoms are common in people who have been taking antidepressants for a long time. But The Lancet the study included mostly people who took antidepressants for only a short period of time—typically about three to six months but sometimes for as little as a week.

So the finding that one in six people who stop taking antidepressants experience withdrawal symptoms is potentially alarming; this number only applies to a small group of people taking antidepressants.

The Lancet The study also found that about 3% of people experienced severe withdrawal symptoms, including suicidal thoughts. Again, this may be an underestimate, as it did not include long-term users who are more likely to experience withdrawal symptoms and have severe withdrawal symptoms.

Find out what is really causing the symptoms

Some people continue to take antidepressants for a long time in the belief that they treat or prevent anxiety or depression symptoms, but because many of the symptoms are the same, they may actually treat or prevent symptoms of depression. to retreat.

However long-term use (longer than 12 months) of antidepressants is not without risk. Taking antidepressants for longer than 12 months can cause:

  • emotional exhaustion
  • sexual dysfunction, which can last for a long time, including low libido and difficulty achieving orgasm in both men and women.
  • body weight
  • tiredness or weariness
  • increased risk of falls among older people.

Poor awareness and recognition of withdrawal symptoms has led doctors and patients to misinterpret withdrawal symptoms as a “relapse” of anxiety or depression and the continued need for medication.

The confusion is easy to understand, as some of the withdrawal symptoms are also symptoms of anxiety and/or depression.

Withdrawal symptoms include nervousness, irritability, insomnia, fatigue and confusion.

Symptoms of anxiety include “feeling nervous, anxious or angry” and “being easily irritated or irritated.”

Symptoms of depression include “difficulty falling or staying asleep,” “feeling tired or low energy” and “restlessness or restlessness.”

But it is possible to distinguish withdrawal from relapse. In addition to feeling anxious and irritable, people who are withdrawing may also experience:

  • dizziness, vertigo (spinning feeling) or light-headedness
  • brain zaps
  • imbalance
  • increased sensitivity to light or noise
  • tinnitus
  • nausea, diarrhea or upset stomach
  • muscle aches or pains
  • vivid dreams or nightmares
  • vibration
  • confusion
  • sweat.

How have people stopped antidepressants in the past?

Until recently, information on how to reduce withdrawal symptoms to help people safely stop antidepressants was limited.

Previous advice was usually to halve the dose, halve again and then stop; or taking antidepressants on other days; or switching to a different drug.

But even though these methods are well-intentioned, they may have caused withdrawal symptoms.

Withdrawal symptoms usually begin hours, days or sometimes weeks after stopping or reducing the dose of an antidepressant and can last for weeks or more.

So how can I stop safely?

Brain imaging techniques support a gradual reduction in the dose of an antidepressant to provide a steady change in the brain to reduce withdrawal symptoms.

“Hyperbolic tapering” uses a gradual decrease in drug doses. For example, a tapering schedule of 50mg, 25mg, 15mg, 10mg, 6mg, 4mg, 2mg, 1mg, then 0mg (stop) provides a stable change in the brain.

A slow and hyperbolic reduction in drug dosage can reduce withdrawal symptoms, giving the brain time to adjust to being off antidepressants and stopping safely.

Updated clinical guidelines now recommend this hyperbolic approach to slowly tapering off antidepressants.

At the University of Queensland, we are currently conducting a randomized controlled trial to test the effectiveness of antidepressant-specific hyperbolic tapering schedules designed to support people safely stopping antidepressants.

The mild antidepressants needed to lower mood are not readily available in Australia. But people can get mini-dose antidepressants through compounding chemistry (or for other antidepressants, by breaking a tablet and mixing with water or diluting the liquid mixture, by talking to your doctor ).

If you are considering getting off antidepressants, talk to your doctor, who can support and monitor you during a safe withdrawal.

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This article is reprinted from The Conversation under a Creative Commons license. Read the first article.Conversation

Excerpt: Many people experience withdrawal symptoms when they try to stop antidepressants. So how can you stop safely? (2024, June 16) retrieved June 18, 2024 from https://medicalxpress.com/news/2024-06-people-symptoms-antidepressants-safely.html

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