Time to How to come off your antidepressants

While they can be a lifeline, they are not a longterm solution, and coming off depression meds can prove challenging. Here, NHS psychiatrist Dr Tiago Reis Marques explains how to quit them safely

Almost a fifth of the population is taking antidepressants, and they are invaluable to people who would struggle to cope without them. But these drugs are not usually meant to be a long-term solution – and coming off them can cause big problems.

“It’s not always easy to come off antidepressants due to fears of relapse, the absence of psychological treatments to replace them and the withdrawal symptoms that can arise after stopping them. This is referred to as ‘discontinuation syndrome’,” explains Dr Tiago Reis Marques, psychiatrist at the Institute of Psychiatry, King’s College London and the South London and

Maudsley NHS Trust.

“Whilst typically mild and short-lived, symptoms can be severe enough to disrupt day-to-day lives.”

Up to 40 per cent of people experience side effects, including dizziness, restless legs, irritability, excessive sweating, fatigue and nausea. More serious side effects include suicidal thoughts, convulsions, insomnia and panic attacks.

“Some withdrawal symptoms can also be mistaken for recurrence of the underlying disorder, leading to long-term unnecessary medication. So many people find themselves trapped in a cycle of taking antidepressants,” adds Dr Marques.

But there is hope. So if you want to quit, and your doctor agrees, here Dr Marques explains the best way to do it.

Keep in touch with your GP

Deciding to come off antidepressants needs to be considered thoughtfully and in consultation with your doctor to make sure you’re not stopping prematurely and risking a relapse of your symptoms.

Your GP can offer you medication, recommend lifestyle changes and provide you with alternative support. See your doctor regularly after you’ve stopped taking the medication to enable them to check if your discontinuation symptoms have eased and if there are any signs of returning depression.

Taper medication

Tapering medication means gradually lowering the dose over a period of time, to prevent discontinuation symptoms. You should never stop cold turkey.

Your discontinuation regime will depend on the antidepressant in question, your current dose and the period of time you’ve been taking it.

Typically, coming off an antidepressant involves reducing your dose in increments, allowing two to six weeks between dose reductions. Studies have shown the best way to prevent and reduce withdrawal symptoms is to taper antidepressants over a period of

months.

Keep a mood diary

Antidepressant withdrawal can look like depression and you may mistake it for a relapse, so keep on top of how you’re feeling. Noting how you feel day to day will bring clarity as to how you can improve your mental health.

It can also benefit your doctor to see a quick overview of your mood. As a rule, discontinuation symptoms emerge within days or a few weeks after stopping the medication or lowering the dose. Relapse symptoms develop later and more gradually.

Talk to friends and family

Those close to us can be a valuable source of support. They can offer insight into changes they’ve seen take place in regard to your mood and routine, as well as offer support and encouragement to seek professional help.

If people around you realise that you’re stopping taking antidepressants and you sometimes might be more irritable or tearful, they’ll be less likely to take offense if you lash out. They may also be able to identify signs of recurring depression that you might not be aware of.

Those close to us can offer insight into changes they’ve seen take place

Have therapy

Therapy is not one size fits all. Factors such as the length and severity of the symptoms will determine the type of therapy you’ll be offered. A therapist will help you understand and work

through the issues that are impacting your life in negative ways and help you develop coping strategies.

Since therapy is goal-orientated, the patient takes an active role, which helps them to acknowledge their thoughts, feelings and triggers.

It has also been found that following through with therapy can reduce relapse or the recurrence rates of depression.

Maintain a healthy lifestyle

By maintaining a healthy lifestyle and making small changes such as eating well and exercising for 30 minutes a day, three to five days a week, you can enjoy better health benefits, ranging from reduced stress to an improved mood. Physical activity has a powerful antidepressant effect and can help people avoid a relapse after recovering from depression.