The People's Perspective on Medicine

Antidepressant Withdrawal Feels Like Circles of Hell

Stopping antidepressant drugs like sertraline suddenly can trigger unbearable symptoms including something strange called "brain zaps."

When a doctor prescribes an antidepressant, does he or she envision the patient taking it forever? Some antidepressant medications are hellishly difficult to discontinue. One reader reported on the experience of sertraline withdrawal.

Sertraline Withdrawal Problems:

Q. I am weaning myself off of the antidepressant sertraline after having taken it for ten years. I am going through hell! I have constant pulses in my head that are driving me crazy. I am confused and irritable, laughing one minute and crying the next.

Tonight it is so bad I have been begging God to kill me if this does not stop. I need help.

Gradual Dose Reduction Could Help:

A. Get in touch with your physician immediately to ask for help with antidepressant withdrawal. Gradual tapering of the dose over several weeks or months is critical.

Stopping a drug like sertraline (Zoloft) too quickly can cause terrible side effects such as dizziness, nausea, sweating and “brain zaps” that feel like electric shocks. Suicidal thoughts are not uncommon, but should disappear once you get through the withdrawal period.

Other Readers’ Sertraline Withdrawal Stories:

DMH described a very unpleasant experience:

“A doctor put me on Effexor several years ago. I took it for 4 months and never had improvement with my depression.

“I quit taking it and the first thing that happened was I got the worst headache that I’d ever had in my life. I took ibuprofen, acetaminophen, aspirin, and nothing helped. I finally realized that it might be the Effexor withdrawal.

“I took one capsule and my headache was gone within 30 minutes. I also had the brain zaps, irritability, etc. and went to several doctors who were unable to help me.

“Basically it took me 3 months to taper myself off of the Effexor. A year later my husband saw something on television about a class action lawsuit against several pharmaceutical companies because of the withdrawal symptoms patients experienced when they stopped (cold turkey), taking the SSRI type of antidepressants.”

OHJ has also had difficulties with antidepressant withdrawal:

“I was in one of the original clinical trials for Cymbalta and continued using it after it was approved by the FDA. After a number of years, I switched to Pristiq. And somehow, I have ended up on Viibryd. All of these drugs cause severe, disabling diarrhea, which I treat with Bentyl and Immodium.

“I tried to withdraw myself from the Pristiq, with my doctor’s knowledge. I was shocked to discover that there is no withdrawal protocol. You cannot cut up the Pristiq tablets into smaller dosages because of the way it is manufactured. You risk Serotonin Syndrome. It is a trap.

“What I discovered on my own is that you need to add an SSRI while reducing the SNRI. Then, you taper off the SSRI. I used Celexa for this process (with my doctor’s help).

Unfortunately, in my search for a brain drug that does not cause absurd diarrhea, I ended up with the last drug available, Viibryd, which is even more addicting than Cymbalta and Pristiq. Viibryd is no better than all the others and now I am addicted again.

“I am seriously considering ECT, in order to be able to quit the brain drugs. ECT, however, requires a two week stay in the hospital, causes memory loss, and has to be repeated periodically. What kind of trade-off is that?

“Anyway, if you are not currently taking Cymbalta and are considering starting it, be aware that it is highly addicting and your doctor will not know how to get you off of it in the event of undesirable side effects. There is no withdrawal protocol. ‘Tapering off’ is wildly unpleasant and takes a long time and interferes with living your life.”

This report is from a health care provider, BNJ:

“Most of my patients are able to change antidepressants without problems. A few however, have had a very difficult time.

“One patient wants to start a support group that will start by saying “my name is Bill and I’m addicted to Cymbalta.”

“Keep trying, the key for most people seems very slow decreases. It is more evidence that these meds are not as safe and innocuous as we once thought-they are changing our brains!”

Neither the FDA nor the pharmaceutical manufacturers have provided clear guidance about how to discontinue such medications. In our opinion, this is a travesty.

So is the widespread use of the term “discontinuation syndrome.” We agree with the Italian investigators reporting that SSRI antidepressants can cause withdrawal symptoms when they are stopped (Fava et al, Psychotherapy and Psychosomatics, Feb. 2015). This condition should be called “withdrawal syndrome” since that is what it is.

To read about other people’s experience with stopping antidepressants and their coping strategies, click here. You may also be interested in our Guide to Dealing with Depression, in which we discuss how to stop such medications.

Revised 6/26/2017

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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Compounding pharmacies are your friend.
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The last time I tried to wean myself off anti-depressant I went to a compounding pharmacy to make the increments much more graduated. It wasn’t terribly expensive and helped tremendously.
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All in all it probably took me 6 months and another month of “milder” symptoms.

LK: My son did ECT without a 2 week stay. At UTSW hospital in Dallas, it is an outpatient treatment. However, he did stay for 4 days at the beginning of the treatment primarily due to withdrawal from his depression and anxiety meds. The withdrawal has to be done as ECT cannot be provided when taking certain meds. The good news is, he completed a short course of ECT (he’s age 19) and is doing significantly better than he was when on multiple meds!! He still takes a couple and probably needs them, although I hope as he gets older, he’ll be able to manage without them.

Withdrawal from antidepressants should be undertaken very slowly, just as in withdrawing from benzodiazepines. Most doctors don’t know this, and expect you to be fully withdrawn within a couple of weeks, often resulting in people going through intense withdrawal agonies.

I took Ativan for years, 1 mg a night. It took me three and a half months to taper off, and at no time did I experience severe withdrawals.

Recently I took 7.5 mg Remeron for insomnia for 6 months. My GP told me 10 days for withdrawal. I had enough pills left that I took my time instead, withdrawing over a month. Again, no issues because I took it slowly.

I do not hesitate to take medications for insomnia because without them, I sleep 2-3 hours a night. Sleep is one of the four requirements for life, along with air, food, and water. Without sleep we die. If taking medications allows me to sleep, and therefore have a life, then I will take them. And I do so with the confidence of knowing that a slow withdrawal taper will get me off them when the time comes.

I was switched from Celexa to Effexor. In a few months I started having terrible anxiety attacks. We traced it to my not taking my Effexor in the morning. When I went to see my neurologist she immediately wanted me off Effexor. However, she put me on a safe taper and wrote me multiple scripts for each one for each dose. It took 2 months, but I wasn’t sick at all. In this day and time most GPs won’t take the time. Whoever prescribed the medicine can help you if they are willing.

I was on a 40 mg daily dosage of Citalopram for ~10 years. Several times I tried quitting this medication but the “crash and burn” of withdrawal was more than I could handle. Late last year, along with the guidance of my nurse practitioner, I started cutting my dosage by 10 mg in cycles of 4-6 weeks. I remained on each new 10 mg dosage for 4-6 weeks before reducing that dosage by 10 mg. It took at least 6 months but I was able to completely discontinue the use of Citolopram. My final dosage was 5 mg.

Even if your doctor doesn’t envision you taking it forever, I’d believe in a heartbeat that drug companies absolutely envision you ” taking it forever”. In fact, I’d not be even a teeny bit surprised if it is part and parcel of creating any new prescription drug. First, come up with some new “disorder”, ” syndrome”, “disease”, then come up with an expensive drug, then make sure its virtually impossible to stop taking it. Viola…an unending, ever increasing fountain of obscene profits. I wonder how many drugs the execs. of pharmaceutical companies take?? I said 30 years ago the industry’s goal is every man, woman, and child being on at least 3-4 (preferably expensive) prescriptions for life. They’re getting there it seems.

I was put on Gabapentin for Meralgia Paresthetica. My Dr. started me on 300 mg. at night but slowly wanted it increased over a week or two. I was drowsy the next day from one so I didn’t increase.
I can’t tell that it help, maybe the dosage is too low.

Thinking about taking citalopram because I have constant ringing in my ears, however, wondering about side effects and also what would happen if I only took it for about 6 mos to a year to get used to this constant ringing in my ears.

The ringing is really, really terrible to deal with. Tried everything for the ringing, dr’s, hearing aid, tinnitus health meds, etc, etc,… anyone who has any suggestions about this please advise… not really depressed just so uptight with this ringing.

I have been struggling with hot flashes and night sweats for awhile, 1-2 an hour and up to an hour at a time at night. I am a cyclist and thought the more I ride/work out the less the flashes would be. NOT true. I ride 100-200 miles a week and walk 20-30 miles a week. So working out is good for your head ,soul , and body but does nothing for hot flashes.
I have been using herbs for awhile but have had no real dent in the hot flashes or night sweats.

So I went to my doctor. I can not take hormone replacement because of family breast cancer so my doctor prescribed Brisdelle.

I have had a serious stomach, diarrhea, headache for a week now. I still have hot flashes and night sweats.

I stopped taking them 2 days ago and still have all the above with chills and fatigue now in between the hot flashes. Hot flashes with chills, now that is something to experience.
I feel like I have been poisoned. I will glad when this is out of my system. I do not recommend this drug at all.

Citalopram use for just 3 days gave me horrendous ringing which I have to this day 5 years later. There are thousands of us this happened to. I took no other medication since then and my life is ruined from 3 pills.

I have ringing in my ears and usually it means the weather is about to change or I need protein. I find myself up at night taking peanut butter.

You’d maybe better to stick with the ringing. You could end up with a whole lots worse to cope with. What about trying a herbalist?

I took celexa for about 5 years, then had to quit because we moved, I got a new doctor, and I couldn’t afford to see him for the prescription. He also would only write the script for a 6 month supply. I get by, somewhat, with taking St. John’s Wort, but am concerned about the side effects, especially on the eyes. (I’m too old to be concerned that it reduces the effectiveness of birth control pills.)
On celexa, it is easier for me to be polite to people, among other things. Off, not so good. I’m now working from home and interact with people only when I can handle them. Getting sunshine helps, as did moving away from the chronically cloudy Pacific Northwest. (I already take extra Vit D to go with calcium because of my age.) If I could, I would paint a wall in my apartment bright yellow. I chew a lot of gum which only helps some.
The take away, the pills worked for me. Yes, there are problems with the prescriptions, but I have a trail of ruined relationships from the depression before I was prescribed celexa, and a few failed jobs from not being on it and biting the wrong person’s head off. I’ll try the Sam-E someone suggested.

I took celexa for 6years.. I tapered over a year and, quit stiöl withdrawal hit me hard. I’ve been free 9mpnths soon .. I’ve been to hell! Still suffer withdrawals..idk when it will end. I’m so angry at the docs and drug companies.. This is worse than hell!!

Hi Bella, I’ve been on antidepressants for over 15 years. Many different one’s. My doctor told me they were completely safe and well tested. After much Internet investigating I found that they are ANYTHING but safe. I’ve been off for about 7 months. I have felt worse then I EVER felt. Very few things feels good anymore. Food taste bad, can’t watch TV, I don’t enjoy anything. Can’t sleep through the night. I’m anxious all the time. I have just felt terrible! I seem to be feeling a tiny bit better now. I am hoping that I may recover from this highly addicting class of drugs. I personally think that it may take years to fully recover. Hang in there.

I was prescribed Lyrica for nerve pain three years ago. I have tried twice, without success, to get off by gradually tapering the drug. The first taper was for five months and the second for two years. I doubt that I will ever get off. Even though I am down to a very small dose, there have been permanent changes to the way my body handles neurotransmitters–especially histamine. Many medications which are high in histamine (about half of all drugs) which I took without trouble before Lyrica, now cause intense itching, insomnia, nausea and diarrhea. Also, I can no longer consume wine and aged cheese without symptoms.

Which oil do you use?? Lemon fish or cod liver oil??

ditto, ditto, ditto….know anybody witdrawaing ? I give up

Regarding withdrawal from antidepressants, a few years back I had gotten a new prescription for my antidepressant and, due to the difference in the appearance of the pills, forgot to add them to my weekly pill-minder. And forgot to take them. I experienced instant withdrawal, with the head-pounding, electric shock symptoms. I headed to the health food store, explained my symptoms, and the very knowledgeable gentleman advised I try either cod liver oil or fish oil in its liquid form. I bought some, took it home, took 1 tablespoon immediately, and within 30 minutes my head was calm. I have since taken these oils in their liquid forms for various purposes and swear by them. Some of them come in lemon flavor, but just hold your nose and take it – it worked for me!

You can get cod liver oil in soft gels. No need to hold your nose.

In terms of withdrawal syndromes, Lyrica and Neurontin are similar. Both are hell to get off if you have been on for any length of time OR if you have a history of being on and off other gabaergic drugs. These are drugs that work on the GABA receptors and include benzodiazapines, hypnotics (Ambien, Sonata etc.) and anti-convulsants (e.g. Topomax). It is true that in the early stages, it is easy to withdraw from these drugs (hence the reports “I had no trouble”). I also had no trouble getting on and off Neurontin several times, but this does not last.
Your doctor or pharmacist may tell you that each of these drugs works on different GABA receptors—-BUT it doesn’t really matter, each exposure adds up. I also suspect that repeated exposures to SSRIs work in the same way. This is something to consider since drug companies are pushing these drugs for all sorts of “every day” uses such as treatment of hot flashes, smoking etc.

Katherine, i will never accept a prescription for Gabapentin again. It didn’t work that well and I experienced several unpleasant side effects while taking it. When I told my Dr. I wanted to withdraw from it, she wanted to prescribe Lyrical. No way!!

I did taper off the gabapentin under my Dr.’s supervision. It took me 5 weeks and was relatively easy – some people aren’t that lucky, and it might take much longer. I was prepared to do whatever it took to get off that stuff.

Trading Gabapentin for Lyrica seemed to me like trading one bad apple with another. I simply put up with and try not to complain about the pain these drugs are supposed to treat. Maybe not an option for some people; i guess I’m lucky with this too. You do what you have to do to live as normally as possible.

I am more concerned about the fact that this patient has constant pulses in his/her head, and wants to die.
In the April 2013 issue of Reader’s Digest (Large Print), Health section (Page 86), on page 89 “Tortured by a Heartbeat,” it was discovered that this patient “had a rare condition called superior semicircular canal dehiscence, which occurs when a pore the size of a pin-head forms in the inner ear.” I’m curious if this patient has been evaluated for this condition.

Getting off Cymbalta was not fun but entirely necessary. It damaged my liver. I think it did help when I was pretty well incapacitated with Guillain-Barre Syndrome, but it wasn’t worth the cost of my health, long-term.

I am curious what dosage you were on? I am on 25 milligrams. I think of that as being low. I wonder if it will take as long to wean off of it?

I’ve taken low-dose Wellbutrin (an antidepressant) very sporadically for a few years, mainly just when I’m anticipating a very bad day, have some serious stressors going on, etc. I take less than one pill per week on average. My dr. insists that taking it like that can’t possibly help, but I know better. If it’s just a placebo effect, great — but it’s a good one. But even in rough times, I never take the Wellbutrin more than 2 days in a row. Why? Because after just 2 days, I notice SIGNIFICANT problems in mood if I don’t take it that 3rd day. I’m somewhat anxious, distracted and angry for no reason at all. This always happens!
I can only imagine what it’d be if I took this med every day for months or years! The very thing it’s supposed to be combating — it creates! Plus a nasty addiction to boot. Same as the rest of ’em.

Why don’t people try talking out with head doctors before they try pills for what is clearly a problem of emotional disturbance? When I was younger it was my doctor who suggested I see a psychologist? He wouldn’t have given me pills.

For some of us depression is very chemical and “talk therapy” is not helpful at all.

I too had an easy time weaning of Zoloft, 10 years ago. But now I am weaning off Cymbalta. (I took it for approx. 1 year.) Several days ago I posted about how easy it had been to wean & how I was dealing with the minor withdrawal symptoms. I followed the process of weaning over six months, by the book. But, the real withdrawal symptoms hit me like a bus whenever I tried to go from my tiny dose to no dose every other day. When other people complained of withdrawal problems I thought they were just being dramatic. Boy was I clueless!
The Vertigo symptoms that many people have noted, I now think have been understated. The dizziness, ringing in the ears, lightheadedness, feeling faint (like having to sit on the floor immediately before you black out), severe nausea, heart palpitations, insomnia, and migraines were so debilitating that I had to take a step back to my previous 1/2 dose. I think reality hits when you have to take yet another big step back. It’s unfortunate that in the process of trying to wean off of Cymbalta (and maybe other antidepressants) you start to experience a great sense of anxiety realizing you may never be able to tolerate the severe withdrawal. Then, the anger hits when you realize that the drug maker & your psychiatrist knew the severe withdrawal symptoms and weaning issues prior to you taking the drug (for short term use) and it was still prescribed!
I’m no doctor, but after one single experience with Cymbalta, I would never recommend Cymbalta unless it was only for long term, very necessary use. (like no other option use!) Here’s my Black Box warning: “Do not start Cymbalta unless you plan to take it forever!”

Anyone here ever have problems taking or getting off Celexa? I’ve been taking a very low dose (20 Mg) daily for about 10 years. I’m not even sure if it’s doing much and would like to be more medicine free.

A family member has been on numerous antidepressants. Celexa, Vibryd, Effexor, Wellbutrin, Prozac etc. The side effects are disastrous and I think the brain circuits are so messed up by now that there may never be a recovery. Trying to get off of them is a horror. These medications along with anti-anxiety meds, and painkillers is a recipe for bizarre behavior and potential suicide threats. I have come to the conclusion that, in my opinion, family doctors and GYNs should not be prescribing these medications. The first one was prescribed by a new GYN on the first visit.
Experience with psychiatric drugs by a psychiatrist is imperative, but I’m afraid we may have learned that too late. General practitioners and GYNs with a prescription pad can be be so dangerous. They write antidepressant prescriptions at the drop of a hat. And the television commercials for these drugs are rampant… including one that says “is your antidepressant not working?”. And of course there is a pill for that too. We are too cavalier about prescription drugs.

Monica Cassani, a social worker who successfully weaned herself off several damaging psychotropic medications, maintains a very useful and informative website at
http://beyondmeds.com/
The Mad in America website started by investigative reporter (and Pulitzer prize finalist) Robert Whitaker is building an online directory of physicians, psychiatrists and other therapists who are willing and able to support patients’ efforts to stop taking these medications — slowly! Go to
http://madinamerica.com/
and look up contributor Laura Delano for more information.

Many drugs, like this one or Neuronton or Lyrica, sound like they can work wonders for patients, however, potential side-effects frighten me! My doctor keeps encouraging me to try Lyrica for persistent migraine headaches, but I’m resistant to trying it after a number of unsuccessful and painful experiences with other drugs, including Neurontin. Have you received feed-back from Lyrica users?
I’m a senior male that seems to be sensitive to almost every new prescription I’m given. The Neuronton seemed to stop my severe headaches but gave me bad pains in my prostate, which continued until I could gradually taper off of the Neuronton. Encouraged to try it again a few months later, I had the same effect, although they tell me there is nothing in the literature that indicates any effect of neuronton upon prostate, even an enlarged one, like mine. I have heard that Neuronton is somewhat related in formulation to Lyrica — is that correct? Thank you for your comments on the prescription medications! HB

I had no problem weaning off Zoloft, nor did my sister have any trouble weaning off Paxil. Don’t know what everyone’s big hurry is. I picked one day the first week to take half a pill. Next week I took half a pill on two days, etc. Therefore I spent 7 weeks reducing my medicine by half. I continued that pattern for another 7 weeks, by then I was taking a quarter of the original dose. Then I would skip a day. The next week I would skip two days. I was eventually taking what I called Zoloft crumbs they were so tiny. So it took a long time (several months) but I had no side affects.

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