In the 21st century, more people than ever are taking antidepressants. Depression is a serious, even debilitating, disorder, but not everyone who is taking an antidepressant medication actually has major depression (Mojtabai, Psychotherapy and Psychosomatics, online March 27, 2013). In fact, up to two-thirds of those on a drug like sertraline or venlafaxine don’t meet the criteria. But once they have started taking an antidepressant, it can be difficult to stop. One reader asked for help getting off Pristiq.
Trouble Getting Off Pristiq:
Q. I took Lexapro for anxiety and depression for four years before my doctor switched me to fluoxetine (which didn’t work) and then to Pristiq. It was also supposed to help with my hot flashes.
This drug worked for a while, but then the benefits seemed to fade and the side effects caught up with me. I was tired all the time and developed diarrhea and fuzzy thinking. I also gained a lot of weight.
I wanted to get off Pristiq, but when I halved the dose the symptoms were unbearable: dizziness, headache, mental fogginess and “brain zaps.” Little things made me so mad I would lash out. I can’t believe my doctor put me on these drugs without an exit strategy. Help!
Antidepressant Discontinuation Syndrome:
A. Although antidepressants can help alleviate mood, nearly three-fourths of patients who had taken them for three years or longer reported withdrawal effects when they tried to stop (Cartwright et al, Patient Preference and Adherence, July 28, 2016). Doctors sometimes term this “discontinuation syndrome” (Carvalho et al, Psychotherapy and Psychosomatics, online Aug. 11, 2016).
Unfortunately, neither the FDA nor the manufacturers have developed clear guidelines on how to get off antidepressants such as citalopram (Celexa), desvenlafaxine (Pristiq), duloxetine (Cymbalta), escitalopram (Lexapro) or venlafaxine (Effexor). That’s why your doctor had no exit strategy.
We are sending you our Guide to Dealing with Depression, which has a number of suggestions on easing withdrawal from such medications. It also describes other treatments for feelings of hopelessness.
Withdrawal symptoms such as electric shock sensations in the brain, vertigo, irritability, digestive distress and fatigue may be eased with a very slow step-down in dose over many months (Yasui-Furukori et al, Clinical Neuropharmacology, May-June 2016). You may also benefit from additional social support as the dose is tapered. Some experts suggest that cognitive behavior therapy may help make this process less difficult (Wilson & Lader, Therapeutic Advances in Psychopharmacology, Dec. 2015).
Revised 3/20/2017
