What Really Happens When You Stop Taking Antidepressants? New Research on Withdrawal Symptoms

What you need to know

• People who stop antidepressants experience on average only one additional symptom compared to those who stop placebo pills
• Dizziness is the most common withdrawal symptom, affecting about 6% of people after accounting for placebo effects
• Mood worsening isn’t typically part of early withdrawal - if depression returns weeks later, it’s likely a relapse, not withdrawal

The Fear of Stopping: A Common Concern

If you’ve ever taken antidepressants, you’ve probably heard stories that made you worry about stopping them. Maybe a friend described feeling “brain zaps,” or you read alarming accounts online about severe withdrawal symptoms lasting months. These stories can be so frightening that some people stay on antidepressants longer than necessary, while others avoid starting them altogether when they could benefit.

But what does the scientific evidence actually tell us about what happens when people stop taking antidepressants? A comprehensive new analysis of research data from nearly 18,000 people provides some reassuring answers that might surprise you.

What the Research Revealed

Researchers analyzed data from 50 clinical studies to understand the true nature and frequency of antidepressant withdrawal symptoms. Think of this like having a bird’s-eye view of thousands of people’s experiences, rather than relying on individual stories that might not represent the typical experience.

The studies used a standardized checklist called the Discontinuation-Emergent Signs and Symptoms scale (DESS) - imagine it as a comprehensive symptom tracker that captures everything from physical discomfort to mood changes. This approach helps distinguish between real medication effects and symptoms that people might experience for other reasons.

What they found was quite different from the alarming narratives often shared: people who stopped antidepressants experienced an average of just one additional symptom compared to those who stopped taking placebo pills (sugar pills with no active medication). To put this in perspective, the scale measures up to 43 possible symptoms, and clinically significant withdrawal syndrome typically requires at least 4 symptoms.

The Most Common Symptoms: What to Expect

When withdrawal symptoms did occur, they followed predictable patterns. Dizziness emerged as the most frequent complaint, affecting about 6% more people than those stopping placebo. Think of this like your brain’s balance system temporarily recalibrating - uncomfortable but manageable for most people.

Nausea was the second most common symptom, followed by feelings of nervousness or anxiety. Interestingly, the research found no evidence that stopping antidepressants caused depression symptoms to worsen in the first two weeks. This finding is particularly important because it suggests that if someone experiences depression returning weeks after stopping their medication, it’s more likely a relapse of their original condition rather than a withdrawal effect.

The specific symptoms varied depending on which antidepressant people were taking. Medications like desvenlafaxine and venlafaxine (both SNRI antidepressants that affect serotonin and norepinephrine) were associated with more withdrawal symptoms, particularly dizziness. Meanwhile, newer medications like vortioxetine showed fewer withdrawal effects.

Timing and Duration: The Natural Course

The research revealed that withdrawal symptoms peak around one week after stopping medication and largely resolve by two weeks. This timeline makes biological sense - it takes time for your brain to adjust to the absence of the medication and reestablish its natural balance.

Importantly, the studies found that gradually reducing the dose over a week (tapering) didn’t show dramatically different results compared to stopping abruptly. This suggests that for many people, elaborate, months-long tapering schedules may not be necessary, though individual experiences can vary.

The research also found that how long someone had been taking antidepressants didn’t predict withdrawal symptoms. Whether you’ve been on medication for months or years, your risk of experiencing significant withdrawal symptoms remains relatively similar.

Understanding the Placebo Effect in Withdrawal

One of the most important aspects of this research was its use of placebo controls - comparing people stopping real antidepressants to those stopping inactive pills. This comparison revealed something crucial: when studies don’t include this control group, withdrawal symptoms appear much more common than they actually are.

Think of it like this: if you expect to feel terrible when stopping a medication, you might interpret normal daily discomforts (headaches, fatigue, mood fluctuations) as withdrawal symptoms. The nocebo effect - where negative expectations create negative experiences - can be powerful. When researchers controlled for this by including people who didn’t know whether they were stopping real medication or placebo, the true rate of medication-specific withdrawal symptoms was much lower.

What This Means for You

These findings offer several practical insights for anyone considering stopping antidepressants or worried about withdrawal effects. First, while withdrawal symptoms are real and can be uncomfortable, they’re typically mild and short-lived for most people. The average person experiences about one additional symptom that resolves within two weeks.

If you’re considering stopping your antidepressant, the most important step is discussing this decision with your healthcare provider. They can help you weigh the risks and benefits based on your individual situation, including your history of depression and current life circumstances. Remember that the risk of depression returning (relapse) is often a more significant concern than withdrawal symptoms.

When withdrawal symptoms do occur, knowing what to expect can be helpful. Dizziness, nausea, and feelings of anxiety are the most common experiences. These symptoms don’t indicate anything dangerous is happening - they’re signs that your brain is readjusting to functioning without the medication.

If you decide to stop your antidepressant, pay attention to your mood in the weeks and months following discontinuation. If depression symptoms return, this likely represents a return of your original condition rather than withdrawal, and it’s important to seek support from your healthcare provider.

Conclusions

• Antidepressant withdrawal symptoms are typically mild, with most people experiencing only one additional symptom compared to placebo
• Dizziness is the most common withdrawal symptom, affecting about 6% of people, followed by nausea and nervousness
• Depression symptoms returning weeks after stopping medication likely indicate relapse rather than withdrawal, highlighting the importance of ongoing monitoring and support