Depression - stopping your medicines

  • Stopping Antidepressant Medicines
    • Antidepressants are prescription medicines you may take to help with depression, anxiety, or pain. Like any medicine, there are reasons you may take antidepressants for a while and then consider no longer taking them.

  • Before You Stop
    • Stopping your medicine may be the right choice for you. But first, you should talk with your health care provider. The safe way to stop taking this medicine is to lower the dose over time. If you stop taking the medicine suddenly you are at risk for:

      • Returning symptoms, such as severe depression
      • Increased risk of suicide (for some people)
      • Withdrawal symptoms, which could feel like the flu or produce sleep problems, dizziness, headache, anxiety, or irritability
  • Why Do You Want to Stop Taking This Medicine?
    • Write down all of the reasons you want to stop taking the medicine.

      Do you still feel depressed? Is the medicine not working? If so, think about:

      • What did you expect would change with this medicine?
      • Have you been taking this medicine long enough for it to work?

      If you have side effects, write down what they are and when they happen. Your provider may be able to adjust your medicine to improve these problems.

      Do you have other concerns about taking this medicine?

      • Are you having trouble paying for it?
      • Does it bother you to have to take it every day?
      • Does it bother you to think you have depression and need to take medicine for it?
      • Do you think you should be able to deal with your feelings without medicine?
      • Are others saying you do not need medicine or should not take it?

      Do you think the problem may be gone, and you wonder if you could stop the medicine now?

  • Making the Decision
    • Take your list of reasons to stop taking the medicine to the provider who prescribed it. Talk about each point.

      Then, ask your provider:

      • Do we agree on our treatment goals?
      • What are the benefits of staying on this medicine now?
      • What are the risks of stopping this medicine now?

      Find out whether there are other things you can do to address your reasons for stopping the medicine, such as:

      • Changing the dose of the medicine
      • Changing the time of day you take the medicine
      • Changing how you take the medicine in relation to food
      • Taking a different medicine instead
      • Treating any side effects
      • Adding another treatment, such as talk therapy

      Get the information you need to make a good decision. Think about your health and what is important to you. This conversation with your provider will help you decide whether to:

      • Keep taking the medicine
      • Try changing something or adding something
      • Stop taking the medicine now
  • If You Decide to Stop the Medicine
    • Make sure you understand what you need to do to stop the medicine safely. Ask your provider how to lower the dose of this medicine over time. DO NOT stop taking this medicine suddenly.

      As you reduce the amount of medicine you take, write down any symptoms you feel and when you feel them, to discuss with your provider.

  • When to Call the Doctor
    • Depression or anxiety might not come back right away when you stop taking the medicine, but it may come back in the future. If you start to feel depressed or anxious again, call your doctor. You should also call your doctor if you have the withdrawal symptoms listed above. It is very important to get help if you have any thoughts of harming yourself or others.

  • References
    • American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013.

      Huffman JC, Alpert JE. An approach to the psychopharmacologic care of patients: antidepressants, antipsychotics, anxiolytics, mood stabilizers, and natural remedies. Med Clin North Am. 2010;94:1141-60. PMID 20951275

      Rotherberg B, Schneck CD. Anxiety and depression. In: Rakel RE, ed. Textbook of Family Medicine. 8th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 47.