Antidepressant Discontinuation Syndrome and Supplements for Relief

Antidepressant Discontinuation Syndrome and Supplements for Relief

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Katie Stone - Naturopath

Written By:

Katie Stone - Naturopath
Kari Asadorian - BSN, RN

Medical Reviewer:

Kari Asadorian - BSN, RN
Jamie Hope - Methyl-Life® Founder

Edited By:

Jamie Hope - Methyl-Life® Founder
Last updated:
Antidepressant Discontinuation | MTHFR | Methyl-Life® Supplements Source: YouTube.com

What is antidepressant discontinuation syndrome?

One of the many concerns with antidepressants is the withdrawal symptoms experienced when someone stops taking them, especially after a long period of use. This is also commonly called antidepressant discontinuation syndrome (ADS).1

The exact causes of withdrawal symptoms are uncertain, but some theories include a decrease in serotonin when treatment ends and a behavioral stress response.2


While antidepressants aren’t considered addictive, it is possible to develop a dependency. People who have been taking their medication continuously for at least one month may be more susceptible to antidepressant discontinuation syndrome if they suddenly stop taking them.3 This can occur with most types of antidepressant, usually within a few days after cessation.
 

Symptoms are more likely when the antidepressant is stopped or reduced very suddenly, especially if you have been taking the drug for longer than a month.

Antidepressant withdrawal symptoms may include:

  • Anxiety and consistent aggravation 
  • Flu-like symptoms
  • Increased blood pressure, heart rate, and excessive sweating
  • Difficulty sleeping and/or vivid or frightening dreams
  • Difficulty urinating
  • Nausea, upset stomach, and vomiting
  • Low mood, loss of interest or enjoyment
  • Rapid mood changes 
  • Anger, irritability 
  • Fatigue
  • Loss of coordination
  • Headaches
  • An electric shock sensation in your arms, legs, or head
  • Difficulty in concentrating
  • Mild dizziness 
  • Restlessness

How long does withdrawal last?

Symptoms are usually mild and can last one to two weeks, although in rare cases they may continue for up to a year.

If you resume the antidepressant or start taking a similar drug, symptoms will usually resolve within one to three days.4

Which drugs are most likely to cause antidepressant withdrawal?

Among the serotonin reuptake inhibitors, paroxetine (Paxil) is most likely to cause antidepressant withdrawal symptoms. Venlafaxine (Effexor) has a short half-life, which means it is also more likely to cause withdrawal, and symptoms may be more severe.
Fluoxetine (Prozac) has the lowest incidence of causing withdrawal symptoms. 


Prevention of antidepressant discontinuation syndrome

Tapering off your medication is often the most effective way to reduce the severity of withdrawal symptoms. This involves taking smaller doses over a few weeks or months before stopping completely.
 

Tapering is especially recommended for antidepressants with short half-lives. However, it may not be necessary if you have been taking your antidepressant for less than four weeks, or if you are taking fluoxetine.
 

Switching to fluoxetine can also help to reduce symptoms for some people.

Natural/herbal/home remedies for antidepressant withdrawal

A range of therapies can help to reduce antidepressant discontinuation syndrome. 


  • Acupuncture when used alone or alongside antidepressants has been successful in reducing symptoms of depression, with clinical benefits similar to psychotherapy and medication alone.5
  • Talking therapy such as cognitive behavioural therapy (CBT) or counselling is often recommended for those with depression, and may be especially helpful when stopping antidepressants. 
  • Many herb-based formulas can help to improve mood. Saffron extract, for example, has been found to improve depressive symptoms, help the mind cope with stress, and reduce the risk of developing stress-related mental health issues.6 Ashwagandha extract is also found to help relieve feelings of anxiety and low mood, and has had promising effects in people with depression, anxiety disorders, and schizophrenia.7

Supplements for antidepressant withdrawal/treatment for Antidepressant Discontinuation Syndrome (ADS)

  • Methylfolate (vitamin B9), the active form of folate, is a key component in the production of neurotransmitters. Methylfolate works alongside B12 and B6 to convert homocysteine to methionine, which is then used to create S-Adenosylmethionine (SAMe). SAMe is required for the synthesis of norepinephrine, dopamine, and serotonin, all of which are vital for healthy mood.8

  • Vitamin B12 can help to regulate the synthesis of neurotransmitters, particularly serotonin, which may be low after taking an SSRI. A deficiency of Vitamin B12 can result in neurological and psychiatric issues, including changes in personality and depression. Low B12 is also known to worsen depression due to the accumulation of homocysteine. When taken as a supplement, Vitamin B12 has been shown to delay the onset of depression and improve the effect of antidepressants.9

  • Gamma-aminobutyric acid (GABA) is the brain’s primary inhibitory neurotransmitter. Its main function is to slow down hyperactivity in the brain, which helps to relieve feelings of anxiety and stress. GABA supplements may be used to increase levels of GABA in the brain, which is shown to be effective in reducing symptoms of depression.10

  • Saffron is a spice that acts as an agonist on GABA receptors, increasing GABA activity.11 Saffron supplements have been shown to relieve symptoms of depression and anxiety, with some studies reporting that saffron extract was equivalent to the antidepressants imipramine and fluoxetine in reducing depression.12 Saffron is also effective in improving sleep quality.13

Antidepressant discontinuation syndrome and supplements for relief

Antidepressants are designed to relieve symptoms of depression by enhancing the availability of neurotransmitters like serotonin, dopamine, norepinephrine, and noradrenaline in the brain. These neurotransmitters support healthy mood and feelings of wellbeing.


However, stopping antidepressant medication may trigger a range of unpleasant symptoms. This is known as antidepressant withdrawal or antidepressant discontinuation syndrome.


This article will discuss antidepressant withdrawal and how you can reduce your risk of symptoms if you decide to stop taking your medication.


Note: It is never advised to discontinue antidepressants without being in the care of a physician and/or psychiatrist. If you are in urgent need of help, please call or text 988 (Suicide and Crisis Lifeline).

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Navigating Antidepressant Discontinuation Syndrome

Frequently Asked Questions about antidepressant withdrawal

How long does antidepressant withdrawal last?

Antidepressant withdrawal symptoms vary from person to person, but usually last one to two weeks. If you resume the antidepressant or start taking a similar medication, symptoms will usually resolve within one to three days.

What are the side effects of coming off antidepressants?

Side effects are usually mild but can include mood disturbances, headaches, nausea, dizziness, sleep disruptions, changes in coordination, and heightened physiological responses like increased heart rate or sweating.

Why is coming off antidepressants so hard?

Antidepressant withdrawal symptoms are different for each person depending on the type of drug and how long they were taking it. Symptoms can be severe if you stop suddenly rather than tapering off, especially if you have been on the medication for a long time.
Speak to your healthcare professional about a tapering plan to manage the effects of an antidepressant drug leaving your system.

What happens if you cold turkey SSRI?

Stopping an antidepressant cold turkey is not recommended as it can lead to a range of unpleasant symptoms known as antidepressant withdrawal or antidepressant discontinuation syndrome (ADS). These symptoms are thought to be caused by the sudden decrease in serotonin in your brain and/or your body’s natural stress response. You may experience rapid mood changes, headaches, nausea, dizziness, trouble sleeping, loss of coordination, increased heart rate, sweating, and many other physiological symptoms. Speak to your healthcare professional about how to taper off your antidepressant.

References

  1. Matthew Gabriel, Verinder Sharma; "Antidepressant discontinuation syndrome"; Canadian Medical Association Journal; 2017 May

    https://pmc.ncbi.nlm.nih.gov/articles/PMC5449237/

  2. Giovanni A Fava, Alessia Gatti, Carlotta Belaise, Jenny Guidi, Emanuela Offidani; "Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review"; Psychotherapy and psychosomatics; 2015

    https://pubmed.ncbi.nlm.nih.gov/25721705/

  3. Matthew Gabriel, Verinder Sharma; "Antidepressant discontinuation syndrome"; Canadian Medical Association Journal; 2017 May

    https://pmc.ncbi.nlm.nih.gov/articles/PMC5449237/

  4. Matthew Gabriel, Verinder Sharma; "Antidepressant discontinuation syndrome"; Canadian Medical Association Journal; 2017 May

    https://pmc.ncbi.nlm.nih.gov/articles/PMC5449237/

  5. Binglei Chen, Carol Chunfeng Wang, Khui Hung Lee, Jianhong Cecilia Xia, Zongting Luo; "Efficacy and safety of acupuncture for depression: A systematic review and meta‐analysis"; Research in nursing & health; 2022 Dec

    https://pmc.ncbi.nlm.nih.gov/articles/PMC10108109/

  6. Philippa A Jackson, Joanne Forster, Julie Khan, Camille Pouchieu, Séverine Dubreuil, David Gaudout, Benjamin Moras, Line Pourtau, Florent Joffre, Carole Vaysse, Karène Bertrand, Hélène Abrous, David Vauzour, Julie Brossaud, Jean Benoit Corcuff, Lucile Capuron, David O Kennedy; "Effects of Saffron Extract Supplementation on Mood, Well-Being, and Response to a Psychosocial Stressor in Healthy Adults: A Randomized, Double-Blind, Parallel Group, Clinical Trial"; Frontiers in Nutrition; 2021 Feb

    https://pmc.ncbi.nlm.nih.gov/articles/PMC7882499/

  7. Paulina Mikulska, Marta Malinowska, Miłosz Ignacyk, Paweł Szustowski, Joanna Nowak, Karolina Pesta, Monika Szeląg, Damian Szklanny, Eliza Judasz, Gabriela Kaczmarek, Ovinuchi Prince Ejiohuo, Magdalena Paczkowska-Walendowska, Anna Gościniak, Judyta Cielecka-Piontek; "Ashwagandha (Withania somnifera)—Current Research on the Health-Promoting Activities: A Narrative Review"; Pharmaceutics; 2023 Mar

    https://pmc.ncbi.nlm.nih.gov/articles/PMC10147008/

  8. Jin Gao, Catherine M Cahill, Xudong Huang, Joshua L Roffman, Stefania Lamon-Fava, Maurizio Fava, David Mischoulon, Jack T Rogers; "S-Adenosyl Methionine and Transmethylation Pathways in Neuropsychiatric Diseases Throughout Life"; Neurotherapeutics; 2018 Jan

    https://pmc.ncbi.nlm.nih.gov/articles/PMC5794704/

  9. Prerna Sangle, Osama Sandhu, Zarmeena Aftab, Adarsh Thomas Anthony, Safeera Khan; "Vitamin B12 Supplementation: Preventing Onset and Improving Prognosis of Depression"; Cureus; 2020 Oct

    https://pmc.ncbi.nlm.nih.gov/articles/PMC7688056

  10. Mario Vitali, Enrico Tedeschini, Martino Mistretta, Kiki Fehling, Franca Aceti, Mauro Ceccanti, Maurizio Fava; "Adjunctive pregabalin in partial responders with major depressive disorder and residual anxiety"; Journal of Clinical Psychopharmacology; 2013 Feb

    https://pubmed.ncbi.nlm.nih.gov/23277244/

  11. Seyyed Kiarash Sadat Rafiei, Setare Abolghasemi, Mahsa Frashidi, Shiva Ebrahimi, Fatemeh Gharei, Zahra Razmkhah, Najmeh Tavousi, Behnaz Mahmoudvand, Melika Faani, Narges Karimi, Amir Abdi, Mahsa Soleimanzadeh, Mahya Ahmadpour Youshanlui, Sayedeh-Fatemeh Sadatmadani, Reyhaneh Alikhani, Yasamin Pishkari, Niloofar Deravi; "Saffron and Sleep Quality: A Systematic Review of Randomized Controlled Trials"; Nutrition and Metabolic Insights; 2023 Jul

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10357048/

  12. Mohammad J Siddiqui, Mohammed S M Saleh, Siti N B Binti Basharuddin, Siti H Binti Zamri, Mohd H bin Mohd Najib, Muhammad Z bin Che Ibrahim, Nur A binti Mohd Noor, Hanin N Binti Mazha, Norazian Mohd Hassan, Alfi Khatib; " Saffron (Crocus sativus L.): As an Antidepressant"; Journal of Pharmacy & BioAllied Sciences; 2018 Oct

    https://pmc.ncbi.nlm.nih.gov/articles/PMC6266642

  13. Seyyed Kiarash Sadat Rafiei, Setare Abolghasemi, Mahsa Frashidi, Shiva Ebrahimi, Fatemeh Gharei, Zahra Razmkhah, Najmeh Tavousi, Behnaz Mahmoudvand, Melika Faani, Narges Karimi, Amir Abdi, Mahsa Soleimanzadeh, Mahya Ahmadpour Youshanlui, Sayedeh-Fatemeh Sadatmadani, Reyhaneh Alikhani, Yasamin Pishkari, Niloofar Deravi; "Saffron and Sleep Quality: A Systematic Review of Randomized Controlled Trials"; Nutrition and Metabolic Insights; 2023 Jul

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10357048/

Katie Stone - Naturopath

About the Author

Katie is a qualified Naturopath (BNatMed) and freelance writer from New Zealand. She specializes in all things health and wellness, particularly dietary supplements and nutrition. Katie is also a dedicated runner and has completed more half-marathons than she can count!

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