What happens when abruptly stopping an antidepressant?

This is reading material for the family and friends of the person trying to stop taking an antidepressant.

The following video will have you join expert practitioners Charlotte Herring, NP and Nicole Lamberson, PA for an essential webinar on supporting loved ones through antidepressant deprescribing. Whether you’re a family member, friend, or caregiver, this comprehensive session provides practical tools and compassionate strategies for navigating this challenging journey together.

In this 40 minute webinar, you’ll discover:

  • What to expect during the tapering process
  • How to recognize and understand withdrawal symptoms
  • Essential self-care strategies for caregivers
  • Practical lifestyle interventions that support recovery
  • Tips for navigating complex healthcare decisions

Featured Speakers:
Charlotte Herring – Board Certified NP, Holistic Health Coach, RYT-200
Nicole Lamberson – Physician Assistant, Co-founder of The Withdrawal Project, Medical Advisory Board Member at BIC

 

 


Your friend or family member will likely have an adverse reaction or withdrawal symptoms.

Please be aware. Please be understanding. Please try to help and support them.

Withdrawal symptoms can be horrific to experience as a patient and as a friend or family member. Relationships can break down. It is vital to remember that these adverse reactions can appear to change the very personality. And yet, to remember that the person suffering will have little idea of what is happening to them.

Doctors may be unaware that the symptoms listed below are ‘just’ withdrawals and not a major episode or illness of some kind. Further dangerous drugs should not be offered to manage this condition. Withdrawal symptoms can mimic bipolar disorder and other mental illnesses.

Please read and act on these suggestions: Crisis and Safety Plan link to that post

Your loved one begins to feel sick.

Physical symptoms appear, for example: flu-like aches, dizziness, nightmares, heart palpitations, headaches, brain zaps. This may occur within a day or two as the half-life of Cymbalta is only 12 hours.

They might express shame and embarrassment or anger for having ever taken the drug.

They might say they feel like “a druggie.”

Anxiety and confusion set in along with an inability to focus.

They start to act and look a little lost or muddled. They might worry that they’re “crazy.” They worry they’re going to hurt you by making you “go through this” with them. You can see an inability to connect thought patterns or individual thoughts with emotions as the abstract thinking process is affected.

Their dreams become more vivid and often disturbing – if they’re able to sleep at all.

Insomnia can be brutal.

Manic and psychotic episodes can come and go at random intervals, triggered in part by severe insomnia.

They may begin to have visual and auditory hallucinations. Perceptions of people, timeframes and events can become skewed and completely inaccurate.

Antidepressant- or withdrawal-induced homicidal, suicidal and violent thoughts and actions can develop.

These can become overwhelming and very specific, even to someone who has never had these tendencies. They may have dangerous impulses to drive into oncoming traffic or objects, jump in front of trains or run out in front of cars. Be on guard. They may not be capable of fighting off these intense, specific thoughts and may not feel safe if left alone. This is not just a way to get attention. These thoughts are not theirs and are very dangerous and life-threatening.

Aggression, irritability, rage, anxiety may pop out of nowhere.

Emotions reappear in sudden, intense bursts and rollercoaster the person between uncontrollable crying fits and anger. They may burst out laughing, blow up in anger or start crying for no apparent reason. You might see them sob for hours then turn and want to rip someone’s head off.

Gaps in memory…

Very often memories that were formed while taking the SSRI or during withdrawal are the ones that seem to go.

Their cognitive abilities and memory become impaired, sometimes to the point of disability.

They may stutter, lose their train of thought in mid-sentence, have problems remembering words and have slurred speech. They may become frustrated and overwhelmed trying to complete simple tasks or remember basic things. They may say they feel like their head is full of cotton or glue.

Autistic responses kick in, meaning physical contact and affection become repugnant.

Social situations may become very frightening. They may keep odd hours, isolate themselves and withdraw from family and friends.

Your loved one suddenly feels the overwhelming need to make big decisions and life-altering changes.

They may want to move, divorce, have more children, adopt, go back to school, paint the house, buy a new car, etc.

They may not be able to sit still and seem to have boundless energy – keep moving – called “akathisia”.

The “fight or flight” mechanism has completely malfunctioned. Warning: this could lead to diagnosis of ADD/ADHD.

They may fixate on things that seem trivial to others, and may make mountains out of molehills.

Fighting over seemingly small things is common, and it is often hard for them to let go. They may take everything personally and become easily offended. OCD-like behaviors may emerge such as cleaning and organizing, repeatedly checking or counting. They may develop quirks and superstitions that seem like nonsense to others, but they feel compelled to do.

The person feels depersonalized and disconnected from him/herself or reality.

You might hear that he/she “feels nothing” as emotional responses are flattened. They might say they feel like they’re “floating outside” their heads. They usually still have an awareness of something wrong, but can’t connect with the feeling.

Your loved one might eliminate input from those nearest.

Including you, often stressing independence and competency to an unreasonable, paranoid level. He or she now appears selfish and arrogant a lot of the time.

The person’s connection to the consequences of their own actions is broken.

Conscience and compassion disappear. That awareness of “something wrong” may disappear, too. They believe their thoughts, memories, feelings and actions are absolutely correct, and no one can tell them otherwise, and they may cut out anyone who suggests they’re not acting and behaving like themselves. Personality and attitude changes become very apparent to you because you’ve been close with this person, but co-workers or casual friends might not see anything wrong.

Your formerly calm loved one can display unusual impulsive behaviors.

Can include promiscuity, impulsive spending, drinking, gambling – even if they never did these things before.

The person vilifies and pushes away the people they care for the most.

This almost always includes a spouse or significant other first. The person in withdrawal might start to believe they never loved their partner. They may shift blame to them for events that may or may not have happened, or fail to recall positive, defining events in the relationship. Duration or quality of the relationship seems to have little bearing on this response.

A “going back in time” phenomenon appears.

The person may grasp mentally and emotionally for people or things they were attached to before their first dose of the antidepressant.

Waves of depression, anxiety, etc. hit.

If a health care provider is unaware that withdrawal symptoms mimic bi-polar disorder and other mental illnesses, a new diagnosis can result in further medication, trapping the person in an endless cycle of psychotropic drugs.

Physical symptoms subside gradually.

The person often doesn’t have full awareness – sometimes for months or even years at this point – that many of their behaviors and decisions are a continued result of withdrawal.

People experience “good days/weeks”, only to have a bad episode hit weeks later out of the blue.

Sudden downswings in emotions have been repeatedly noted 2-3 months and then again around 6 months after the last dose. This may or may not resolve over time.

At 1-3 years out, people are still reporting sudden intense neurological twitches and muscle spasms.

Very scary, but they seem to self-correct. Even years after the last dose, losing weight, detoxing or “flushing” the digestive track may produce new withdrawal symptoms that can last 2-3 weeks or longer.

Final note: Every brain is chemically individual.

The severity, order of symptoms and duration of withdrawal vary from person to person. Some experience a handful of symptoms. Others experience every symptom imaginable. Others experience very few or almost none. Cold turkey or abrupt withdrawal drastically increase these symptoms.

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