- Physical benefits * Mental benefits * Discontinuation symptoms * When not to stop * Side effects * Getting assistance
When should you consult a doctor?
Antidepressants may be helpful in treating a variety of disorders, but the decision to begin and discontinue one is very personal. While antidepressants may improve your mood, they can also have mental and physical adverse effects.
There may be advantages to discontinuing your antidepressant medication. It is important to consult with a healthcare professional before discontinuing antidepressant usage to verify that the benefits outweigh the disadvantages.
The majority of medicines have some adverse effects. Antidepressants are no exception, especially when used over an extended period of time.
According to a 2020 review article, individuals who use a popular kind of antidepressant, selective serotonin reuptake inhibitors (SSRIs), may suffer physical adverse effects such as: * sexual dysfunction * sleeping difficulties * weight gain
These adverse effects have been observed with long-term antidepressant usage and may develop with age.
Other kinds of antidepressants include: * serotonin-norepinephrine reuptake inhibitors (SNRIs) * norepinephrine-dopamine reuptake inhibitors (NDRIs) * noradrenergic and selective serotonergic antidepressants (NaSSA) * tricyclic antidepressants (TCAs) * monoamine oxidase inhibitors (MAOIs) (SARIs)
The sexual function
Antidepressants may have a variety of sexual adverse effects, ranging from decreased sexual desire to difficulties reaching orgasm.
Within the first 2 to 6 weeks of taking an antidepressant, an estimated 25 to 80 percent of individuals may notice a change in their sexual function. It’s also worth noting that up to 70% of individuals suffering from depression are at risk of having sexual dysfunction. As a result, you should consider this while deciding whether or not to discontinue your medicine.
For about 30% of individuals who suffer sexual adverse effects, symptoms typically resolve by week 12 of antidepressant treatment. They do not, however, go away for everyone.
In most cases, discontinuing antidepressants restores a person’s sexual function to pre-antidepressant levels.
Many individuals who use antidepressants experience weight gain.
Those who take the antidepressant bupropion (Wellbutrin) may suffer weight reduction as well.
There is little research available on what occurs when you stop using antidepressants and lose weight.
Because some medical experts believe that antidepressants enhance appetite and food cravings by altering neurotransmitters, quitting antidepressants may help you feel less hungry.
If you reduce your daily calorie consumption as a consequence, you may be able to lose weight by discontinuing your antidepressants.
If, on the other hand, you have a lack of appetite as a result of depression and your depression returns after quitting antidepressants, you may lose weight.
Other potentially beneficial consequences
Other possible adverse effects that may diminish if you discontinue antidepressants include: * headaches * daytime sleepiness * vivid or unpleasant nightmares
Again, this is dependent on the medications you are presently on.
Advantages for the mind
Long-term antidepressant usage may potentially have negative consequences for a person’s mental health.
Some medicines have the potential to impair your capacity to experience emotions (for example, make you feel numb). It may also have an impact on a person’s autonomy by making them feel reliant on medical assistance.
The longer someone takes the drug, the more likely they are to have withdrawal or discontinuation symptoms. This depends on the medication(s) being taken.
Symptoms of discontinuation
If you stop taking antidepressants abruptly, you may have discontinuation symptoms, which are comparable to withdrawal symptoms but relate to the cessation of medicine rather than addictive substances.
Some medicines, such as paroxetine (Paxil), may cause symptoms to appear quickly, while others may take a few days. This is also true if you miss medications or do not take complete dosages.
The mnemonic aid is used by many physicians. FINISH
Most doctors would suggest gradually decreasing antidepressant dosages over a period of several weeks. However, certain medicines, such as paroxetine and venlafaxine, may require longer durations of tapering.
Longer half-life medications, such as fluoxetine, may not require a lengthy tapering plan.
The symptoms of tapering off antidepressants are often minor and will pass with time.
In a survey of more than 250 individuals who had stopped using antidepressants, 20% said it was “extremely simple,” while slightly more than 50% said it was “pretty easy.”
When you should not discontinue antidepressants
You should not discontinue antidepressants without first seeing your doctor. Your doctor is aware of critical information such as: * your mental health history * how long you’ve been taking antidepressants * what medication(s) you’re taking * the dose you’re taking
That is why it is important to speak with your doctor so that you can devise a tapering strategy together or decide if discontinuing antidepressants is the best option at this time.
Because there is a possibility of rebound effects — when your depression symptoms increase after you stop taking the medication — it is especially critical that you address them with your doctor. You may devise a strategy for what to do if this occurs.
How to Handle Adverse Effects
If you and your doctor decide that stopping antidepressants now is not the ideal moment, there are certain measures you may take to reduce the negative effects of your prescription.
This involves pursuing health wherever feasible, such as: * Eating numerous modest meals throughout the day. This helps to prevent hunger by maintaining stable blood sugar levels.
- Exercising for at least 30 minutes most days. Walking, riding a bike, swimming, gardening, or watching an exercise video may all help you burn calories, reduce stress, and improve your sleep.
- Attempting to drink lots of water every day (till your pee is light yellow). Staying hydrated may improve your overall sense of well-being and keep you from mistaking hunger for thirst.
- Incorporating activities that aid in stress relief. Meditation, yoga, tai chi, writing, putting together a puzzle, or even coloring are all examples. These activities may assist to improve overall emotions of well-being.
- Sleeping and waking up at the same time each night may help decrease sleep deprivation. This allows you to have a better night’s sleep while also avoiding evening eating.
You should speak with your doctor or a nutritionist for specific advice on how to stay healthy while taking antidepressants.
Where to Look for Help
Consider the following sites if you need a first or second opinion on whether continuing on antidepressants is appropriate for you:
- American Psychiatric Association: On their website, you may use the “Find a Psychiatrist” feature to locate a mental health expert in your region.
- Telehealth visits: If you don’t have a doctor in your region, try a telehealth visit via one of the numerous sites that provide psychiatric consultations. LiveHealthOnline, MDLive, and Teladoc are a few examples. These confidential programs put you in touch with a mental health expert online, and many take insurance.
- The National Alliance on Mental Illness (NAMI): NAMI is a non-profit organization that may assist you in locating a mental health expert. You may reach them by phone at 800-950-NAMI, in addition to visiting their website.
When should you consult a doctor?
When you initially start talking about lowering your antidepressant dosage with your doctor, you should also ask them what you may anticipate. Knowing the potential adverse effects of discontinuing your antidepressant may help you prepare.
Inquire about the kinds of symptoms that might necessitate contacting a doctor or seeking medical attention.
Some signs, such as suicidal or self-harming thoughts, need immediate crisis intervention or emergency assistance.
There is some evidence Trusted Source that abruptly discontinuing medications may result in depressive symptoms – sometimes much severe than before.
If you are unsure if a symptom is “normal” or safe, you should see a healthcare professional. They may tell you whether you should resume taking your medication and how much you should take, or they can discuss an alternate plan with you.
Antidepressants may have side effects that impact how a person feels both psychologically and physically.
If you take antidepressants in conjunction with other therapies, such as talk therapy and wellness tools, you should discuss whether or not you can discontinue the antidepressants.
Because there is a danger of withdrawal symptoms after discontinuing an antidepressant, a doctor may advise you on how to taper off safely. Ideally, this will allow you to get the advantages of stopping antidepressants while avoiding the downsides.
Combination Medication Therapies for Depression * Medication Role * Atypical Antidepressants * Antipsychotics * L-triiodothyronine * Stimulants
You may be taking at least one antidepressant if you have major depressive disorder (MDD).
Combination medication therapy is a kind of treatment that has become more popular among physicians and psychiatrists over the last decade.
Until recently, physicians only administered one antidepressant medicine from a single pharmacological class, and only one prescription at a time. This is known as monotherapy.
Doctors usually start with a low dose and gradually increase it before ruling out the possibility that the drug isn’t functioning.
If this occurs, they may try another drug in the same family or move to a different class of antidepressants altogether.
According to new research, using antidepressants from several classes may be the most effective approach to treat MDD.
Antidepressants that are not often used
Bupropion is highly successful on its own in treating MDD, but it may also be used in conjunction with other medicines to treat difficult-to-treat depression.
Bupropion is, in fact, one of the most frequently used combination treatment medicines. It is often used with selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) (SNRIs).
Bupropion is usually well tolerated in patients who have had significant side effects from previous antidepressant medicines.
It may help alleviate some of the sexual adverse effects associated with popular SSRIs and SNRIs (such as reduced libido or difficulties achieving orgasm).
Mirtazapine may be an option for individuals who are suffering lack of appetite and sleeplessness. Sedation and weight gain are the most frequent adverse effects.
Mirtazapine, on the other hand, has not been well researched as a combo therapy.
According to research, treating persistent symptoms with SSRIs and atypical antipsychotics such as aripiprazole may be beneficial.
Some of the potential adverse effects of these medicines include: * weight gain * muscular tremors
- alterations in metabolism
Discuss the benefits and drawbacks of antipsychotic medications with your doctor. Their adverse effects may prolong or exacerbate certain depressive symptoms.
Some physicians combine L-triiodothyronine (T3) with tricyclic antidepressants (TCAs).
According to Trusted Source, combining T3 with a TCA may result in a quicker response to therapy than taking a TCA alone, although further study is required.
Triiodothyronine at a dosage of 25 micrograms (mcg) per day is often utilized for this purpose. If that dose fails to provide the desired effects after approximately a week, it is raised to 50 mcg each day.
D-amphetamine (Dexedrine) and methylphenidate (Ritalin) are stimulants that are used to treat depression. They may be taken on their own, but they can also be used with antidepressant drugs.
Many doctors believe that combining antidepressants with modest doses of stimulants, such as methylphenidate, may help alleviate depression that hasn’t responded well to therapy.
However, not all clinical studies have proven that this approach is beneficial.
Stimulants are particularly useful when a fast reaction is needed. People suffering from severe depression or other disorders, such as chronic illnesses, may be excellent candidates for this combination.
As a first-line treatment, combination therapy is used.
Monotherapy treatment has a poor chance of success. As a result, many researchers and physicians think that combination therapies are the first and best strategy to treating MDD.
Nonetheless, many physicians will start therapy with a single antidepressant drug.
Allow the medicine time to act before making a choice.
When first starting an antidepressant, it’s usual to start with a low dose and gradually raise it to minimize the chance of adverse effects.
If the drug isn’t functioning as well as it should after a trial period — typically 6 to 8 weeks — your doctor may want to switch medications or add another prescription to see if the combination helps.