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What does SSRI Withdrawal Feel Like?

SSRI antidepressants have a very wide range of characteristic withdrawal symptoms. SSRI use has continued to skyrocket around the globe, as has been reported in a considerable body of clinical research. These antidepressants are typically prescribed for very long periods of time. The longer the period of use, the more likely the withdrawals will be increasingly problematic. Not everyone experiences the same withdrawal phenomena, but there are some SSRI withdrawal symptoms that come up frequently. Examples of these are listed below.1,2,4-6,11,18,19,24,35,36

SSRI withdrawal symptoms can include:
  • ssri withdrawal symptomsWorsened depression
  • Suicidality
  • Aggression, irritability, mood swings
  • Changes in behavior, hyperarousal
  • Tremor
  • Flu-like symptoms — headache, fatigue, nausea, dizziness, vertigo, lethargy, diarrhea
  • Anxiety
  • Insomnia
  • Visual disturbance
  • Brain zaps
  • Prickling sensation under the skin
  • Imbalance, unsteady gait

Here in the Alternative to Meds Center drug treatment program, we provide SSRI withdrawal help designed to reduce harsh SSRI withdrawal symptoms so it is as comfortable as possible. Many drug advertisements and paid researchers seem completely unaware of how SSRI withdrawal feels, and most surprisingly, downplay that it even exists. More importantly, perhaps, many physicians may mistake SSRI withdrawal symptoms for a relapse of a mental disorder, if they are unfamiliar with what can happen even shortly after missing or delaying a single dose. 24

SSRIs are prescription medications prescribed for depression as well as other psychiatric illnesses. While perhaps helpful during a crisis, SSRIs can be extremely difficult to stop taking because of the discomfort felt during SSRI withdrawal. Picture this scenario: you have been on an antidepressant SSRI for 5 years or more. You discuss with your doctor your desire to decrease your dosage. He prescribes alterations and tapering in typical 10mg increments. After a few days of beginning this, you may start to show severe flu-like symptoms — diarrhea, headache, nausea, dizziness, vomiting, chills, and fatigue. Electric shock-like sensations, agitation, vivid dreams, insomnia, impaired concentration, irritability, and suicidal thinking can also occur.1,2 These SSRI side effects last anywhere from a week to as long as a year and, rarely, longer, and can fluctuate in their intensity. You are wondering what the hell is going on! Well, that is quite commonly how SSRI withdrawal feels.

What is SSRI Antidepressant Withdrawal Syndrome?

SSRI antidepressant withdrawal syndrome is a result of reducing your dosage faster than your CNS can accommodate. Stopping too quickly, or stopping altogether, can be intolerable and even life-threatening in rare cases.

ssri withdrawal syndromeSSRI drugs have varying “half-lives” that affect how long until withdrawals start to occur.3 Some SSRI medications have a very short half-life, which means that these drugs don’t stay active in the body for a prolonged period of time. They go in, work for a few hours, then they start to become inactive. One of the most prescribed SSRI antidepressants on the market today is Effexor©. In as little as 5 hours symptoms of SSRI discontinuation syndrome can begin. If you miss just one dose, SSRI withdrawal symptoms can occur. Five hours is frighteningly short. Electric shock sensations or brain zaps may start to occur. This phenomenon tends to present at random times, which can make you feel vulnerable and anxious. If you’ve ever been to the Grand Canyon or a very tall building and looked down, there is a falling feeling that takes you by surprise — though you are not falling at all. Your head feels like jiggly jelly with vertigo causing overwhelming spinning feelings. You get a migraine. You feel incapacitated. You may think you are having a panic attack and you end up in the ER, where you are given a psychiatric assessment by a doctor you’ve never met before, and a rushed recommendation for hospitalization. Your family doesn’t understand any of this and fearfully agrees with the “new diagnosis.” Physicians, though well-meaning, are often unfamiliar with SSRI withdrawals and also, untrained in how to help a person safely taper from these medications. These are some reasons why a person should never attempt abrupt SSRI withdrawal.4,5,18,19

How Long does SSRI Withdrawal Last?

SSRI medications are nothing to fool around or experiment with. Stopping an SSRI cold turkey is dangerous. Without access to help, a person can end up in a complex web of worsening symptoms with a hopeless feeling underscoring day-to-day life.

There are ways to gradually decrease the dosage of SSRI medications without experiencing harsh withdrawal symptoms. It does not have to be difficult or confusing, but it does require enough time for the body to adjust as the dosage decreases. Your physician may not feel equipped to help you and you may feel left on your own to figure it out.6 Despite your desperation, you probably don’t want to end up opening up an Effexor capsule to calculate the number of granules, aiming to lessen the dosage one granule at a time each day. For one thing, you cannot just take out one granule, since one capsule may contain more granules than another capsule, and you would have to add up the number of granules in each capsule every day. Without a simple, easy-to-follow path, both patients and their doctors often decide to restart the drug, mistaking SSRI withdrawal symptoms for relapse. This error is more common than one might expect.5,6,19 You just want to feel better. This is why it is crucial to plan an SSRI withdrawal process that is safe, simple enough to execute, and tolerable enough to carry it through to the endpoint. It doesn’t have to take forever, but it could be overly optimistic or even foolish to think it will be as swift as a week or 2, as the drug label might suggest.12 It does take adequate time, it takes nutritive and psychological support, and the timeline will vary from person to person.

What Can Help SSRI Withdrawal Symptoms?

Alternative to Meds Center has carefully devised simple techniques and protocols that allow for safe and gentle SSRI withdrawal that have helped thousands of our clients to reach their goals with surprising ease and comfort. We help our clients achieve what we have come to call “natural mental health,” that is, achieving mental wellness using holistic and alternative approaches before, during, and after SSRI withdrawal.

One very popular example is acupuncture. Research published in the Journal of Medical Acupuncture has shown that acupuncture all by itself showed similar remission success compatible with psychotherapy and pharmacologic treatments for MDD.7

A second review of the medical literature on acupuncture found that an astounding 64% of participants in a published trial reached full remission of MDD after treatment with acupuncture.8

This is especially impressive since medical literature continues to struggle to show that medications have any significant, demonstrable efficacy at all over placebo effects.9

Another fascinating area of treatment involves utilizing specific supplements that can assist in reducing symptoms of depression, normalizing CNS function, and therefore can be extremely efficacious during and after SSRI withdrawal. Supplements tested and proven helpful in clinical trials include omega-3 fatty acids, chromium, SAM-e, magnesium, and countless other nutraceuticals.10,20-23

SSRI Withdrawal Should be Slow

It is important that SSRI withdrawal be done as slowly as needed to be well-tolerated. That might realistically mean weeks or months and always under the supervision of an experienced mental health specialist. Think of your doctor as your partner in healing. Don’t go off one of these drugs without medical supervision that can act as your safety net. The safest method of getting SSRI withdrawal relief is to wean off the medication slowly while providing nutritive and psychological support for the transition. By reducing the dosage in small increments, the neurochemistry can gradually adjust to the change and slowly adapt to gradually lower amounts of the drug in the system. Despite a long-standing tendency to dismiss or downplay SSRI discontinuation syndrome, these SSRI withdrawals can last up to a year or longer, especially where the timeline for SSRI withdrawal was too abbreviated, or not well-supported.1,6,19

Neurotoxicity and Depression — Handling Root Causes

Often overlooked in a hurried visit to the doctor, testing for neurotoxic accumulations in the body is a fundamental treatment segment at Alternative to Meds Center. We have found that in many cases, neurotoxic load in the body is significant because neurotoxicity symptoms often mimic mental health symptoms and disorders. Testing for and then safely purging these toxins out of the body can have some surprisingly positive results. For example, pesticides containing organophosphates or other compounds not only have a toxic effect on the targeted insect or weed but also have neurotoxic effects on human beings.25

Symptoms of toxic exposure can include:
  • ssri neurotoxicityDepression
  • Euphoria
  • Suicidal ideation
  • Mood swings
  • Impaired memory, amnesia
  • Melancholia
  • Neurosis
  • Dementia
  • Delirium
  • Crying spells
  • Lethargy
  • Loss of libido

… and many, many other symptoms, which are also symptoms that a doctor might prescribe antidepressant medication for if toxic exposures were untested. As toxins bioaccumulate, it may take many years for levels to reach a point of emerging symptoms. For these reasons, neurotoxicity is often overlooked in a diagnosis of depression.

Other common toxic exposures might include heavy metals such as mercury from dental amalgams, cleaning solvents, chemical additives to municipal water supply, industrial waste released in the open air or leeching into landfills and groundwater, chemicals used to process food, manufacture clothing, carpets, personal hygiene products, household products, and so many other potential sources. At Alternative to Meds Center, we know it is effective to search for root causes of depression and address what is found. We have observed that automatically writing a prescription for a drug might not work for very long, if at all, especially if the person’s symptoms are originating from the presence of a neurotoxic load. Just like trying to fix a flat tire with a rubber band, taking medication to fix a case of neurotoxic exposure may even lead to a worsened state of health 25-27

Are There Other Treatments for Depression Besides SSRIs?

SSRI withdrawal is best accomplished once any external factors that may have led to depression are resolved or at least are being gotten under control through counseling or other psychological support. Psychological counseling has been shown highly effective in discovering and resolving root causes and contributing factors leading to depression or other symptoms. For example, evidence suggests that relapse of depression is observably less frequent when CBT (cognitive behavioral therapy) has been utilized.17

natural treatments for depressionVitamin deficiencies have been studied and found positively associated with psychiatric type symptoms. For example, according to a study published in the 2013 British Journal of Psychiatry, vitamin D deficiency was found to be an increased hazard in depressed persons, especially in severe cases, after analyzing a cohort of over 31,000 participants.28

A study published in the 2020 Journal of Nutritional Biochemistry concluded that vitamin C was a neuroprotective nutrient in cases of stress-related disorders such as anxiety, and depression. The report goes on to reveal that correction of vitamin C deficiency showed an antidepressant effect and improved moods. The treatment proved to have low toxicity and high tolerance.29

Another astonishing study was done on over 100 frequently relapsing patients with multiple sclerosis and related symptoms of fatigue and depression. The trial showed remarkable improvements after one year of vitamin A therapy utilized in a clinical setting. The randomized, double-blind, placebo-controlled trial, published in the 2016 International Journal of Allergy, Asthma, Immunology also revealed that Vitamin A therapy reduced the population and activation of inflammatory T- helper cells in these MS patients.30

A link between diet and psychiatric symptoms such as depression is discussed in a paper published in the Journal of Nutritional Neuroscience. While more studies are needed, researchers Opie et al note that the cumulative and synergic effect of nutrients in the whole diet should be given more attention, in addition to the benefits of individual nutrients found in any single particular food.31

In addition to fruits and vegetables and a well-rounded diet, also recommended is probiotics for microbiome health. Probiotics, found in sauerkraut, yogurt, and other fermented foods, are known to have anxiolytic and antidepressant effects. The microbiome is often referred to as the “second brain” making a healthy gut a fundamental pillar for whole-body health and mental health, in its role as the seat of natural neurochemical production and distribution throughout the body.32-34

From all the research that is ongoing, it can be seen that nutritional therapies may provide much non-toxic assistance prior to, during, and after SSRI withdrawal.

In addition to nutritional therapies, non-pharmacologic treatments can come in many, many forms and can be the most important factor leading to success during this time. Having various therapies in place to stay physically comfortable throughout the process of SSRI withdrawal is also recommended, such as therapeutic massage, mineral baths, acupuncture, mild exercise, sauna, nature therapy such as forest bathing, and many other physical therapies.13-16

Holistic SSRI Withdrawal Treatment at Alternative to Meds Center

The Alternative to Meds Center SSRI withdrawal program searches for potential underlying sources that are contributing to depression, anxiety, insomnia, or other symptoms. There can be physical and medical reasons for your symptoms for which drugs alone will not be able to provide relief.3 Our program uses laboratory testing, natural substances for promoting neurochemistry stability, SSRI withdrawal syndrome treatments, safe tapering, removal of accumulations of environmental toxins, personal counseling in private sessions as well as support from peers, IV therapy, targeted nutritional treatment, including both corrected diet and supplementation, yoga, personal exercise training, acupuncture, massage, Equine therapy, and the advantages of many other therapies that offer effective SSRI withdrawal relief. You are invited to call us and talk, so you may receive a better understanding of the holistic SSRI withdrawal help available to you or your loved one today at Alternative to Meds Center.

1. Black K, Shea C, Dursun S, Kutcher S. Selective serotonin reuptake inhibitor discontinuation syndrome: proposed diagnostic criteria. J Psychiatry Neurosci. 2000 May;25(3):255-61. PMID: 10863885; PMCID: PMC1407715. [cited 2022 July 28]

2. Fagan M. Seponeringssyndrom etter bruk av selektive serotoninreopptakshemmere [Withdrawal syndrome after the use of serotonin reuptake inhibitors]. Tidsskr Nor Laegeforen. 2000 Mar 20;120(8):913-4. Norwegian. PMID: 10795494. [cited 2022 July 28]

3. Hiemke C, Härtter S. Pharmacokinetics of selective serotonin reuptake inhibitors. Pharmacol Ther. 2000 Jan;85(1):11-28. doi: 10.1016/s0163-7258(99)00048-0. PMID: 10674711. [cited 2022 July 28]

4. Moncrieff J. Why is it so difficult to stop psychiatric drug treatment? It may be nothing to do with the original problem. Med Hypotheses. 2006;67(3):517-23. doi: 10.1016/j.mehy.2006.03.009. Epub 2006 Apr 24. PMID: 16632226. [cited 2022 July 28]

5. Guy A, Brown M, Louis S, et al, “The ‘patient voice’ : patients who experience antidepressant withdrawal symptoms are often dismissed, or misdiagnosed with relapse, or a new medical condition.”: Sage Journal Nov 9 2020 [cited 2022 July 28]

6. Fava GA, Gatti A, Belaise C, Guidi J, Offidani E. Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review. Psychother Psychosom. 2015;84(2):72-81. doi: 10.1159/000370338. Epub 2015 Feb 21. PMID: 25721705. [cited 2022 July 28]

7. Sniezek, D. P., & Siddiqui, I. J. (2013). Acupuncture for Treating Anxiety and Depression in Women: A Clinical Systematic Review. Medical acupuncture, 25(3), 164–172. [cited 2022 July 28]

8. Allen JB, Schnyer R, Hitt S, “The Efficacy of Acupuncture in the Treatment of MDD” Sage Journals Sept 1998 [cited 2022 July 28]

9. Santarsieri D, Schwartz TL. Antidepressant efficacy and side-effect burden: a quick guide for clinicians. Drugs Context. 2015;4:212290. Published 2015 Oct 8. doi:10.7573/dic.212290 [cited 2022 July 28]

10. Complementary & Alternative Medicine for Mental Health PDF 2016 Mental Health America Updated April 8, 2016[cited 2022 July 28]

11. Read J, Cartwright C, Gibson K. How many of 1829 antidepressant users report withdrawal effects or addiction? Int J Ment Health Nurs. 2018 Dec;27(6):1805-1815. doi: 10.1111/inm.12488. Epub 2018 Jun 5. PMID: 29873165.[cited 2022 July 28]

12. FDA Label Paxil (paroxetine hydrochloride) [cited 2022 July 28]

13. Vickers A, Zollman C, Reinish JT. Massage therapies. West J Med. 2001;175(3):202-204. [cited 2022 July 28]

14. Mikkelsen K, Stojanovska L, Polenakovic M, Bosevski M, Apostolopoulos V. Exercise and mental health. Maturitas. 2017 Dec;106:48-56. doi: 10.1016/j.maturitas.2017.09.003. Epub 2017 Sep 7. PMID: 29150166. [cited 2022 July 28]

15. Hansen MM, Jones R, Tocchini K. Shinrin-Yoku (Forest Bathing) and Nature Therapy: A State-of-the-Art ReviewInt J Environ Res Public Health. 2017;14(8):851. Published 2017 Jul 28. doi:10.3390/ijerph14080851 [cited 2022 July 28]

16. Sarris J, de Manincor M, Hargraves F, Tsonis J. Harnessing the Four Elements for Mental Health. Front Psychiatry. 2019;10:256. Published 2019 Apr 24. doi:10.3389/fpsyt.2019.00256 [cited 2022 July 28]

17. Gautam M, Tripathi A, Deshmukh D, Gaur M. Cognitive Behavioral Therapy for Depression. Indian J Psychiatry. 2020;62(Suppl 2):S223-S229. doi:10.4103/psychiatry.IndianJPsychiatry_772_19 [cited 2022 July 28]

18. Alicja Lerner, Michael Klein, Dependence, withdrawal and rebound of CNS drugs: an update and regulatory considerations for new drugs development, Brain Communications, Volume 1, Issue 1, 2019, fcz025 [cited 2022 July 28]

19. Hengartner M, Davies J, Read J, Antidepressant withdrawal – the tide is finally turning, Cambridge U press 22 Aug 2019 [cited 2022 July 28]

20. Sarris J, Papakostas GI, Vitolo O, Fava M, Mischoulon D. S-adenosyl methionine (SAMe) versus escitalopram and placebo in major depression RCT: efficacy and effects of histamine and carnitine as moderators of response. J Affect Disord. 2014 Aug;164:76-81. doi: 10.1016/j.jad.2014.03.041. Epub 2014 Apr 1. PMID: 24856557.[cited 2022 July 28]

21. Wani AL, Bhat SA, Ara A. Omega-3 fatty acids and the treatment of depression: a review of scientific evidenceIntegr Med Res. 2015;4(3):132-141. doi:10.1016/j.imr.2015.07.003 [cited 2022 July 28]

22. Davidson JR, Abraham K, Connor KM, McLeod MN. Effectiveness of chromium in atypical depression: a placebo-controlled trial. Biol Psychiatry. 2003 Feb 1;53(3):261-4. doi: 10.1016/s0006-3223(02)01500-7. PMID: 12559660. [cited 2022 July 28]

23. Rajizadeh A, Mozaffari-Khosravi H, Yassini-Ardakani M, Dehghani A. Effect of magnesium supplementation on depression status in depressed patients with magnesium deficiency: A randomized, double-blind, placebo-controlled trial. Nutrition. 2017 Mar;35:56-60. doi: 10.1016/j.nut.2016.10.014. Epub 2016 Nov 9. PMID: 28241991.[cited 2022 July 28]

24. Shelton RC. Steps Following Attainment of Remission: Discontinuation of Antidepressant Therapy. Prim Care Companion J Clin Psychiatry. 2001 Aug;3(4):168-174. doi: 10.4088/pcc.v03n0404. PMID: 15014601; PMCID: PMC181183. [cited 2022 July 28]

25. Costa LG, Giordano G, Guizzetti M, Vitalone A. Neurotoxicity of pesticides: a brief review. Front Biosci. 2008 Jan 1;13:1240-9. doi: 10.2741/2758. PMID: 17981626.[cited 2022 July 28]

26. Collaborative on Health and the Environment, Mental Health and Environmental Exposures [November 2008] [cited 2022 July 28]

27. Brown JS Jr. Psychiatric issues in toxic exposures. Psychiatr Clin North Am. 2007 Dec;30(4):837-54. doi: 10.1016/j.psc.2007.07.004. PMID: 17938048. [cited 2022 July 28]

28. Anglin RE, Samaan Z, Walter SD, McDonald SD. Vitamin D deficiency and depression in adults: systematic review and meta-analysis. Br J Psychiatry. 2013 Feb;202:100-7. doi: 10.1192/bjp.bp.111.106666. PMID: 23377209. [cited 2022 July 28]

29. Moritz B, Schmitz AE, Rodrigues ALS, Dafre AL, Cunha MP. The role of vitamin C in stress-related disorders. J Nutr Biochem. 2020 Nov;85:108459. doi: 10.1016/j.jnutbio.2020.108459. Epub 2020 Jul 3. PMID: 32745879. [cited 2022 July 28]

30. Bitarafan S, Saboor-Yaraghi A, Sahraian MA, Soltani D, Nafissi S, Togha M, Beladi Moghadam N, Roostaei T, Mohammadzadeh Honarvar N, Harirchian MH. Effect of Vitamin A Supplementation on fatigue and depression in Multiple Sclerosis patients: A Double-Blind Placebo-Controlled Clinical Trial. Iran J Allergy Asthma Immunol. 2016 Feb;15(1):13-9. PMID: 26996107. [cited 2022 July 28]

31. Opie RS, Itsiopoulos C, Parletta N, Sanchez-Villegas A, Akbaraly TN, Ruusunen A, Jacka FN. Dietary recommendations for the prevention of depression. Nutr Neurosci. 2017 Apr;20(3):161-171. doi: 10.1179/1476830515Y.0000000043. Epub 2016 Mar 2. PMID: 26317148. [cited 2022 July 28]

32. Liu RT, Walsh RFL, Sheehan AE. Prebiotics and probiotics for depression and anxiety: A systematic review and meta-analysis of controlled clinical trials. Neurosci Biobehav Rev. 2019 Jul;102:13-23. doi: 10.1016/j.neubiorev.2019.03.023. Epub 2019 Apr 17. PMID: 31004628; PMCID: PMC6584030. [cited 2022 July 28]

33. Järbrink-Sehgal E, Andreasson A. The gut microbiota and mental health in adults. Curr Opin Neurobiol. 2020 Jun;62:102-114. doi: 10.1016/j.conb.2020.01.016. Epub 2020 Mar 9. PMID: 32163822. [cited 2022 July 28]

34. Mörkl S, Butler MI, Holl A, Cryan JF, Dinan TG. Probiotics and the Microbiota-Gut-Brain Axis: Focus on Psychiatry. Curr Nutr Rep. 2020 Sep;9(3):171-182. doi: 10.1007/s13668-020-00313-5. Erratum in: Curr Nutr Rep. 2020 Jun 5;: PMID: 32406013; PMCID: PMC7398953. [cited 2022 July 28]

35. Haddad P. Newer antidepressants and the discontinuation syndrome. J Clin Psychiatry. 1997;58 Suppl 7:17-21; discussion 22. PMID: 9219489. [cited 2022 July 28]

36. Henssler J, Heinz A, Brandt L, Bschor T. Antidepressant Withdrawal and Rebound Phenomena. Dtsch Arztebl Int. 2019 May 17;116(20):355-361. doi: 10.3238/arztebl.2019.0355. PMID: 31288917; PMCID: PMC6637660. [cited 2022 July 28]

Originally Published Nov 4, 2019 by Diane Ridaeus

This content has been reviewed and approved by a licensed physician.

Dr. Samuel Lee

Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente.  He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.

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SSRI Withdrawal – Symptoms, Treatment Help
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Nothing on this Website is intended to be taken as medical advice. The information provided on the website is intended to encourage, not replace, direct patient-health professional relationships. Always consult with your doctor before altering your medications. Adding nutritional supplements may alter the effect of medication. Any medication changes should be done only after proper evaluation and under medical supervision.

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