{"id":92218,"date":"2026-08-04T11:12:33","date_gmt":"2026-08-04T17:12:33","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=92218"},"modified":"2026-08-04T11:12:33","modified_gmt":"2026-08-04T17:12:33","slug":"stopping-antidepressants-what-you-need-to-know","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/stopping-antidepressants-what-you-need-to-know\/","title":{"rendered":"Getting off antidepressants: What you need to know"},"content":{"rendered":"
<\/div>
\"patient
Deciding whether to start, continue or stop taking an antidepressant should be a shared conversation between patients and their doctors, with careful consideration of the risks, benefits and individual circumstances. Photo: Getty Images.<\/figcaption><\/figure>\n

Hippocrates\u2019 descriptions of depression, written 2,400 years ago, mirror those of modern times, UCHealth psychiatrist Dr. Christopher Schneck<\/a> reminds his University of Colorado Anschutz School of Medicine<\/a> students.<\/p>\n

Metaphors of being in a hole you can\u2019t climb out of or stuck in a dark cave appear to be timeless. Depression is \u201ca deeply biological illness,\u201d Schneck said.<\/p>\n

Hippocrates attributed what he called \u201cmelancholia\u201d to an excess of black bile. His treatments included donkey milk and a plant called hellbore. Today, we have proven therapies that work much better than Hippocrates\u2019 go-to cures: antidepressants. These consist mainly of selective serotonin-reuptake inhibitors, or SSRIs, such as Prozac and Zoloft; and serotonin-norepinephrine reuptake inhibitors, or SNRIs, including Cymbalta and Effexor.<\/p>\n

Roughly 16%<\/a> of U.S. adults use an antidepressant. They help<\/a> millions of people, though exactly how remains unknown.<\/p>\n

There can be side effects, and, when someone goes off an antidepressant, they may experience unpleasant withdrawal symptoms.<\/p>\n

A May 4 \u201cMental Health and Overmedicalization Summit\u201d\u00a0kicked off<\/a> recent federal efforts encouraging patients to taper off or stop using antidepressants.\u00a0And some health activists are calling on medical providers to \u201cdeprescribe\u201d antidepressants. Efforts to reduce the use of antidepressants or to encourage people who have been taking them for long periods of time to stop using them have gotten a lot of recent attention.<\/p>\n

These new trends raise many questions. Do antidepressants work? If people who are coping with depression don\u2019t use antidepressants, then what drugs or therapies will help them? What are the risks of tapering off antidepressants or deprescribing them? Where do major medical societies stand on those topics? How common is antidepressant withdrawal? What are the symptoms? To answer these and other questions, we talked with Schneck and reviewed relevant research.<\/p>\n

Do antidepressants work?<\/strong><\/h2>\n

Yes, antidepressants work, although it often takes some trial and error to find the right medication and dosage, Schneck said.<\/p>\n

\"Dr.
Dr. Christopher Schneck, a UCHealth psychiatrist, discusses antidepressants. Photo: UCHealth.<\/figcaption><\/figure>\n

A big study<\/a> found that half of participants\u2019 depression symptoms had improved after either the first or second antidepressant they tried, and nearly 70% of patients who continued trying up to four different medications eventually became symptom-free.<\/p>\n

Do antidepressants address a ‘chemical imbalance?’<\/strong><\/h2>\n

No one knows precisely how antidepressants work. The early theory behind SSRIs, prevalent in the 1990s into the 2000s, rested on the now discredited idea of a \u201cchemical imbalance.\u201d That imbalance had to do with having too little serotonin, a mood-regulating chemical messenger, in the brain. The body constantly produces and then breaks down serotonin; an SSRI\u2019s reuptake inhibitor slows that process, the idea being that more serotonin stays in the brain and improves depression symptoms. The same would hold for norepinephrine, another chemical messenger, in an SNRI.<\/p>\n

But research has shown that, while SSRIs and SNRIs do work, there\u2019s more going on<\/a> than just a simple chemical imbalance<\/a>. The complexity of the brain so far has defied scientists\u2019 ongoing attempts to figure out how antidepressants actually work.<\/p>\n

Why is antidepressant tapering and deprescribing in the news?<\/strong><\/h2>\n

U.S. Department of Health and Human Services Secretary Robert F. Kennedy Jr. presided over a Mental Health and Overmedicalization Summit on May 4. Leaning harder into alternatives to antidepressants and curbing antidepressant overprescribing and deprescribing were key themes at the event. A series of meetings through the summer may lead to<\/a> new formal clinical guidance on \u201cthe appropriate use of psychiatric medications and tapering and discontinuation.\u201d<\/p>\n

The nature of that guidance already has emerged. The day of the summit, the Department of Health and Human Services\u2019 Substance Abuse and Mental Health Services Administration, or SAMHSA, issued a public\u00a0\u201cdear colleague\u201d letter to providers<\/a>\u00a0as well as\u00a0guidance<\/a> on billing information for alternatives to antidepressants.<\/p>\n

What are alternatives to antidepressants in managing depression?<\/strong><\/h2>\n

The \u201cdear colleague\u201d letter mentions \u201cpsychotherapy, social connection, behavioral approaches, sleep-focused treatments, physical activity interventions, and dietary and nutrition-related strategies.\u201d These are, the letter continues, not to be viewed as \u201cinterchangeable with medication in every circumstance, nor should they be presented as sufficient for all individuals,\u201d but rather made available as part of a bigger depression-care picture.<\/p>\n

Medical experts already rely on a variety of types of medications, therapies and interventions to help patients, Schneck said.<\/p>\n

\u201cWe have many proven psychotherapies that help treat depression, although we also have studies showing that the best treatment for severe depression is a combination of medications and psychotherapy, or now other neuromodulation techniques<\/a> like transcranial magnetic stimulation, esketamine or ketamine<\/a>, and ECT,\u201d referring to electroconvulsive therapy<\/a>, first developed nearly a century ago but \u201cstill an incredibly effective treatment,” said Schneck, who is also a professor of psychiatry at the University of Colorado Anschutz School of Medicine.<\/p>\n

Are there barriers to accessing antidepressant alternatives?<\/strong><\/h2>\n

Yes. There are many barriers to accessing some alternative antidepressant therapies. The American Psychiatric Association put it<\/a> this way:<\/p>\n

\u201cToo many patients cannot access timely, comprehensive care, while care remains unevenly distributed across our health system,\u201d psychiatric experts wrote.<\/p>\n

Other challenges include: \u201cpersistent workforce shortages, limited psychiatric beds, inadequate visit time, barriers to psychotherapy and social supports, insufficient integration of psychiatric expertise in primary care through the Collaborative Care model and the lack of a true continuum of care.\u201d<\/p>\n

Schneck encounters these issues often. When he suggests psychotherapy, some patients tell him they can\u2019t find a therapist, their insurance won\u2019t cover sessions with a therapist or their copays are too high, he said.<\/p>\n

\u201cIt\u2019s not just a matter of there being lots of alternatives to medications,\u201d he said. \u201cIt\u2019s also about accessibility.\u201d<\/p>\n

What are the risks if patients decide to stop antidepressants?<\/strong><\/h2>\n

The principal risk of going off antidepressants is falling into depression \u2014 a risk that itself depends on a patient\u2019s history with depression. The data show that, if you have a single episode of depression, your lifetime chance of recurrence is 50%. With two episodes, it\u2019s about 65%, and it rises to 90% with three or more episodes. In that case, \u201cYou\u2019re virtually guaranteed that you\u2019re going to have a relapse of depression,\u201d Schneck said.<\/p>\n

Another risk, though a far less likely one, is antidepressant withdrawal.<\/p>\n

What is antidepressant withdrawal?<\/strong><\/h2>\n

Withdrawal is the body\u2019s reaction to withholding a drug it\u2019s gotten used to. Antidepressant withdrawal (technically, antidepressant discontinuation symptoms) can include irritability, anxiety, low mood, insomnia, problems concentrating, dizziness, and numbness, among others symptoms.<\/p>\n

\u201cPatients sometimes feel like they have the flu. Sometimes, patients say they get these weird electric-shock sensations, either up the back of the neck or in the brain. Dizziness, lightheadedness, vertigo, nausea \u2014 those are fairly common,\u201d Schneck said.<\/p>\n

His experience has been that patients generally experience antidepressant withdrawal in the first two to four weeks, but withdrawal symptoms sometimes can last for months.<\/p>\n

How common is antidepressant withdrawal?<\/strong><\/h2>\n

A 2024 study<\/a> concluded that at least one symptom of antidepressant withdrawal happens in about 15% of patients, so roughly one in six to seven patients who stop using an antidepressant may experience antidepressant withdrawal. The placebo effect played an interesting role: 17% of patients who had been on a placebo also reported withdrawal symptoms.<\/p>\n

The study found that about 3% of patients dealt with severe withdrawal symptoms.<\/p>\n

\u201cThe vast majority of patients can get off these medications successfully, and fairly easily,\u201d Schneck said.<\/p>\n

Are there ways to minimize antidepressant withdrawal? <\/strong><\/h2>\n

Yes. It\u2019s called hyperbolic dose reduction<\/a>, which means tapering the antidepressant dose over time to help the body acclimate to its progressive absence.<\/p>\n

Those doses can get truly tiny, Schneck said.<\/p>\n

\u201cAs you get to lower and lower doses, you have to go smaller and smaller in terms of the milligrams you\u2019re giving patients. Because pills don\u2019t come in those sizes, you need to use things like compounding pharmacies or liquid formulations or liquid films, which not every doctor knows how to do,\u201d Schneck said.<\/p>\n

He has even had patients who open Effexor extended-release caplets and carefully count specific, ever-declining numbers of the microspheres inside as they continue to taper off the drug.<\/p>\n

How do providers and patients decide whether antidepressants are the right choice?<\/strong><\/h2>\n

\u201cI think what a good doc does is say, \u2018You know, I think you have depression, and here are the treatment options,\u2019 just like if you had some other condition,\u201d Schneck said. \u201cIt\u2019s a shared decision.\u201d<\/p>\n

Part of that decision is about how long the patient might expect to be on antidepressants, he said, and that estimation will depend on the severity of the patient\u2019s depression.<\/p>\n

What should patients and providers discuss before tapering off or stopping an antidepressant? <\/strong><\/h2>\n

This is another shared decision, Schneck said.<\/p>\n

\u201cYou talk about the risks and benefits if you go off this drug, and, certainly with depression, the risk is getting depressed again,\u201d he said.<\/p>\n

Patients should keep doctors informed about how they\u2019re doing after they\u2019ve stopped using antidepressants, Schneck said. Part of the deprescribing conversation should be about signs of recurring depression that patients should look for, and, if they happen, the importance of immediately reaching out to get help.<\/p>\n

What are doctors and some major medical societies saying about deprescribing antidepressants and the federal push for it? <\/strong><\/h2>\n

Deprescribing and antidepressant withdrawal risk has been a serious topic in psychiatry for years, Schneck said. Just as he and colleagues have for years referred to the mainstay \u201cMaudsley Prescribing Guidelines in Psychiatry<\/a>,\u201d they now do the same with the \u201cMaudsley Deprescribing Guidelines<\/a>, which came out in early 2024, he said.<\/p>\n

In a statement<\/a> timed for the May 4 summit, medical experts at the American Psychiatric Association said they welcomed attention placed on the country\u2019s mental health crisis and federal health officials\u2019 plans for more investment on research and training in prescribing and deprescribing. But the 40,000-member association strongly objected to \u201cframing the nation\u2019s mental health crisis as primarily a problem of \u2018overmedicalization\u2019 or \u2018overprescribing.\u2019\u201d<\/p>\n

\u201cIn psychiatry, as in all areas of medicine, prescribing and deprescribing occur every day as part of an individualized evidence-based treatment planning between physicians and patients,\u201d association officials said.<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Hippocrates\u2019 descriptions of depression, written 2,400 years ago, mirror those of modern times, UCHealth psychiatrist Dr. Christopher Schneck reminds his University of Colorado Anschutz School of Medicine students. Metaphors of being in a hole you can\u2019t climb out of or stuck in a dark cave appear to be timeless. Depression is \u201ca deeply biological illness,\u201d […]<\/p>\n","protected":false},"author":23,"featured_media":92247,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[6,8],"tags":[4750,113,112],"class_list":["post-92218","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-healthy-living","category-news","tag-access-to-care","tag-behavioral-health","tag-mental-health"],"acf":[],"yoast_head":"\nStopping antidepressants: What you need to know - UCHealth Today<\/title>\n<meta name=\"description\" content=\"Can you safely stop antidepressants? 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