It's usually recommended that a course of SSRIs continues for at least 6 months after you feel better, to prevent your condition coming back when you stop. However, if you've experienced previous episodes of depression, a 2-year course may be recommended.
Guidance from the National Institute of Health and Care Excellence recommends that antidepressants are used as 'maintenance' treatment for up to 2 years to prevent their depression returning (relapse). It also recommends cognitive-behavioural therapy to change habits of thought and behaviour.
During long-term SSRI therapy, the most troubling adverse effects are sexual dysfunction, weight gain, and sleep disturbance.
It's usually recommended that a course of antidepressants continues for at least 6 months after you feel better, to prevent your condition recurring when you stop. Some people with recurrent illness are advised to carry on taking medicine indefinitely.
It's important that you do not stop taking antidepressants suddenly. A dose of antidepressants should be slowly reduced, normally over 4 weeks, but sometimes longer. This is to prevent any withdrawal symptoms you might get as a reaction to coming off antidepressants suddenly.
You are feeling better, and you and the doctor agree that it is time to stop. You have been taking the medicine for at least 6 months after you feel better. You are having counselling to help you cope with problems and help change how you think and feel. You are not worried about the depression coming back.
From the 14 studies that provided usable data, they calculated that 56% of antidepressant users experienced withdrawal symptoms when they discontinued the medication. Just four studies looked at the question of severity, they found, but of those, 46% of people experienced severe symptoms.
Although this is beneficial for someone who's depressed, for someone who does not have depression, taking antidepressant medication can cause serotonin to build up in the body, resulting in serotonin syndrome. When serotonin levels are too high, the person may experience symptoms like: Agitation or restlessness.
You may be tempted to stop taking antidepressants as soon as your symptoms ease, but depression can return if you quit too soon. Clinicians generally recommend staying on the medication for six to nine months before considering going off antidepressants.
Antidepressants interfere with serotonin, the neurotransmitter that regulates anxiety and mood while also controlling appetite. In particular, these changes may increase cravings for carbohydrate-rich foods, such as bread, pasta, and desserts.”
Selective serotonin reuptake inhibitors. These include fluoxetine (aka Prozac), paroxetine (aka Paxil), sertraline (aka Zoloft), fluvoxamine (aka Luvox), citalopram (aka Celexa), and escitalopram (aka Lexapro). They tend to be the first line choice for multiple anxiety disorders and depression.
If you have been taking antidepressants for many months or years, it's best to taper more slowly (again, at a rate you find comfortable). This will usually be over a period of months or longer. It's also best to reduce the dose slowly if you have had withdrawal symptoms in the past.
For most people, antidepressants are the main cause of emotional blunting. In most cases, feelings of numbness go away when you stop taking the antidepressant that is causing you to feel this way. If you feel emotionally numb, it's important to tell your doctor.
If you have been feeling better for 6 months or more, your doctor may suggest coming off escitalopram. Your doctor will probably recommend reducing your dose gradually over several weeks, or longer if you have been taking escitalopram for a long time.
Those who took antidepressants in higher doses for a longer time have more intense symptoms. Withdrawal symptoms typically persist for up to three weeks. The symptoms gradually fade during this time. Most people who quit taking their antidepressants stop having symptoms after three weeks.
The NICE guidelines for treating depression recommend that doctors offer you a type of talking therapy or counselling. This will often be cognitive behavioural therapy (CBT). Therapy may be offered instead of antidepressants, or in addition to them.
Specifically, weight gain seems to be a common long-term risk, especially the medications that affect serotonin levels. This could be because serotonin is associated with an increase in appetite. There is also a risk of higher blood sugar levels and diabetes with taking antidepressants long-term.
Perhaps the fundamental reason why antidepressants are so widely prescribed and used is that they fit with the 'medical model' of mental illness, which has become the standard view in western culture. This model sees depression as a medical condition which can be “fixed” in the same way as a physical injury or illness.
If your depression or anxiety is mild to moderate, and if time and a talking treatment have not helped, and especially if things are getting worse, then you should consider taking an antidepressant.
One major, highly stigmatised side effect, however, is that they can also dramatically reduce people's libido and ability to orgasm. “If you take an SSRI, it raises the levels of serotonin in your body,” says Juliette Clancy, a relationship and psychosexual therapist.
Quitting an antidepressant suddenly may cause symptoms within a day or two, such as: Anxiety. Insomnia or vivid dreams. Headaches.