Depression depletes people's motivation, saps energy, and makes even the most optimistic of us feel hopeless. For many, antidepressants help rebalance our brain's serotonin. However, antidepressants often have unpleasant side effects. Sometimes, it may not feel like they're working after long-term use. So the question remains: can you quit antidepressants?
People who stay on antidepressants long-term may notice diminishing beneficial effects and want to get off them.
Eliminating and minimizing stress can help preserve brain function, as chronic stress is linked to decreased synaptic connections in the brain.
Getting off antidepressants requires the supervision of a healthcare provider, a strong support system, and an assessment of your lifestyle.
Reasons people take antidepressants long-term
There is a myriad of reasons people take antidepressants. Sometimes, it's to get through a rough patch, like a tough breakup. However, many take antidepressants long-term.
Long-term antidepressants are often used for:
- OCD (obsessive compulsive disorder).
- MDD (major depressive disorder).
- GAD (generalized anxiety disorder).
- PTSD (post-traumatic stress disorder).
For these conditions, antidepressants help individuals manage anxiety, stress, and negative feelings. Since these conditions are chronic, individuals are often on these medications for years, even decades.
Antidepressant benefits and side effects
From 2015-2018, 13.2% of adult Americans took antidepressants. In 2021-2022, antidepressant prescriptions increased by 5.1% in England — the sixth consecutive year with an uptick, according to the Pharmaceutical Journal. Two common types of antidepressants include SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin and norepinephrine reuptake inhibitors). However, SSRIs affect the neurotransmitter serotonin, and SNRIs affect serotonin and norepinephrine neurotransmitters.
Selective serotonin reuptake inhibitors work by blocking the serotonin transporter, a protein that removes excess serotonin from the gap between brain cells — called the synapse. When the serotonin transporter is blocked, more serotonin stays in the synapse, allowing it to activate receptors in the brain for longer. Serotonin and norepinephrine reuptake inhibitors work similarly, but the neurotransmitter norepinephrine continues to activate brain receptors and serotonin receptors. The increased activity of serotonin and/or norepinephrine can elevate mood and reduce depression symptoms. However, excess serotonin and norepinephrine in the brain also come with side effects.
Potential benefits of antidepressants:
- Improved mood.
- Better memory.
- Easier time falling asleep.
- Decreased anxiety.
- Lower stress levels.
Side effects of antidepressants:
- Lowered sex drive.
- Weight gain.
- Digestive problems.
- Increased suicide risk.
*Risk for suicide is most prevalent in adolescents and people under the age of 25. It's most common in the first few weeks of starting an antidepressant. Talk to your doctor or mental health provider immediately if you experience suicidal thoughts while starting or taking an antidepressant.
Antidepressants may stop producing the desired effects if taken for long periods. Additionally, life circumstances can change that improve your overall well-being. When this occurs, you may want to discuss stopping antidepressants with your healthcare provider.
Should you quit antidepressants?
Deciding to stop taking your antidepressant medication should not be viewed lightly. Always discuss these types of decisions with your doctor or therapist. Quitting or weaning yourself off your medication is a decision you should make with the advice of a medical professional.
Signs you could quit antidepressants:
- You feel like you're in a good place, your support system is stable, and your job and daily activities are going well.
- You don't feel like antidepressants are "working" for you. Though they may have helped in the past, you no longer find them beneficial.
- The negative side effects of antidepressants outweigh the potential benefits — you feel emotionally detached or not like yourself.
Always consult a healthcare professional
If you've been thinking about quitting your antidepressants, you should talk to your healthcare provider or psychiatrist. They'll help you navigate how to stop the type of medication you're on. In addition, many antidepressants have withdrawal effects. Furthermore, there's also the potential for depression relapse. For these reasons, it is only advisable to alter prescribed medication when under the care of a medical professional.
Symptoms to watch out for
When weaning off antidepressants, be aware of the potential for withdrawal and relapse. As a result, some antidepressants need to be tapered off slowly. In addition, be aware of depression relapse. Relapse may include symptoms of increased apathy, anhedonia (reduced ability to experience pleasure), sadness, and mood changes.
Being on antidepressants for an extended period can diminish their effects. Increasing the dose or switching to a different antidepressant are standard solutions. However, it's important to evaluate your lifestyle in addition to adjusting or tapering your medication dosage.
Chronic stress and regenerative growth factors
For decades, the consensus was that a chemical imbalance in the brain caused depression. However, recent research brought to light that this wasn't entirely true. Treating depression is more complex, a finding which has led to alternate solutions.
One study demonstrated that chronic stress rewired the brain to be more prone to depression. Synapses, which are how brain cells communicate, become depleted after chronic stress. According to the study, the hippocampus and prefrontal cortex shrunk in individuals with MDD. This study indicates that chronic stress plays a large role in brain function alternation.
The good news is that antidepressants help regenerate new synapses in the brain. This is one reason why they can help treat depression and anxiety. In addition, a 2016 study demonstrated the effects of BDNF or brain-derived neurotrophic factors. This growth factor helped regenerate the brain's hippocampus. Additionally, it simulated the effects of SSRIs, depicting how antidepressants can be effective in creating new brain connections.
Studies show that BDNF is present after ketamine use. Ketamine is a new alternative therapy for treatment-resistant depression. In a recent study, ketamine had a more rapid effect on depressive symptoms. People experienced relief from MDD symptoms within 24 hours. Though the FDA does not yet approve ketamine infusion for depression, a nasal spray is available. The nasal spray Spravato is comprised of the “S” form of ketamine (esketamine) and is used in conjunction with oral antidepressants.
Additional ways to manage mood and depression involve getting outside and resting. This can be challenging in our productivity-obsessed society. However, altering your lifestyle is a must when considering quitting antidepressants.
Though getting outside first thing in the morning can be challenging, it's one way to boost serotonin production naturally. The effects of natural sunlight helps regulate circadian rhythms, contributing to optimal hormonal balance. In addition, a circadian rhythm that's in sync leads to better sleep — another key component for better mental health and hormones. Medical professionals agree that people should strive for eight hours of sleep.
Another proven method for combating depression and balancing hormones is exercise, which can work as well as antidepressants. Going for a run, walk, or gym sweat session boosts endorphins — the body's feel-good chemicals. Nervous-system soothing activities that promote the body-mind connection are also beneficial. Practicing yoga and meditation provides numerous mental and physical benefits — and is more easily accessible than going to the gym.
Take care of your body and mind. When you are considering getting off antidepressants, make sure to create a lifestyle that will support your long-term goals. Simple activities like daily movement and adequate sleep have exponential effects on your quality of life.
If you feel like quitting antidepressants is right for you, talk with your mental healthcare provider. Engage in beneficial lifestyle changes ahead of time. Stay alert to the potential for relapsing depression and withdrawal side effects. With the proper support, awareness, and mindset, getting off antidepressants is possible.