Tips for Starting and Stopping Antidepressants Safely

Published June 16, 2022 (current as of December 31, 2024)

Taking care of yourself both physically and mentally is important. In some cases, medicines may be needed for both. For example, you may need to take medicine to treat a physical condition such as high blood pressure or an infection. And you may need to take medicine to treat mental health conditions such as depression.

Antidepressants are a class of medicines used primarily to treat depression. They are prescribed by a healthcare provider. Usually, the medicine is started at a very low dose to help prevent or limit side effects. Antidepressants take time to work, sometimes up to 4 to 6 weeks or longer. Your healthcare provider may tell you to increase the dose over a few weeks until you start feeling better, which may take up to 12 weeks. However, it is important to discuss the treatment plan with your healthcare provider and to follow their recommendations to minimize any side effects. If the directions are not followed, or an error is made, the medicine may make you feel worse.

For example, a woman was to start her antidepressant by taking a half tablet each day for the first week, then a whole tablet each day for the second week. The woman misread the label and started by taking a whole tablet each day. After four days she began feeling jittery and called her pharmacist who discovered the error.

When you and your healthcare provider decide it is okay to stop your antidepressant, a plan needs to be put in place to gradually reduce the dose over time. Antidepressants should not be suddenly stopped as this could lead to withdrawal symptoms. These symptoms may include headache, nausea, trouble sleeping, flu-like symptoms, and muscle aches. In addition, stopping antidepressants suddenly can result in the possible relapse of your depression.

Here’s what you can do: Consider the following recommendations when discussing your treatment plan of starting and/or stopping antidepressants:

• Know the dose of medicine you should take and for how long.
• Ask for suggestions to help you follow your medicine plan (e.g., calendar).
• Schedule a follow-up appointment with your healthcare provider.
• Ask what to do if you experience side effects or miss a dose.
• Learn the common side effects – which ones will likely decrease or go away as you get used to the medicine and which will need medical attention if they occur.
• Share your plan with a significant other or family member.
• Talk with your healthcare provider when you decide you want to stop taking your antidepressant.
• Work with your healthcare provider to develop a plan to stop the medicine over a period of weeks or months to reduce the risk of withdrawal or relapse.
• Use a calendar to help follow your plan for stopping the medicine.
• Ask your healthcare provider about withdrawal effects or relapse symptoms to watch for – your plan may need to be adjusted if you experience any of these effects.

We would like to thank ISMP Canada for contributing information for this article.

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