Antidepressant Topic Index
Common side effects of SSRIs & SNRIs. | SSRI Overview and Topic Index | SSRI/SNRI poop-out (tachyphylaxis) & equivalences.

Table of Contents (hide)

  1. 1. Symptoms
  2. 2. How to deal with it
  3. 3. Causes

This page is so under construction. Consider it a placeholder. Here’s the best article I’ve seen on SSRI/SNRI discontinuation. I’ll be stealing as much as I dare from it using that article as a key resource when I get off my lazy ass to finish this. Any doctor who suggests a discontinuation schedule as conservative, if not more so, than mine is really on to something as far as I’m concerned.

1.  Symptoms

There’s a term, “brain shivers.” You’ll know it if you ever experience it. Other symptoms include dizziness, nausea, headache, painful tingling / pins & needles feelings (paresthesia) - especially in your hands and feet, fatigue, vomiting, irritability, insomnia, diarrhea, anxiety, and excessive sweating (hyperhidrosis).

To suddenly stop taking them is to feel so very much worse than you were feeling before you ever considered taking meds.

Not everyone experiences SSRI discontinuation syndrome, and for those who do the effects range from mild to extreme. Not all doctors recognize this as an issue, so that sucks even more.

Selective serotonin reuptake inhibitor discontinuation syndrome: proposed diagnostic criteria.

2.  How to deal with it

If you’re taking, or an immediate-release form of the med is available like Effexor has, invest in a pill splitter.

Be sure to read the section about how long it takes for a med to clear out of your system and wait that long to taper down to the next stage in your dosage.

Another option is to switch to the liquid form that many of the meds have available, that way you can reduce your dosage by as much as you damn well please and take as long as you can afford to discontinue to med. If it’s really bad you may want to switch to liquid Prozac (fluoxetine) for the final discontinuation. That can take a very long time, but because of Prozac’s 9.3 day half-life it usually has the mildest discontinuation syndrome effects of all the SSRIs. The long half-life is a double-edged sword. If you’re on a high dosage and especially sensitive to the discontinuation syndrome, it will take forever to get off of Prozac, but at least it won’t be as bad as the other meds. If you’re not as sensitive to the discontinuation syndrome, Prozac’s long half-life makes it easier to discontinue than any of the other SSRIs.

Some atypical antipsychotics like Seroquel and Geodon offer enough serotonergic action (Geodon does both serotonin and norepinephtrine reuptake inhibition) to make the discontinuation nowhere near as bad, if it happens at all. So if you have some Seroquel (quetiapine) on hand for insomnia, you’ll want to take some for your SSRI discontinuation. Be careful though, as both Seroquel and Geodon have discontinuation syndromes themselves!

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3.  Causes

What causes SSRI Discontinuation syndrome? Good question. According to the somewhat controversial neurotransmitter depletion hypothesis, discontinuation syndrome happens because:

  • You were depressed because you didn’t have enough brain juice to start with.
  • The drug would poop-out if you kept taking it, but you stop taking it before that happens, because the side effects suck too much, you ran out, etc.
  • That starts a cascade of events in your brain that results in no serotonin (or whatever) at the receptors involved and your brain developing a tolerance to it in any event.

As for the mechanism behind the symptoms, that’s an even better question. I.e. they know even less. I’ve found one paper so far: A possible explanation for dizziness following SSRI discontinuation. According to the authors the vestibular nucleus complex (VNC) has “an abundance of serotonin receptors,” so an “abrupt withdrawal from an SSRI is likely to have a substantial impact on the electrophysiological activity of neurons within it.” That will make you dizzy.

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Common side effects of SSRIs & SNRIs. | SSRI Overview and Topic Index | SSRI/SNRI poop-out (tachyphylaxis) & equivalences.
Antidepressant Topic Index

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SSRI/SNRI Discontinuation Syndrome by Jerod Poore is copyright © 2011 Jerod Poore
Date created: 1 July 2011 Last edited by: JerodPoore on: 2014–05–31

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1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.

2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.

3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?* I don’t even need my big-ass rant any more. Heartbleed has made my case for me. And that’s just the one that got all the media attention. The very nature of an open source operating system makes security as much of an illusion as anonymity on teh Intergoogles. Before you flip out too much: the domain Crazymeds is hosted on uses a version of SSL that is not affected by the Heartbleed bug. That’s one of the many reasons why I pay a lot of money and keep this site on Lunarpages.

* Yes, I know I’m using open source browsers. I also test the site using the now-defunct IE and Safari browsers. Their popularity - and superiority - killed IE and Safari, so that’s why I rely on the open source browsers. It’s like brand vs. generic meds. Sometimes the generic is better than the brand.

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