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Getting off an antidepressant takes more than “cut it in half and see.” Know what withdrawal can do, get a plan and speak up when it’s going badly.
You can be glad an antidepressant helped and still want to stop taking it, and you don’t have to pick a side in the antidepressant argument to do that. If stopping feels rough, get some help with it instead of deciding you’re stuck on it forever.
Work out the gradual cuts with the person prescribing it, including how you’ll check in after each step. That’s NICE’s advice too. You can have withdrawal, and depression can return. Tell them what happened before deciding which one explains every symptom.[1]
What withdrawal can feel like
Cutting back, stopping or missing doses can make you dizzy or nauseous, screw up your sleep or bring weird electric sensations, anxiety and irritability. You should hear about that when you start the prescription, not discover it halfway through a miserable weekend.[1]
Some people stop with little trouble. Others struggle to get through the day. NICE says symptoms often settle within a couple of weeks, but sometimes last several weeks or months. Tell the person treating you if you’re still having symptoms, even if you were told they’d usually be gone by now.[1]
The Effexor XR label has reports of serious withdrawal that went on for a long time, and I’d take those seriously. That’s what people reported, though, not the odds for everybody else or a prediction of how your own attempt will go.[2]
Withdrawal isn’t the same as addiction
Your body can get used to a medication and react when the dose changes. We call that physical dependence. Addiction includes a different pattern, with things like craving and losing control over use. Difficulty stopping an antidepressant doesn’t prove you’ve got that pattern. Calling it the right thing doesn’t make the withdrawal less real.[3]
You can have a hard withdrawal without having misused the drug. It doesn’t prove permanent damage or that taking it was a mistake, either. Be honest about what happened without making it prove your entire opinion about psychiatric medication.
Timing helps, but it doesn’t settle everything
Tell the prescriber when symptoms started. Soon after a dose cut can suggest withdrawal, especially with unfamiliar electric sensations. Your original depression or anxiety often takes longer to come back. But fluoxetine leaves the body slowly, which can delay withdrawal too. The timing gives you a clue. It doesn’t prove the cause.[3]
Bring notes on the prescription changes, when each symptom started and whether it feels like the problem you had before treatment. The person treating you needs to check for withdrawal, the original illness coming back and other causes, so bring the details instead of deciding every bad day has the same explanation.
Those percentages aren’t all counting the same thing
There’s a reason you’ll see different percentages quoted. A 2024 review covered 79 studies: about 31 percent had at least one symptom after stopping an antidepressant, compared with 17 percent after stopping placebo. Those weren’t all matched groups in the same trials. The authors tried to account for symptoms that can happen for other reasons. Their estimate after that was roughly 15 percent. When they looked separately within randomized trials, the difference was eight percentage points. Those calculations weren’t asking quite the same thing, and the results were all over the place. You don’t get to leave that out because one number makes your argument easier.[4]
In a 2025 review of randomized trials, people who stopped an antidepressant averaged about one extra symptom in the first week compared with people who stopped placebo or stayed on treatment. Most trials using the main symptom scale watched people for only two weeks. That average doesn’t tell you how rough it was for each person, and two weeks can’t answer what happens in prolonged withdrawal.[5]
Another 2025 review challenged the earlier evidence because of things like short follow up and relying on people to report problems without being asked. That’s a real disagreement about how withdrawal was measured. Quoting your favorite percentage louder doesn’t resolve it, and it doesn’t help the guy trying to get through a medication change.[6]
A taper is a plan you can adjust
Tapering means cutting back in stages. The drug, how long you’ve taken it and what happened last time all matter. NICE recommends discussing smaller reductions as the dose gets lower, with a pace you agree on. Get that worked out with the prescriber, including who you’ll call between visits.[1]
The last part of a taper can need smaller cuts. A 2019 review asked how SSRI dose lines up with how many serotonin transporters the drug occupies. The authors used that relationship to argue for smaller cuts near the end. They didn’t test a perfect taper for every drug and person. That paper can’t give you your own stopping schedule.[7]
Get the plan in writing. Have the person prescribing it and the pharmacist show you how to make those cuts with the exact pills or liquid you have. If it gets rough, call the person managing it. Don’t start changing the plan from an internet chart. The Effexor XR label calls for monitoring and reductions fitted to the person, not a schedule everybody copies.[2]
Write it down before the visit
Take notes to the visit so you don’t have to remember every detail while somebody’s waiting for an answer. Write down what you want changed and what’s happened so far. These are appointment notes, not permission to start your own taper.
- Bring the medication name, formulation, current prescription and how long you’ve taken it.
- Write down what treatment helped, what still bothers you and why you’re considering a change.
- Describe any earlier stopping attempt, including the dates of changes and symptoms.
- Leave with a written plan for follow up, symptom changes and who to contact between visits.
Get help when the change goes badly
New suicidal thoughts during a medication change need help promptly, whether it’s withdrawal, depression or something else. Contact your treating clinician immediately. If you might act on the thoughts or can’t stay safe, get emergency care now. Getting help comes before figuring out which explanation is right.[3]
If the last attempt was awful, bring the details back and go through what happened. One bad attempt doesn’t prove you can never stop. Get the next decision made with the person treating you, including the support and follow up you’ll actually use.
Sources
- NICE. Depression in adults, NG222. Selected stopping recommendations, 2022.
- DailyMed. Effexor XR prescribing information, revised August 2023. Selected discontinuation sections.
- Royal College of Psychiatrists. Stopping antidepressants.
- Henssler and colleagues. Incidence of antidepressant discontinuation symptoms, 2024.
- Kalfas and colleagues. Incidence and nature of antidepressant discontinuation symptoms, 2025.
- Evidence on antidepressant withdrawal. An appraisal and reanalysis of a recent systematic review, 2025.
- Horowitz and Taylor. Tapering of SSRI treatment to mitigate withdrawal symptoms, 2019.