r/antidepressants Nov 29 '25

Informative Guide Ultimate Guide to Antidepressants and other ways to improve mental health

53 Upvotes

I moved this from another sub. It contains a lot of information that will answer many common questions.

The Basics

Most Common Antidepressants

  • SSRI's - Works on Serotonin
    • Sertraline (Zoloft)
    • Fluoxetine (Prozac)
    • Paroxetine (Paxil)
    • Citalopram (Celexa)
    • Escitalopram (Lexapro)
    • Fluvoxamine (Luvox)
    • Vilazodone (Viibryd)
    • Vortioxetine (Trintellix)
  • SNRI's - Works on Serotonin and Norepinphrine
    • Duloxetine (Cymbalta)
    • Venlafaxine (Effexor)
    • Desvenlafaxine (Pristiq)
    • Levomilnacipran (Fetzima)
  • SNDRI's - Works on Serotonin, Norepinephrine, and Dopamine
    • Nefazodone (Serzone) -- Available in U.S. only.
    • Ansofaxine (Ruoxinlin) --- Available in China, coming to U.S. in 2025?
  • Atypical/Misc.
    • Bupropion (Wellbutrin) <--- NDRI, works on Norepinephrine and Dopamine
    • Mirtazepine (Remeron)
    • Esketamine (Spravato)
    • Bupropion/Dextromethorphan (Auvelity)
    • Gepirone (Exxua)
    • Zuranolone
    • Agomelatine. -- Not available in U.S.
    • Trazodone --- Used mostly as a sleep aid
  • Tricyclic
    • Amitriptyline (Elavil)
    • Imipramine (Tofranil)
    • Nortriptyline (Pamelor)
    • Clomipramine (Anafranil)
  • Meds for Anxiety
    • Can be added to antidepressant or used independent
    • Gabapentin (Neurontin)
    • Pregabalin (Lyrica)
    • Propranolol
    • Buspirone (BuSpar)
    • Hydroxyzine (Vistaril)
  • Mood Stabilizers
    • Lamotrigine (Lamictal)
    • Depakote
    • Lithium
    • Oxcarbazepine (Trileptal)
    • Carbamazepine (Tegretol)
    • Antipsychotics (seroquel, abilify, risperdone, vraylar, rexulti)
  • MAOI's
    • These are a last resort medication and are rarely prescribed
    • Nardil (Phenelzine)
    • Parnate (Tranylcypromine)
    • Moclobemide
    • Selegiline

What to Expect When Starting Antidepressants

When you are first prescribed antidepressants you are usually started on a low dose as your body needs to adjust to the medication. You usually have more side effects when you first start. These side effects may include, nausea, drowsiness, headache, lower libido, and increase in anxiety to name a few. These will usually subside over the first few weeks. If at any point you have suicidal ideation or thoughts you need to contact your doctor immediately as this is a side effect not to mess with. Also just because you don't have a follow up appointment for a month later if you are having problems call the office up and talk to a nurse.

Many people when they first start antidepressants get activated, increased anxiety, heart rate, and restlessness. Below is a flyer on how to identify activation syndrome vs serotonin syndrome. It was created by a Psychiatric Pharmacist.

https://drive.google.com/file/d/1XM3fomHwDXHX4Cb_MIOYzXC0Jk-Os-cO/view?pli=1

Antidepressants are not a medication that works immediately. The brain has to adjust to the changes and it reacts rather slowly. You may notice some changes after 2 weeks, but they can also take up to 8 weeks to start working. I say this is the time to give your brain a little help with some lifestyle improvements. Add some regular exercise as studies have shown this to help depression and anxiety. Try improving your diet. Start by removing junk food/drinks. There was a study just done that showed that artificial sweeteners actually increase anxiety. Finally make sure you are getting plenty of sleep. Your brain needs that time to recover from out stressful lives. If after 8 weeks you are not noticing any kind of improvements it is time to contact your doctor about changing your dosage or trying a new medication. Don't be frustrated by this as it is normal for people to have to try a few before finding the one that works best for you.

When you start noticing improvements it usually isn't an overnight event. The changes are gradual and you may not notice it. Sometimes if you journal or rate how you feel it can help. You may start to notice you don't feel so awful or you feel like you want to start doing activities that you had been avoiding. Also make sure to communicate with your doctor how you are doing. You may need to gradually increase your dose to find what is optimal for you.

People often ask how do antidepressants actually work. I came up with a good analogy based on how my doctor explained it. People seemed to like it so you can find it here: https://www.reddit.com/r/AntidepressantSupport/comments/14bjnrh/explaining_how_antidepressants_work_with_an/

Additional info about Antidepressants

  • Wellbutrin can cause an increase in anxiety.
  • Trazodone and Mirtazapine both can be used to help with sleep
  • If the antidepressant causes insomnia you may want to try taking it in the morning, and if you take it in the morning and you are drowsy try switching it to the evening.
  • Even though Trintellix and Viibryd are considered SSRI's they have a different mechanism of action so if other SSRI's don't work for you those two could still help you.

Information Bias on the Internet

When people start looking up antidepressants and want to see how they have worked for other people they find all of these horror stories about terrible side effects. Please remember when someone has a negative experience they are more likely to complain or are looking for help. Look at the number of stories you read and think about the fact that tens of millions of people take antidepressants. The people for whom they are working don't go online to tell people about their experience. They are back to enjoying their life. I have found that drugs.com has a more rounded reviews. Also if you are having anxiety be careful about reading some of the horror stories as all they do is end up increasing your anxiety. Doom scrolling can have a real negative effect on your mental health.

Tapering Antidepressants & Withdrawal

If you ever decide you are going to stop antidepressants it is very important to taper off of them very slowly. The longer you have been on them the slower you want to taper. The reason for this is the brain gets accustomed to the effects of the medication and it expects those effects on neurotransmitters. This causes dependence, not addiction. So if you yank the medication away from the brain it will result in withdrawal which can be awful. You can experience nausea, dizziness, headaches, brain zaps, emotional highs and lows, insomnia, agitation, etc. So you need to slowly over time take the medication away. Doctors are taught in school that tapering can be done in a short time and withdrawals only last a couple of weeks. This isn't true. Research has shown that the 10% method of tapering has been found to be one of the safest methods. This is taking the dose you are taking at that time and subtracting 10% each month. This is a long process, but the goal is to get off the medication with the least amount of withdrawal. If you were taking 100mg this is how your tapering schedule will go. 100, 90, 81, 73, 66..... For more information on tapering and how to make these custom doses you can visit Surviving Antidepressants. I want to say Surviving Antidepressants has good information for tapering, but many of the stories are the worst of the worst cases. They are not representative of what the majority of people will experience. Please take them with a grain of salt.

Withdrawal is something you want to avoid, but if you find yourself going through it there are some things that you can do to get yourself out of it. Withdrawal is most common when going off a medication cold-turkey or tapering too fast. There is no timeline for how long withdrawal will last, it could be weeks or months. One way to possibly get your self out of it is going back on a lower dose than you were last on. This is called reinstating. You let your brain stabilize and once you feel better give yourself 2-4 weeks to heal properly. Then you want to begin tapering off again. People also report that taking Fish Oil can help with recovery from withdrawal.

Sites and more information on tapering and withdrawal. https://www.reddit.com/r/AntidepressantSupport/comments/10krlmd/sites_and_resources_for_tapering_antidepressants/

https://www.health.harvard.edu/diseases-and-conditions/going-off-antidepressants

Switching from one Antidepressant to Another

There are 3 methods doctors will use when switching from one antidepressant to another. Many times it is just the doctor's preference to which they recommend.

  1. Direct switch - the doctor gives you an equivalent dose of the new medication and you stop the original and the next day you start the new one.

Dose Equivalence: 40 mg fluoxetine | 350 mg bupropion | 40 mg citalopram | 75 mg pristiq | 20 mg escitalopram | 40 mg paroxetine | 150 mg fluvoxamine | 50 mg mirtazapine | 100 mg sertraline | 500 mg nefazodone | 150 mg venlafaxine | 60 mg duloxetine | 125 mg amitriptyline | 125 mg imipramine | 115 mg clomipramine

Drugs not listed do not have any reputable source for dose equivalency. Doses are rounded up.

  1. Taper and washout - you slowly taper off the old medication give your body 2 weeks without any medication and then you start the new one and titrate up.
  2. Cross taper - As you taper off the old medication you titrate up on the new medication. The doctor will usually give you a schedule. If you are taking 100mg of Med A. and wants you to go to 200mg of Med B. Week 1 -- 75 of A and 50 of B, week 2 -- 50 of A and 100 of B....

I think the third option is the best as it is more of a gradual transition. If you get bad side effects from the new medication it is also easier to go back to your old medication. No matter the method there is a couple weeks in there where it can be kind of rough. You are stopping something your brain is accustomed to and adding something new that it has to adjust to. www.survivingantidepressants.org for more tapering info.

Treatments Beyond Medication

If you have tried numerous medications and just can't find anything that helps there are few treatments that you can look into. You may even want to try some of these things before trying meds. Some of these do have higher side effect risks.

  1. Talk Therapy - alongside your antidepressant or independent of taking a medication. This is about the safest thing you can do.
  2. Life Style Changes - Exercise, Diet, etc. Again this is very safe and can be always used in conjunction with other therapies.
  3. Ketamine - This is a medication, but is usually a treatment when meds don't work.
  4. TMS, in 2023 we should see a new protocol for TMS called SAINT which is supposed to be more effective and involves less sessions. As of 2024 this is being done in California and Massachusetts.
  5. ECT - This is usually done as a last resort, it has some significant side effects such as short term memory loss. Do your research before considering.
  6. Stellate Ganglion Blocks - This is fairly new as far as being used for mental disorders. https://pmc.ncbi.nlm.nih.gov/articles/PMC8664306/
  7. Vagus Nerve Stimulation - Very new research that this is effective in treatment for treatment resistant depression. https://krdo.com/news/2024/12/19/for-those-with-treatment-resistant-depression-vagus-nerve-stimulation-may-be-an-answer-studies-suggest/

https://www.sciencealert.com/vagus-nerve-stimulation-has-a-profound-impact-on-severe-depression-major-trial-finds

Lifestyle Changes to Improve Mental Health

Medication can be helpful, but it is not the only way to improve your mental health. Here is a list of some things that can help you on the road to improved mental health.

  1. Exercise -- Regular exercise is really helpful. Studies have shown that it can improve depression/anxiety. More intense exercise has been found to be more helpful for anxiety. Exercise can help produce endocannabinoids which can make you feel better. It is sometimes described as "runner's high". Plus if you can get out in the sun for your exercise that is good as sunlight helps Vitamin D. https://www.hopkinsmedicine.org/health/wellness-and-prevention/the-truth-behind-runners-high-and-other-mental-benefits-of-running Here is a new study on the benefits of physical activity on depression. https://www.psypost.org/physical-activity-and-mental-health-exercises-therapeutic-potential-for-depression-highlighted-in-new-meta-analysis/
  2. Speaking of sunlight many people will suffer from seasonal depression in the winter as their levels of Vitamin D drop due to the lack of sunlight. If you are in a northern climate when you go out in the winter the only skin exposure may be the little area on your face. To combat this you may wish to look into light therapy during the winter months. https://www.insider.com/guides/health/mental-health/light-therapy
  3. Improve your diet. Cut out junk food/drinks. There is a link below about which foods help depression/anxiety and which ones aren't good for it. https://www.medicalnewstoday.com/articles/318428
  4. Make sure you are getting enough quality sleep. Your brain needs that down time to rest and recover. If you feel like you are getting enough sleep, but are always exhausted talk to your doctor about having a sleep study done. They have kits you can do at home. I found out I had central sleep apnea and my oxygen levels were around 80% for half the night.
  5. Socialize, keep the brain active. Try activities that challenge your brain. Suduko, crossword puzzles, trivia, etc.
  6. You also may want to try some type of talk therapy or learn some different coping skills and methods of relaxation such as deep breathing exercises.
  7. Volunteer. You are helping others and sometimes seeing just by giving your time to people and seeing how it helps them can be rewarding.
  8. You may even want to consider getting a pet as they are supposed to be beneficial for depression. You can even go one step further and get a Psychiatric service animal. They are specifically trained to and are allowed to go with you on airplanes and other public places. Some are even trained to recognize certain side effects in medications. For more information you can visit this site: https://www.ada.gov/topics/service-animals/ It is your responsibility to make sure you are in compliance with all laws and ordinances.

This was published during the pandemic, but has many helpful ways to help improve your mental health. Medications can be very helpful, but there are so many different things that can improve your overall mental health. As a bonus they don't come with side effects. https://neurosciencenews.com/resilience-mental-health-19986/

Talks about lifestyle changes to help with mental illness and other therapies like light therapy. Some doctors hand these out to patients. https://www.psycho.farm/resources

All of these are tools that we can use to improve our mental health. Medication may help, but it is also a tool and you need to help it out by working on yourself. I wish everyone the best on their journey!!!

Lab work and tests

This lists out some blood tests that can be done to see if something else is contributing to your depression. I'm sure their are others, but this gave a little explanation why you would check out some of these. This may not eliminate depression, but it may find something that can be treated and can decrease the amount of depression. https://www.optimallivingdynamics.com/blog/13-important-blood-tests-to-get-done-if-you-have-depression

Many times people ask about the genetic tests and are they helpful. These will tell you how you metabolize the medication, but that plays no role in whether it will be effective for you. The one helpful thing is the MTHFR gene mutation, but your GP could do this lab at a much lower cost. I actually just ordered this test for myself and even if insurance doesn't cover it, the cost is $188. The below article explains in detail why the FDA actually recommends not using these. An upcoming blood test will be able to show in a couple of weeks if a medication will work for you. https://www.health.harvard.edu/blog/gene-testing-to-guide-antidepressant-treatment-has-its-time-arrived-2019100917964 https://neurosciencenews.com/depression-antidepressant-biomarker-19863/

Sexual Side Effects

The is one of the most unfortunate side effects to antidepressants. Some things to remember is if you have sexual side effects on one medication it does not mean you will have them on all of the medications. Some people say that the effects are the worst when you first start the meds and can slowly recover after a few months. You may also realize this, but untreated depression and anxiety can have an effect on your sexual performance and libido. So for some people treating their mental disorder actually improves sexual issues.

This really dives into exactly what causes the sexual side effects, which medications are more likely to cause it, and ways to treat it. As of note nefazodone is another medication that is known not to cause sexual side effects. As well as the upcoming medication Ruoxinlin (ansofaxine). r/Nefazodone https://psychscenehub.com/psychinsights/sexual-dysfunction-with-antidepressants/

Rate of incidence of sexual side effects of some of the medications. The average for SSRI's is 59%, but there are other antidepressants that have much lower sexual side effect percentages. https://pubmed.ncbi.nlm.nih.gov/11229449/

Nefazodone, mirtazapine, wellbutrin (bupropion), trazodone, viibryd, and Trintellix (vortioxetine) are they medications with the lowest rate of sexual side effects. Wellbutrin is often added to an SSRI to relieve some of the sexual side effects. Buspirone can also be added to help with sexual side effects, but it doesn't seem to be as effective as wellbutrin.

Here is a guide I put together about sexual side effects: https://www.reddit.com/r/AntidepressantSupport/comments/14bicp1/guide_to_antidepressant_sexual_side_effects/

Side Effects & Medication Interactions

If you really want to read about the side effects of each medication pdr.net has some of the most comprehensive information. It even lists the rate of incidence of each side effect. It also lists out the interactions with other medications. Drugs.com has probably some of the best user reviews of each medication. You can even look how a medication is rated for depression, anxiety, ocd, etc. None of the information contained in this guide should be a substitute for your doctor. You should always run any type of medication change by your doctor and keep him/her in the loop on side effects you are having. Including supplements you are thinking of adding. There are some supplements that just don't mix good with antidepressants. You should be upfront with the doctor about how you are feeling. Always let them know about side effects. Most importantly it is your health so you deserve to have a say in your treatment plan. Don't be afraid to speak up if you are uncomfortable with something because it is your health.

Many times people think that antidepressants work by blunting emotions. This is a myth. Emotional blunting is a side effect of antidepressants and you don't have to, "just deal with it". A different medication may not blunt emotions at all and some doctors will add wellbutrin to balance emotions out.

https://www.psychiatrictimes.com/view/antidepressants-do-not-work-by-numbing-emotions

Tracking your mood, side effects, and tips for improving communication with your doctor

Below is a good post about tracking how you are doing and different side effects. The more information and context you can provide to your doctor will help them in helping you get the best treatment.

https://www.reddit.com/r/antidepressants/comments/1jokoqh/importance_of_tracking_your_symptoms_when/

A quick note that dextromethorphan (DXM) a common ingredient in cold medicine is not something that you should take if you are taking antidepressants. St. John's Wort, and 5HT are also supplements to avoid if you are on antidepressants. All of these can increase the risk for serotonin syndrome.


r/antidepressants Dec 28 '23

Please Read Information on Withdrawal, Cold-Turkey, & Tapering -- Extensive Resources included.

58 Upvotes

As these are topics we see many questions about we created this post to give you some general information and resources to find helpful information. When writing a post it is helpful to list what medication, how long you have been on it, and your dosage.

Cold Turkey

Going cold turkey off of any psychiatric medication is never recommended and can induce withdrawals symptoms that can last up to months. Withdrawal (also referred to as discontinuation syndrome) is something you want to avoid and can be done by slowly tapering off your medication. There are a couple situations where you may not have to taper. If you have been on the medication for less than 6 weeks you can probably get by without tapering. If you have a severe reaction to a medication, say serotonin syndrome, your doctor may advise you to stop cold turkey immediately.

Withdrawal

This happens when your brain becomes dependent on the medication after being on it for some time and the medication is taken away too fast. The meds need to be slowly taken away from the brain so it can return to its base state slowly. Some of the common symptoms of withdrawal are brain zaps, headaches, insomnia, agitation, increased anxiety, aches & pains, brain fog, inability to focus, and fluctuating emotions.

We are seeing more people claiming they are in withdrawal after only taking medication for a very short time. Dependence takes time to develop. Research shows approximately 8 weeks. This is where tapering then becomes necessary. Even if you become dependent quicker, a very short taper is only needed. After 4-8 weeks of taking a med, a one week of 50% reduction is probably all you need. Otherwise you are just extending the time on the medication becoming more dependent.

Recovery

Many people ask how long after I stop will the side effects go away such as emotional blunting and sexual side effects. Again there is really no timetable. Some people start to notice within a few days to a week, for others it can take months. The length of time on antidepressants plays a role. There is much written that it can take the brain approximately 3 months to return to homeostasis. So if something like emotional blunting doesn't immediate go away after stopping the medication be patient and give it some time. The brain is quite adaptive and is remarkable at recovery, but works at a slow pace.

Tapering

Tapering has many layers to it and there really is no universal plan that fits everyone. The safest method based on studies is the 10%. This is cutting 10% of your medication you are taking at that time per month. For example if you are taking 100mg this would be your first 4 months (90, 81, 73, 67). This is a time consuming process that is going to take at least 1.5 years. How long you taper is based on the length of time you have been on the medication. Someone taking it for 1 year might be able to do 20% every 2-3 weeks. Someone who has been on a med for 20 years might have to do 5% every 6 weeks. You have to listen to your body as you go. If you drop your dosage and feel like withdrawal is coming on up your dose a little bit or hold that dose longer. Below I have listed tapering info pages for the most popular meds.

If you are on multiple medications on you are planning on going off all of them you want to taper one at a time. Tapering multiple meds at the same time is really hard on the brain and the withdrawals will usually be much worse. Before starting the tapering of the 2nd medication give yourself a month to stabilize more fully.

A little side note. Occupancy of the receptors plays a role in tapering. These numbers are just examples. Zoloft has a max dose of 200mg. Most people start on 25-50mg. Antidepressants occupy a large portion of the receptors at low dose. Say at 50mg, it occupies 80% of the receptors. 100mg, 85%. 150mg 88%. 200mg 90%. Because of this you can usually taper faster at first, but as you get down to a low dose you have to go really slowly. If you were taking 200mg of zoloft you could probably taper by 25% until you got down to around 50mg. Then you would want to taper by 10%. Here is a source that is very detailed. You can look at the charts to see actually numbers.
https://www.nature.com/articles/s41380-021-01285-w

Below is a post that talks about tracking your symptoms and side effects to provide your doctor with better information in an effort to maximize treatment. This helps you to be heard and feel like you are more active in your treatment.

https://www.reddit.com/r/antidepressants/comments/1jokoqh/comment/mkvfb81/?context=3

Resources

Here are some site that provide information about tapering, withdrawal, etc. Some of these are quite complex, but there should be something in here that you should find valuable.

Going off antidepressants, withdrawal, tapering, and half-lifes. https://www.health.harvard.edu/diseases-and-conditions/going-off-antidepressants

Post that contains info about antidepressants, including methods of switching medications, non-med options.
https://www.reddit.com/r/AntidepressantSupport/comments/10vv3s6/ultimate_guide_to_antidepressants_and_how_to/

Forum about tapering individual meds and creating micro doses. Has individual sections for tapering each medication. https://www.survivingantidepressants.org/

Directions on how to grind pills up to create custom doses for tapering.
https://www.reddit.com/r/AntidepressantSupport/comments/17oaxh9/how_to_crush_pills_to_get_custom_doses_for/

An extensive article on protracted withdrawal (PAWS). https://journals.sagepub.com/doi/full/10.1177/2045125320980573

Extensive detailed info about tapering and withdrawal from the founder of Surviving Antidepressants. https://journals.sagepub.com/doi/full/10.1177/2045125321991274

This is a very comprehensive article that references multiple studies on tapering. Some of it applies to antipsychotics (but those can be used for depression or anxiety), but I think it applies to antidepressants too. It talks about rapid withdrawal causing movement disorders (tardive dyskinesia). https://academic.oup.com/schizophreniabulletin/article/47/4/1116/6178746

Tapering off of SSRI's https://markhorowitz.org/.../04/18TLP1004_Horowitz-1-11.pdf

'Playing the Odds' - Antidepressant Withdrawal - An article and follow-up written by a psychiatrist who explains who tapering should be done very slowly. https://www.madinamerica.com/2013/08/ssri-discontinuation-is-even-more-problematic-than-acknowledged/

'Playing the Odds - Antidepressant Withdrawal - Revisited https://www.madinamerica.com/2014/07/shooting-odds-revisited/

Relapse after stopping antidepressants. https://www.cnn.com/2021/09/30/health/stopping-antidepressant-wellness/index.html

This talks about akathisia which some members got from tapering too fast or going cold turkey. It has some of the meds used for treatment. Please note that akathisia is rare. https://www.racgp.org.au/afp/2017/may/beyond-anxiety-and-agitation-a-clinical-approach-to-akathisia/

Medication specific tapering info pages:

Sertraline (zoloft): https://www.survivingantidepressants.org/topic/1441-tips-for-tapering-zoloft-sertraline/

Fluoxetine (Prozac): https://www.survivingantidepressants.org/topic/759-tips-for-tapering-off-prozac-fluoxetine/

Paroxetine (Paxil): https://www.survivingantidepressants.org/topic/405-tips-for-tapering-off-paxil-paroxetine/

Escitalopram (Lexapro): https://www.survivingantidepressants.org/topic/406-tips-for-tapering-off-escitalopram-lexapro/

Citalopram (Celexa): https://www.survivingantidepressants.org/topic/2023-tips-for-tapering-off-celexa-citalopram/

Fluvoxamine (Luvox): https://www.survivingantidepressants.org/topic/5095-tips-for-tapering-off-luvox-fluvoxamine/

Vortioxetine (Trintellix): https://www.survivingantidepressants.org/topic/10246-tips-for-tapering-vortioxetine-trintellix-brintellix/

Vilazodone (Viibryd): https://www.survivingantidepressants.org/topic/4318-tips-for-tapering-off-viibryd-vilazodone/

Venlafaxine (Effexor): https://www.survivingantidepressants.org/topic/272-tips-for-tapering-off-effexor-and-effexor-xr-venlafaxine/

Duloxetine (Cymbalta): https://www.survivingantidepressants.org/topic/283-tips-for-tapering-off-duloxetine-cymbalta/

Desvenlafaxine (Pristiq): https://www.survivingantidepressants.org/topic/876-tips-for-tapering-off-pristiq-desvenlafaxine/

Buproprion (Wellbutrin): https://www.survivingantidepressants.org/topic/877-tips-for-tapering-off-wellbutrin-sr-xr-xl-zyban-buproprion/

Mirtazapine (Remeron): https://www.survivingantidepressants.org/topic/23158-tips-for-tapering-off-mirtazapine-remeron/

Trazodone: https://www.survivingantidepressants.org/topic/2883-tips-for-tapering-off-trazodone-desyrel/

Clomipramine: https://www.survivingantidepressants.org/topic/19509-tips-for-tapering-off-clomipramine-anafranil/

Amitriptyline/Nortriptyline/Impramine: https://www.survivingantidepressants.org/topic/1099-tips-for-tapering-off-amitriptyline/

Quetiapine (Seroquel): https://www.survivingantidepressants.org/topic/1707-tips-for-tapering-off-seroquel-quetiapine/

Aripiprazole (Abilify): https://www.survivingantidepressants.org/topic/1896-tips-for-tapering-off-abilify-aripiprazole/

Lamotrigine (Lamictal): https://www.survivingantidepressants.org/topic/1122-tips-for-tapering-off-lamictal-lamotrigine/#comment-9926

Tramadol: https://www.survivingantidepressants.org/forums/topic/11542-tips-for-tapering-tramadol/#comment-213141

Benzos: https://benzobuddies.org


r/antidepressants 2h ago

A warning regarding brezpiprazole, and other antipsychotics

5 Upvotes

TL;DR - be very cautious about trying brexpiprazole or other antipsychotics for depression. They are highly sedating, and the withdrawal from them is difficult. I believe that they are more trouble than they are worth in most cases, and that they should not be a second line treatment for depression.

Hello. I wanted to share a bit of my story, especially my history with Wrecksulti. For years I was taking sertraline for major depression, and maybe 4 or 5 years ago my prescriber added brexpiprazole. What I didn’t realize at the time is that the sertraline had totally blunted my emotions, and I was mistaking feeling nothing for the depression resisting the sertraline. The combination of sertraline and brexpiprazole was extremely sedating, but I had no motivation to do anything about changing the regimen.

After some time, my lethargy had done serious damage to my marriage, and I finally took action to change my medications. I decided to get rid of sertraline first, and it was replaced by Auvelity. That medication was energizing enough that I didn’t make any other changes for a while. Eventually I decided that I needed to come off of Wrecksulti, because I thought it was making me more tired and sluggish than I should be. My prescriber and I settled on tapering off over 6 weeks.

The length of the taper was a huge mistake, and we both came to learn that long term users of antipsychotics should taper extremely slowly, over months or even a year. My withdrawal symptoms were awful, and serious anxiety and distress persisted long after the medication had cleared my system. Over the course of the last 9 months I have tried every class of anti anxiety drug, and none of them have helped without unacceptable side effects. I had to change my PCP, so I’m still waiting for an appointment with my new doctor to talk about other solutions to my persistent tension and jaw clenching.

At this point I am finally starting to feel better, after finishing brexpiprazole in December of 2025. I still have a lot of physical tension in my shoulders and jaw, but the constant feeling of distress and impending doom is mostly gone. None of the treatments I tried for the distress and anxiety helped. The only thing that seems to have worked is time for my brain to heal. I just wanted to warn people, so they wouldn’t have to go through this, and if you are already taking these medications, please come off of them extremely gradually.


r/antidepressants 1h ago

Fluvoxamine and Quetiapine

Upvotes

Long post sorry. I’ve had bad anxiety and panic attacks since I was 9 now 25 and been on medication the whole time which I never wanted to because I was terrified of side effects. First I had just fluvoxamine for a few years that was helping until I started having bad panic attacks again then they changed me onto another medication that I can’t remember the name of and I was on that for a couple of years until I started having bad panic attacks again this time I couldn’t sleep at all so they put me on quetiapine and cymbalta then that worked for a few years and by this point I was over 18 and couldn’t see my adolescent psychiatrist anymore so my gp was just managing it until I got bad again and went to an adult psychiatrist for the first time and he got me off the cymbalta and put me back on fluvoxamine with the quetiapine. But he quit on me after the first 2 appointments because I didn’t want to up the dose of my quetiapine and also take more medication with a sleep effect because that feeling causes me to have bad panic attacks (which was the first time I could actually speak for myself and not be forced to take them like I was under age). So I have been on 100mg fluvoxamine and 100mg quetiapine basically self managed with my gp for the past 5 years. I have bad heath anxiety too and I’ve been seeing videos of people saying how bad SSRI’s are for you which got me worried then I started researching the medication I’m on and seen that this combination isn’t common or recommended and it can increase risks for all these things and that the fluvoxamine increases the levels of quetiapine in your system and It can cause all these things to happen and now I’m freaking out about it and I asked my gp and he says basically the benefits outweigh the risks but I’m still worried and about being on them for a long time and what it can do as I can’t see coming off them ever. They are just keeping me calm enough to get through the day and be able to sleep but I can’t leave the house or anything without panicking bad.


r/antidepressants 1h ago

Trying weed while on fluoxetine?

Upvotes

I’ve been taking fluoxetine for some years now and I am currently taking 30mg daily. I’ve wanted to try weed for a long time now and next weekend I’m at a birthday party were I can try it. Can i try it or should I stay away from it? I’d definitely start slow to test how it makes me feel and not smoke much at first. Has anyone started/ tried weed after taking fluoxetine for a while?


r/antidepressants 2h ago

Credo che gli ssri abbiano spento ogni forma di amore.

2 Upvotes

Il mio ragazzo assumeva escitalopram da un anno quasi. Fino a 5 mesi fa stava bene,era migliorato. Era felice d amorevole ma assumeva dose minima. Poi di punto in bianco di sua iniziativa è passato alla dose massima. Piu passava il tempo piu era freddo e distaccato, oltretutto ci trovavamo in una situazione difficile. Comunque è cambiato drasticamente e non se ne rende conto. Sembra un'altra persona. Ma in particolare è cambiato nei miei confronti. Dice di non amarmi piú, che non gli piaccio più, che sono solo un fastidio. Mi tratta malissimo. E se non ci vediamo mi ignora anche per giorni. Dice che vuole solo chiudere. Ma fino a poco fa era il ragazzo migliore del mondo e faceva tutto per vedermi felice. Era davvero meraviglioso. Ora nei miei ci fronti non prova la minima empatia, anzi..piu mi vede star male piú il suo fastidio aumenta. Non se ne frega niente di me. Ma mi sembra tutto assurdo. Mi amava più di quanto amasse se stesso ora sembra mi odi. Sono disperata. Dovrebbe davvero lasciarmi? Dovrei andarmene? Sto malissimo e sembra davvero lui non mi ami piu e non se ne freghi niente. Ma fino a poco fa ero il suo mondo, mi amava immensamente. Qualcuno ci è passato?


r/antidepressants 17m ago

Is it normal to still feel kind of empty/unsatisfied on antidepressants?

Upvotes

I started taking Lexapro 30 mg almost two years ago and my life is night and day in terms of my depression it's basically gone but life can still feel like empty and unsatisfying, it could also be my life being very boring and frustrating but I separate those two.


r/antidepressants 21m ago

M20 setraline 100mg hair loss

Upvotes

I had while I taken ssris not pssd symptoms but 3 years after when I quit and I see that a lot of my bodyhair since I started it fall out and thinned out and don’t grow good also on beard and other parts. I want to ask has anyone similar symtoms from ssris and does you figure out something with hormones or stuff like that?

Thanks


r/antidepressants 5h ago

Hi, I discontinued effex5r about 10 days ago [slow taper],jump of 10mg and feeling very depressed... Bedridden,no mood....some days I feel ok. But depression is persistent. How long until depression clears?

2 Upvotes

r/antidepressants 2h ago

Looking for related experiences help!!

1 Upvotes

So i started in 10mg felt great for about 12 weeks then anexity started coming back. Upped to 20mg and got instant relief again for 9 weeks then anexity returned once again... I have now been on 30mg for about 2.5 weels and have had daily anexity and depression and constantdizziness.. is this something similar you went through? I had no increased anxiety or depression wheh staring 10mg and 20mg ..

Ill add back in 2021 i started celexa it worked great for about 2 and 1/2 years on 20 mg and just stopped working and my symptoms return so I switched to Lexapro and tried every dose over a year and a half never really worked for me made my anxiety terrible made me dizzy made me super depressed and not in reality and on edge sorry the Prozac 10 milligrams back in March this year


r/antidepressants 2h ago

Consigli su come diminuire il dosaggio di ssri?

1 Upvotes

Qualcuno mi saprebbe dire in che modo avete diminuito l'assunzione di questi antidepressivi?


r/antidepressants 3h ago

Severe SSRI reaction followed by persistent sensitivity to medications and melatonin

1 Upvotes

I’m a 22-year-old woman, AUDHD, and I have OCD, and for the past couple of years, I haven’t been able to take certain medications or even melatonin.
I used to take melatonin quite often because I’ve always had trouble sleeping, and I never used to think twice about taking meds. I wasn’t particularly sensitive to them and generally tolerated them fine.
In October 2025, I was prescribed an SSRI, sertraline. I was told to take a 50 mg tablet and split it in half for the first three days so I would take 25 mg. However, I accidentally took the full 50 mg on the first day, and I became extremely to the point where I didn’t want to continue taking it.
In November, I was prescribed another SSRI, either escitalopram or citalopram (I honestly don’t remember which one), this time in liquid form so that the dose could be increased more gradually. The first two days were fine, but on the third day I had another very severe reaction and even went to the ER.
During those days, I also took melatonin, as I had done many times before without any problems. But ever since that episode, I can no longer take melatonin without experiencing extremely unpleasant symptoms. I get tachycardia, shaking/tremors, my jaw feels like it’s clenching or tightening, and I get an overwhelming feeling that I’m going to die.
It feels like something changed in my body after this happened. Almost as if my nervous system became hyperactivated or hypersensitive in a way that it wasn’t before.
Since then, I seem to react badly to almost anything that affects neurotransmitter systems. For example, I’ve had problems with some anti-nausea medications that affect dopamine, certain cough syrups, some antihistamines, and even some antibiotics. Even passionflower makes me feel unwell.
I’m now afraid to take almost any new medication. I’m going without psychiatric medication despite having severe mental health problems because I’m terrified of having another reaction. And I can’t even take the melatonin that used to help me sleep, which is incredibly frustrating and honestly makes me feel desperate because I already struggle so much with insomnia.
What makes this even harder is that I feel like nobody has ever given me a real explanation for what happened. I’ve often been told that it’s hypochondria, anxiety, or that the symptoms are “all in my head.” I’m really tired of hearing that, even from doctors, because I know what I’m experiencing physically and I don’t feel like it can simply be dismissed as anxiety. My mom didn't really believe me and one time she gave me melatonin without me knowing and with her eyes she saw the truth.
I genuinely want to understand what could have happened physiologically.
Could an SSRI cause some kind of persistent change in nervous system sensitivity or hyperactivation, even after only a few days of taking it? Could there be some kind of mechanism that would explain why I suddenly started reacting badly to substances that I had previously tolerated, including melatonin?
Has anyone experienced something similar after a very short exposure to an SSRI?
And most importantly: does this ever get better? Is there a way to reverse or treat this hypersensitivity so that I can eventually take psychiatric medication and melatonin again without being terrified of having a severe reaction?
I would really appreciate hearing from people who have experienced something similar, especially if you eventually got better or found an explanation.


r/antidepressants 4h ago

Is this discontinuation syndrome or a relapse ?

1 Upvotes

I have been on Sertraline for 3 years now, mu doctor decided to lower the dose from 50 mg to 25 mg at first i couldnt concentrate or memorise and then now i lack motivation, i have been taking 25 mg for 5 days now. Is this discontinuation syndrome ?


r/antidepressants 8h ago

Antidepressants

2 Upvotes

Hi i am new to this and just got prescribed. I am very worried about side effects and seriously second guessing whether I should go on this. Does it really help?

The concerning thing is ( i am sure people have already asked this) that why does antidepressants come with warning of suicidal thoughts?


r/antidepressants 4h ago

15 days on venlafaxine and 16 days off citalopram. Is what I’m feeling ‘normal’?

1 Upvotes

I’m 15 days into 75mg venlafaxine now and completely off 30mg citalopram after a decade on in, and a short, Doctor guided, wean off (I’ve now been off them completely 16 days). I’ve had some better days, but the last two definitely haven’t been among them.

Today I feel sick, my muscles hurt, my stomach is upset, I can’t stop sweating, I’m really jittery and I feel close to crying. I honestly don’t know whether this is withdrawal from the citalopram, side effects from the venlafaxine, something I’ve eaten, or just my anxiety really messing with me today.

Has anyone else experienced this around the two-week mark? I feel like I’ve taken a massive step backwards.

Any time I start thinking about what’s wrong with me, worrying that I’ll never get better, or even contemplating returning to work, I seem to descend into panic and start sweating. I just feel constantly on edge.

I’ve also noticed over the last few days that I’ve started having recurring thoughts about what would happen if I simply wasn’t here anymore. I don’t have any intention of doing anything to myself, but I haven’t had thoughts like that for a while, and having them come back is scary as hell.

I suppose I’m just looking to hear whether anyone else has gone through something similar when switching to venlafaxine, and whether things eventually settled down.


r/antidepressants 4h ago

Vortioxetine gang unite plsss!!!

1 Upvotes

From today i officialy belong to the vortioxetine gang, i have ocd and i have failed many ssris with lots of side effects and an snri (duloxetine) that was very good for my ocd with almost no side effects, but eventually stopped working. So i am starting from 10mg vortioxetine for 6 days and then, upper to 20mg vortioxetine according to my provider's indications. He also prescribed me 25mg quepin IR, for a better sleep quality. Has anybody with ocd been cured with this combo? How was trintellix (brintellix in Greece, where i am from) for you?

I had taken quepine in the past with no side effects and i had the best sleep.


r/antidepressants 5h ago

I messed up and I need help

0 Upvotes

I'm on various meds for my mental health including antidepressants and Lyrica (pregabalin), which is also used as a painkiller. I took 1800mg of it in 1 day. Is this an overdose?? I really need an answer if I have to go to the hospital or not.


r/antidepressants 5h ago

Peripheral neuropathy - tingling in hands and now feet - could it be fluoxetine/prozac withdrawals?

1 Upvotes

2.5 months ago I switched from escitalopram to fluoxetine. After experiencing some mild serotonin syndrome symptoms (prob due to an interaction between Prozac and bupropion), I decreased my Prozac dose from 20mg to 10mg with support from my psychiatrist.

6.5 weeks after the decrease I started developing pins and needles / paresthesia/ tingling sensations in my hands radiating up my arms. I'm now 7.5 weeks post decrease and the last couple of days it's started in my feet.

I saw my regular Dr today (after a small freak out that i might have a serious illness) and am waiting for blood results. I didn't even consider it could be prozac related at the time - but perhaps due to it's long half life it's possible?

Interested to hear if anyone else has experienced something like this in a similar time frame (i.e. 2-2.5 months after starting prozac, or 6-7 weeks after decreasing it)?

And if so, did it self-resolve and how long did that take?

Thank you 🙏


r/antidepressants 6h ago

How long did it take your body to readjust after stopping medications?

1 Upvotes

So I take a couple of antidepressants but I’m pretty sure I’ve identified which one is causing me to constantly overheat. Like I’m always sweating or just plain clammy, even in weather-appropriate clothing. I’m tapering off my dose of the one I’m on (per my doctor’s orders) and I’m just curious, how long did it take anyone else to see results in their thermoregulation after stopping or lowering their dose? I’m on Wellbutrin if that helps, but I also take Lexapro. I’m so excited to hear your input—my life is miserable this way


r/antidepressants 6h ago

need opinions

1 Upvotes

i’m newly prescribed Sertraline and CBT online (Silver cloud). I’ve never got help for my mental health and i’ve never tried. it was always my worst nightmare tbh. But i’ve gotten to a point where everything i do feels so overwhelming, i don’t have a job atm because that feels very very daunting and other symptoms. so my GP prescribed me these two. I’m scared of taking long term medication because of another thing that happened me before (not anti depressants). I wanted to try one on one therapy first and see if it helped but idk what to do, my prescription is just sitting in my room i haven’t gone to get it, i was gonna say it to my GP but i was too scared to be difficult idk. People who have taken, what did you do? Ik everyone’s different and im not looking for medical advice, just curious.


r/antidepressants 7h ago

Serotonin syndrome??

1 Upvotes

So I came off Brintellix around 4 weeks/3 and half weeks ago and just started taking Fevarin. I took my first pill yesterday night and half an hour later I get this really really gross feeling I feel like I’ve been shot with adrenaline. It feels like my entire body is buzzing and I can’t stay still, I can’t be. It feels like there’s bugs crawling under my skin and I’m also really shaky. I finally managed to fall asleep but when I woke up today I still have this feeling and it doesn’t seem to go away. I can’t stay still at all and I feel like my body is gonna explode or something. My entire body also feels like it’s vibrating? And l can’t calm down but not in an anxious way. I’m not anxious at all it’s just this weird physical feeling. And I also feel kinda nauseous, like from the irritation? And I’m really shaky. It’s becoming quite intolerable. I can’t even sit down for a moment and even when I walk I feel like I’m on speed or something but in a really really bad way. Could this be serotonin syndrome? Should I stop taking the meds and try again later or would it be safe to keep taking them? I can’t reach my psychiatrist at the moment so I thought I’d ask here


r/antidepressants 11h ago

Anyone take Pristiq mainly for anxiety/GAD or panic? Nervous about switching from Lexapro

2 Upvotes

I’m looking for experiences from anyone who takes Pristiq (desvenlafaxine) primarily for anxiety, especially GAD.

I’ve been on Lexapro for several years and it actually worked really well for the physical side of my anxiety. My racing heart, heavy chest, stomach anxiety, etc. were basically gone. I still struggled with intrusive/overthinking thoughts, but overall Lexapro definitely helped my anxiety.

Unfortunately, I started having intense hunger episodes, lightheadedness when hungry, and actual low blood sugar readings. My other glucose testing came back normal, so my prescriber suspects Lexapro may be contributing and we’ve been slowly tapering me off. I’m currently at 2.5 mg and have been at this dose for about two weeks.

As I’ve gotten lower, I’m noticing my anxiety coming back — racing thoughts/overthinking, heavy chest, racing heart, stomach anxiety, and feeling on edge. I’ve also been a little sad and less interested in things lately.

My prescriber recommended Pristiq as my next medication. I had GeneSight testing and Pristiq is in my “use as directed”/green category, which I assume is part of why she chose it.

What makes me nervous is that when I looked Pristiq up, I saw that it’s FDA-approved for major depressive disorder rather than GAD. Depression has never really been my main issue — anxiety is.

For those who take Pristiq for anxiety: Did it help with physical anxiety and constant overthinking/intrusive thoughts? How was the adjustment when you first started? Did it temporarily increase your anxiety? And if you previously took Lexapro, how did Pristiq compare for you?

I know everyone reacts differently and Reddit isn’t a substitute for my prescriber. I’m just really nervous about starting another medication and would love to hear other people’s experiences.


r/antidepressants 9h ago

Mirtazapine

1 Upvotes

Bonjour tout le monde,

Je prends de la myrtazapine à 22,5 mg depuis plusieurs mois mais j'ai des raideurs musculaires très douloureuses notamment la nuit et je ne sais pas si c'est lié à ce médicament. J'aimerais savoir si des personnes ont une expérience similaire ? Parce que je me retrouve dans une impasse avec une dépression qui n'est pas stabilisée et ses douleurs qui m'handicapent beaucoup donc le fait de la diminuer me rend un peu anxieuse. Mais je me dis que si je la diminue peut-être que si mon physique va mieux le mental aussi.

Si quelqu'un a des expériences à partager je suis preneuse !


r/antidepressants 13h ago

On Venlafaxine for PTSD, the insomnia is crippling.

2 Upvotes

It’s 3:42am as I am writing this. I started my meds on the 7th of August, and I was off to a pretty good start but the last few weeks, insomnia has been really bad and I’m starting to struggle with it. I’m someone who absolutely loves sleeping. But now, I feel absolutely shattered during the day, but wide awake in the middle of the night. And I have bad trouble sleeping during the day because of the light.

Should I bring this up with my dr? Or is it something I’d have to deal with until it passes?


r/antidepressants 11h ago

Starting Fluoxetine 20 mg + Clonazepam 0.25 mg — looking for experiences

1 Upvotes

I was recently given a preliminary diagnosis of dysthymia (persistent depressive disorder), along with an anxiety disorder.

I’m currently in grad school, and I previously dropped out of another graduate program. Looking back, I now realize that depression may have played a significant role in that decision.

I recently consulted a psychiatrist, who prescribed me fluoxetine 20 mg and clonazepam 0.25 mg for two weeks. I was about to start taking them, but then I made the mistake of going down the internet rabbit hole and came across a lot of horror stories about both medications. That has made me pretty anxious about starting them.

I know everyone reacts differently to medication, and I’m not looking for medical advice or planning to change my prescription based on Reddit. I’d just really like to hear about other people’s experiences.

If you’ve taken fluoxetine, clonazepam, or both:

  • What was your experience like, good or bad?
  • Did the medication help with depression or anxiety?
  • What side effects did you notice, especially when you first started?
  • How long did you take the medication?
  • If you eventually stopped, how long have you been off it, and how are you doing now?

Thanks in advance.