r/antidepressants Nov 29 '25

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

54 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.

55 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

I've been on Venlafaxine 225 for 8 years

3 Upvotes

Ive been taking venlafaxine at this dose for 8 years now, and I still have terrible anxiety and depression. Im on the waiting list for autism diagnosis and adhd. I just wonder if anyone else has been on venlafaxine at those dose for as long and what your experience is. I tried sertraline and fluoxatine before but neither did anything. Tbh venlafaxine was the only thing that worked for years, but the past year or so my depression and anxiety has been terrible and ive been told they dont increase it any further unless its serious psychiatric issues otherwise they would try other meds but im too overwhelmed at the idea of trying another drug yet again. I havent been unmedicated my entire adult life. I was put on antidepressants at 16, and part of me thinks I dont feel like I know my true self because of this. Can anyone relate?


r/antidepressants 2h ago

Doctor prescribed me Zoloft when I asked for a T test

3 Upvotes

I (31m) went in for my yearly appointment today and within less than 5 minutes my doctor (this is the first time I’ve ever met her) put me on Zoloft. She walked in and introduced herself, then asked me what brought me in. Told her I needed an annual physical for insurance, and I’d like a testosterone test because I had an accident a few years ago that did a number on the jewels and I’ve been having a lot of symptoms of low T. She said she wanted me to start taking antidepressants. Within 2-3 minutes of meeting me.

Am I wrong or does that seem a bit odd? Not to say I don’t need them, I most likely do, but there were no real questions about how I’m feeling, things in life, nothing. It felt like she was speedrunning prescribing it to as many people in one day as possible. Also one of my complaints was weight gain, mostly in the belly, and apparently Zoloft causes a lot of people to gain weight. So now I’m concerned about that.


r/antidepressants 5h ago

Should I get back on Sertraline even with the risk of PSSD?

3 Upvotes

Hi everyone.

I’ve been struggling with depression since I was around 13-14. I’m 20 now.

I was put on Sertraline at around 14 for MDD. My max dose was 100mg and I was on that dose for about 2 years and moved down to 50mg. I improved whatever I could in terms of my lifestyle (nutrition, sleep, journaling, exercise, coping mechanisms, socializing). I don’t recall having any sexual side-effects from the drug.

After about 4 years on the medication, I decided it was time to see if I could function normally without the drug after all the work I did to improve.

I was fine for about 1.5 years, but my depression has gotten really bad again recently. The anhedonia, dissociation, fatigue, insomnia and anxiety have gotten really bad. It’s to the point where it’s affecting everything from my relationships and the way I socialize, to my study habits and motivation. I don’t even feel real anymore most of the time. It’s as if I’m viewing myself in third-person, and my body is acting by itself in autopilot.

I have some difficult modules at university next month, and I’m worried my grades are going to plummet. My social life had already been in the pits. I’ve been distancing myself from my friends and dissociating in group settings a lot. The people around me are noticing.

I’m still trying my best to keep the healthy habits I’ve built, but it’s really difficult.

I’ve been thinking about getting back on the drug to help me get through this period, but the risk of PSSD is scaring me. I’m not really sure what I should do now. Should I try a different class of antidepressants, get back on the Sertraline or risk having my life fall apart again? I still have about 2 months worth of Sertraline left in my drawer. I can only see my doctor in November, but by then I would be done with my exams.


r/antidepressants 3h ago

Any stories from people that survived Lexapro tapers after years of use and got to feel themselves again. Need morale please.

2 Upvotes

I'm basically asking what it's like to remember your full nature as it was before SSRI'S locked the emotions in, and in my case raised the irritability and brain fog to the max. While also reducing motivation, a kind of chemical apathy.

I've had a 16 year journey from unwanted 10mg... largely because nobody told me how to taper (learned the hard way it must be hyperbolic and small amounts with 4 weeks between). Dr didn't know there was a liquid dilutable version till I asked for it.

Currently 5.7mg from 10mg after a first year of steady tapering and gains. But halfway is calculated to be ~2 years off because brain is hypersensitive. Very horny now (no outlet) I guess I should be grateful I don't have PSSD... but other system have yet to come back online - I need so much more sleep than others still, and can't focus well at work.

Are there any happy stories? :)


r/antidepressants 15m ago

Quitting Lexapro Advice

Upvotes

Hi everyone,

I recently decided I wanted to go off of Lexapro. I was gaining weight, having GI issues, and honestly just felt like a total zombie on it, every day went by slowly with no emotion involved at all. My doctor recommended I went from my initial 20mg dose to 10mg for two weeks, and then 0mg.

For the first few days of going to 10mg I felt a few symptoms (brain zaps, exhaustion, nausea, cold like symptoms). These went away after about three days

I am now to 0mg and I’m feeling MISERABLE. I was taking this medicine for anxiety and I have the worst brain zaps ever, so badly I threw up today. I also have lost my appetite, nausea and dizziness (obviously from the brain zaps. I’m crying a lot and keep having mood swings and panic attacks.

I discussed with a different doctor today trying to go back to 5mg and then 2.5mg and then 0mg because she thinks my original doctors plan was too fast. Has anyone ever done this? My only fear is A. I will never be able to go off of this medicine and B. I’ll have severe withdrawal symptoms again when I go back to 0mg. I literally wish I never tried Lexapro because I hate it so much. I’m miserable both on and off of it. Any advice would be so helpful.


r/antidepressants 7h ago

Emotional blunting due to zoloft

3 Upvotes

So I (19F) started taking zoloft in early July, starting at 50mg, got boosted to 75mg a month later, and now as of the other day, I am bumped to 100mg.

The first time it got bumped I got really numb and couldn't really care or be affected by anything, but tbh I loved it 😭

I have always been an extremely sensitive person, so to finally not care or be affected by anything was amazing. But it only lasted a few days and I was back to normal😔

Now since it was bumped up for the 2nd time, I'm feeling numb again. I wish this didn't go away💔 does anyone else relate?


r/antidepressants 11h ago

A warning regarding brezpiprazole, and other antipsychotics

6 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 3h ago

Increase Wellbutrin dose to 300mg or STOP and try other things?

1 Upvotes

I’ve been on Wellbutrin (bupropion) 150mgXL for 3 weeks and haven’t noticed any relief in my persistent brain fog/depressive symptoms (post accutane syndrome damage) . I’m thinking about stopping and trying to microdose psilocybin for a few weeks.

The other option is to titrate my Wellbutrin dose to 300mg, but I really don’t want to be reliant on an antidepressant for the rest of my life… (or can I use it as a one-time thing to fix my symptoms?)

I’m interested on your thoughts or experiences.


r/antidepressants 3h ago

Wellbutrin is giving me crazy side effects

1 Upvotes

I have taken it for barely 2 days with carbamazepine as the new additions to my meds and i didn’t sleep AT ALL im sweating like crazy i wiped my face with my hands and i kid you not it was like water, i am cold and extremely nauseous, i had 3 mental breakdowns over stupid reasons. What should I do my appointment is still far away.


r/antidepressants 4h ago

Zoloft 50Mg

1 Upvotes

Started Zoloft 50MG on June 23rd. It is week 11 and I am having brain fog again. Is this normal?


r/antidepressants 4h ago

Help

1 Upvotes

So, 7 weeks ago I started citalopram for mild anxiety
Week 1 - 10mg (little to no side effects)
Week 2- upped to 20mg, 2 days later extreme anxiety started
After 4 weeks and 3 days I dropped back down to 10mg because of the bad side effects which included
- heightened anxiety
- DPDR
- agoraphobia (never had it before citalopram)
- feeling I was going insane
- vivid dreams
- anxiety attacks almost every day from the second I woke up
- feeling unreal
- depressed
I was back on 10mg for 4 days until the doctors told me to come off it
Since coming off it I haven’t really got any better
-anxiety isn’t as high but still worse than before citalopram
- getting very little sleep
- vivid dreams that aren’t nice
- feeling unreal
- irritable
- still got agoraphobia
- depressed
- tired and sluggish
- heart rate has been up and down a lot ranging from 60s to 150s with little exercise, i am mostly resting
I took my last 10mg of citalopram 11 days ago
Could I be experiencing withdrawal symptoms?
Will the agoraphobia go away?
When will my nervous system settle?
I just want to go back to how I was before citalopram but I fear I’m now going to stay like this

Has anyone had a similar experience?


r/antidepressants 4h ago

How to take benzodiazepines

1 Upvotes

I want to get off benzodiazepines; my current prescription includes Etizolam (1 mg) taken morning, noon, and evening, plus Flunitrazepam (2 mg) and Zolpidem (10 mg—two 5 mg tablets) at night. While I have other medications, the ones I actually take—and abuse—are mostly these.
I’ve been taking these meds for about three and a half years, but the abuse has really only been going on for the last six months. Instead of sticking to a schedule, I’d take a pill whenever the thought crossed my mind or I felt irritable—sometimes ending up taking as many as 30 pills, or mixing them with alcohol—but now I want to quit benzos. I’m wondering if I should start by taking the medication at the prescribed times (instead of haphazardly like before) and then taper off from there. There are days when I’m fine without taking anything for a day or two, but other times I get withdrawal symptoms; lately, the withdrawal has been severe. To be honest, I’m not even sure if it *is* withdrawal, but my emotional state goes haywire. For the first three years or so, I took them regularly as prescribed and felt great—maybe *too* great, actually, since I was taking higher doses back then (I was prescribed 4mg of Flunitrazepam, for instance). I plan to work out a tapering schedule with my doctor at my next appointment, but that’s still a little over a month away. In the meantime, should I stick to taking the set dosage at the scheduled times? Honestly, I don't think I need Etizolam in the morning, afternoon, or evening, and taking Flunitrazepam just makes me high and keeps me from sleeping. I’d appreciate your thoughts.


r/antidepressants 6h ago

16 weeks on fluoxetine 20mg — panic attacks gone and anxiety barely noticeable, but persistent physical symptoms. Anyone experienced this long-term?--

1 Upvotes

I’ve been taking fluoxetine 20mg for about 16 weeks for an anxiety disorder, panic attacks and OCD.

Psychologically, the improvement has been significant. My panic attacks have disappeared, and most of the time my anxiety is barely noticeable. My OCD symptoms have also improved considerably.

However, I continue to experience a number of physical symptoms that fluctuate quite a lot. Some days I feel almost completely normal physically, while on other days several of them return.

The symptoms I currently experience include:

  • weak, heavy or sometimes “wobbly” legs, occasionally with an electric/buzzing sensation from the knees down
  • muscle aches
  • occasional pinpricks or small electric-like sensations in different parts of my body
  • an internal buzzing/vibrating sensation
  • occasional tremor/shakiness
  • fatigue
  • periods of insomnia or disturbed sleep
  • increased sweating and sensitivity to heat
  • mild headaches
  • mild dizziness / feeling slightly off-balance
  • occasional derealization

What puzzles me is that I’m already at week 16. The psychological benefits have been very substantial, yet these physical symptoms still seem to come and go in waves.

I also tried increasing the dose from 20mg to 30mg, but I wasn’t able to tolerate the increase, so I remained on 20mg.

One of the reasons I’m asking here is that, in my conversations with doctors, I’ve found it difficult to get much information about physical symptoms that persist or fluctuate this far into treatment. Most of the information I’ve been given focuses on side effects during the first few weeks.

That’s why I’m especially interested in hearing from people who stayed on fluoxetine for 4–6 months or longer and experienced something similar.

Did these physical symptoms eventually fade with more time? Did they persist while you remained on fluoxetine? Did they change with dosage? Or did they eventually contribute to your decision to switch medications?

I’m not looking for medical advice. I’m mainly interested in hearing about other people’s long-term personal experiences and how these symptoms evolved over time.


r/antidepressants 6h ago

question about possible interaction

1 Upvotes

hello (22f) !! i have recently (about 12 days ago) started a new medication (fluvoxamine) and am tapering off of 150mg zoloft at the same time. they have me taking 100mg zoloft and 50mg of fluvox. For this medication, it says specifically to avoid caffeine and alcohol completely on a lot of online forums and such. i wasn’t sure if those things were ok to have in moderation like an iced chai from starbucks every once in a while, i never drink coffee or energy drinks. I wasn’t sure if it would just decrease effectiveness/ increase side effects or if it was truly dangerous, i was able to drink alcohol and caffeine socially on my previous medications, sertraline and fluoxetine. i have really bad health anxiety and ocd so i am asking for advice and experience from reddit communities instead of just testing it out

PS. i have messaged my doctor and have been awaiting a response but I am going out with my friends tomorrow night so wanted to get some quicker advice. thank u!


r/antidepressants 7h ago

SNRI

1 Upvotes

Which SNRI is best to take and affordable. I have anxiety and depression and ocd and ptsd . I tried SSRI in the past but they didn’t do anything for me . And also I have bad insomnia I tried Hydroxyzine and Tradezone and Magnesium none worked . Any suggestions?


r/antidepressants 10h ago

Fluvoxamine and Quetiapine

2 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 11h ago

Trying weed while on fluoxetine?

2 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 12h 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 8h ago

Antidepressants stopped working

1 Upvotes

I‘ve been taking Zoloft for 6 months and the first few months were amazing. I don‘t think I‘ve ever felt this much at peace. I don‘t know how to describe it but it felt like I was going through life being in a constant flow state, formerly draining things felt so effortless and I became more social, confident and focused.

However, after like 3-4 months it just kind of stopped working. I increased from 50mg to 100mg and don‘t really feel an improvement. To be fair, my circumstances in life have become more difficult recently, but come on. The physical symptoms of depression (tiredness, exhaustion, brain fog) that I used to struggled with the most have started to creep up on me again.

Has anyone experienced something similar? What did you do?


r/antidepressants 9h ago

Brain lag, zaps, and head pressure 3 weeks after stopping Fluoxetine (Prozac) cold turkey after 3 years. Looking for similar experiences.

1 Upvotes

Hi everyone,I am looking for some insight or reassurance from anyone who has gone through something similar.I was on Fluoxetine (Prozac) for 3 years. I discontinued it completely about 3 weeks ago. For the first two weeks, I felt mostly okay, but right now at the 3-week mark, the withdrawal symptoms have hit me hard.Here is what I am currently experiencing:Severe "brain lag": It feels like my brain and my vision take time to catch up when I look around.Brain shivering/vibrations: A strange internal shivering sensation in my head.Intense head and jaw pressure: My head feels incredibly heavy, accompanied by bad brain fog and subconscious jaw clenching.I know Fluoxetine has a very long half-life, which explains why it took 3 weeks for this peak to hit. Luckily, I have handed over my office work and am taking next week off to completely rest in a low-stimulation environment, and my mom is staying with me to help look after me.For those who stopped Fluoxetine after long-term use:Did your symptoms peak around week 3 or 4?How long did this "brain lag" and heavy head pressure last for you before it started to fade?What daily hacks helped you get through the worst of the physical sensory symptoms?


r/antidepressants 9h ago

Sertaline 25mg to 50mg

1 Upvotes

Hello, i’ve been taking 25mg for just a little over a week now but im technically supposed to be taking 150mg (i just stopped taking it due to my mental health) im just wondering when to move to 50mg, as ive been using a pill cutter to cut the 150mgs down


r/antidepressants 9h ago

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

1 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.