Antidepressants Are Effective—But Not Always Forever

Antidepressants like escitalopram, sertraline, venlafaxine, and paroxetine have helped millions overcome depression and anxiety. But here’s what many people don’t realize:

Most antidepressants were never meant to be lifelong.

Unfortunately, in India (and globally), many individuals remain on these medications far longer than clinically necessary, often without regular review.

In this post, I’ll explain:

• When it’s appropriate to stop antidepressants

• The safest way to taper without withdrawal

• What symptoms to expect

• What you can do to stay well after stopping

• Why you should never stop suddenly

⏳ How Long Should You Take Antidepressants?

Based on national and international guidelines (e.g., Maudsley, NICE):

Key point: If you’ve been stable and symptom-free for 6–12 months, you may be ready to taper with support.

🚫 Why You Shouldn’t Stop Antidepressants Suddenly

Sudden discontinuation can trigger withdrawal symptoms, also called SSRI discontinuation syndrome. These are physical and psychological reactions—not a relapse.

🔄 Common Withdrawal Symptoms:

• Dizziness or “brain zaps”

• Headaches

• Irritability or tearfulness

• Trouble sleeping

• Anxiety-like sensations

• Nausea, fatigue

• Vivid dreams or nightmares

These symptoms are transient and usually resolve within 1–4 weeks—if the taper is done properly.

📉 How to Taper Antidepressants Safely: Step-by-Step

Tapering must be individualized based on:

• Drug half-life

• Duration of use

• Dose

• Sensitivity to changes

✅ General Rule:

Reduce the dose by 25% every 2–4 weeks and adjust based on how you feel.

✏️ Example Tapering Plan: Escitalopram 10 mg

💡 Use liquid formulations or tablet splitting for precision in low doses.

Paroxetine and venlafaxine often need even slower tapers or switching to fluoxetine (which has a longer half-life and smoother taper).

🧘 What Helps During and After Tapering?

Stopping antidepressants is about more than just cutting the dose. You need strategies that help keep you well, naturally.

🧠 Evidence-Based Support:

• CBT (Cognitive Behavioural Therapy): Reduces relapse risk

• Exercise: Boosts mood and neuroplasticity

• Mindfulness and relaxation techniques

• Sleep optimization

• Supportive therapy or group counselling

✅ Regular follow-up appointments are crucial during tapering to track progress, prevent relapse, and make dose adjustments.

🛑 When Should You NOT Taper?

Hold off on tapering if:

• You’re going through a major stressor (loss, job change, illness)

• Your symptoms have returned recently

• You have a history of multiple relapses

In these cases, postponing tapering or trying combined approaches is safer.

📍 Chennai’s Advantage: Regulation, Awareness, and Safer Prescribing

Unlike many parts of India, Chennai is taking active steps to regulate psychotropic medication use:

• Surprise inspections of pharmacies

• Crackdowns on over-the-counter sales

• Enforcement of Schedule H1 protocols

• Promotion of guideline-based deprescribing

This means safer care—and better outcomes—for patients.

👨‍⚕️ About Dr. Srinivas Rajkumar T

Dr. Srinivas Rajkumar T, MD (AIIMS, New Delhi), DNB, MBA (BITS Pilani)
Consultant Psychiatrist – Chennai

I specialize in:

• Safe antidepressant tapering

• CBT and psychotherapy for anxiety, depression, and sleep

• Natural recovery plans without dependence

• Sleep and anxiety management without long-term medications

📍 Practice Locations:

• Apollo Clinic, Velachery (Opp. Phoenix Marketcity)

• Kumar’s Healthcare, Chromepet (Near Tambaram, Pallavaram)

📞 Appointments: 8595155808
“Antidepressants work—but you shouldn’t need them forever. Let’s taper safely and build emotional resilience for the long term.”