Discontinuation syndrome

• Antidepressants should not be stopped suddenly. The dose should be reduced slowly over at least four weeks to minimise discontinuation symptoms (unless there is an urgent need to stop).
• Symptoms:

  • Usually mild but occasionally more severe
  • Typically start within 2-3 days of stopping treatment and resolve within 1-2 weeks
  • Flu-like symptoms
  • Electric shock sensations
  • Irritability
  • Insomnia
  • Vivid dreams
• In severe cases, the antidepressant can be reinstated and then withdrawn more cautiously, or by switching to a drug with a longer half life such as fluoxetine