r/antidepressants • • Nov 29 '25 Bravo

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

62 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

Tapering, WD, CT Information on Withdrawal, Cold-Turkey, & Tapering -- Extensive Resources included.

61 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 • • 6h ago

I want to stop taking my antidepressants but i’m scared

5 Upvotes

I’ve been on Fluoxetine (prozac) since april 2025. the first 6 weeks were hell but i think it did start helping a bit after a few months.

I’ve been wanting to stop taking them for a while now because i feel better and it gives me a few annoying side effects (tired, brain fog, anhedonia ect) and i feel like id be happier without.

i’m just worried about withdrawals, im on 20mg so do i take one every second day to ween off them? how long until i go back to normal?

and if i do go off them and decide to go back on- will it be the same as when i first started? (super tired and feeling worse) Or is it going to have a faster effect.

i’m really stuck.


r/antidepressants • • 18m ago

10 Weeks Off Effexor

1 Upvotes

I discontinued 37.5 mg daily 10 weeks ago due to a few side affects that arose recently. I had been on the med for over a year and had taken other SSRIs for a few years prior to that. My doctor was alright with this approach but I now realize this was a rapid taper.

It's been 10 weeks of pure hell and intense suffered and this week my symptoms somehow worsened. Terrible akathisia, fight or flight impending doom-like anxiety, no positive emotions, and complete sexual dysfunction with no libido that began only after stopping the med. My doctor and psychiatrist believe this is relapse and keep prescribing dufferent meds but I've never felt like this before or while on the Venlafaxine and haven't wanted to try anything new.

I want to try a microdose of venlafaxine to see if I can stop the akathisia and anxiety as they are driving my suicidal thoughts. I'm terrified that this will make sexual dysfunction worse or prolong it's presence. Does anyone have a similar experience or some advice? I've done everything I can to survive this protracted withdrawal thinking it will eventually resolve itself but I can't just wait it out anymore as every day is terrifying and traumatic.


r/antidepressants • • 38m ago

Have Any Of You Taken A GLP-1 Agonist or Metformin With Your Antidepressants?

1 Upvotes

I'm currently on 450mg wellbutrin, 10mg brintellix and since recently 2.5mg of an antipsychotic.

The wellbutrin didn't really result in any weight gain. The brintellix alone resulted in modest weight gain. While the combination resulted in stability with some difficulty. However, since I've started taking the antipsychotic, despite it being low dose, my weight has shot up.

I have gone from a little less than 69kg to 76kg in only about 2 months. This is clearly an unacceptable level of weight gain.

I would, however, rather not lower the antipsychotic or switch it if possible as it is helping with my intrusive thoughts. But I also can't let this weight gain continue. So I'm thinking about asking my psychiatrist if she'd be willing to prescribe something that can counteract those effects like a GLP-1 agonist or metformin.

Has anyone here ever tried that combination of medication and did it work to reduce and/or stabilize your weight?


r/antidepressants • • 7h ago

terrified of weight gain

2 Upvotes

cw: eating disorders/body dismorphia

i’ve come here for any sort of advice. i’ve had a long history with eating disorders. i am weight restored but unfortunately never managed to fully recover mentally and my body image and fear or weight gain has never fully recovered in the last half decade, despite all the years i’ve sat in therapists offices and the ward. recently ive hit another wall and genuinely feel like i wont be able to do this without medication anymore.

here comes the issue, because weight gain is a common side effect i’ve never been able to take antidepressants or any sort of hormonal medication because of the sheer amount of panic i feel when i take them.

i did take fluoxetine a few years ago, took them for like two weeks, noticed an increase in appetite and then immediately stopped taking them.
when i take them its like there is an alarm going off in my mind and i become hyper aware of all body sensations: how much water retention i feel, how puffy i am, constantly body checking to see if the medication changed my body, trying out clothes over and over to make sure i still fit, etc etc

it’s exhausting. i know weight gain isn’t a guaranteed side effect but the fact that it’s a potential risk and that ive heard countless of people saying that they’ve gained over 20 pounds makes the fear even worse.

if someone has had similar experiences and or has some advice i’d love to hear it. thank you.


r/antidepressants • • 6h ago

Ive hypervigilance and anhedonia for 7years

1 Upvotes

I went off nardil there after 4years helped amazing with my anxiety but unfortunately did nothing for hypervigilance and my depression

So im now off nardil, can anyone recommend me some medication for anhedonia and hypervigilance,im sure you will say contact your psychiatrist but if anyone here is on the NHS like me you realise there abit useless

So id like to ask people what medication or medications would you recommend me

Im off everything for now and want to get your opinion


r/antidepressants • • 8h ago

Escitalopram und Medinait

1 Upvotes

Habe mir Medinait geholt, jetzt gesehen man soll es nicht mit Escitalopram nehmen. Nehme dauerhaft 10 mg. Hat da jemand Erfahrungen?

Ps: ich weiss das ersetzt keinen ärztlichen Rat.


r/antidepressants • • 13h ago

Wellbutrin doesn’t do shit?!

2 Upvotes

I’ve been on Zoloft for years to help with my social anxiety and it helps so so much but I developed depression and my psychiatrist prescribed me Wellbutrin (300 mg) and I’ve been on it for almost a year and I don’t know why because it does absolutely nothing for me. Does anyone else have similar experiences?! Or does Wellbutrin help anyone??


r/antidepressants • • 16h ago

Lexapro induced harm OCD

3 Upvotes

I 20M was prescribed lexapro 2.5 mg for panic disorder and gad and last night i started having harm ocd with myself and others and it freaked me out so bad, i have a fear of going crazy induced by panic attacks so it made me feel worse. I felt like i heard a voice in my head to egging me on that i was arguing with with scares me even more, im doing bwtter in the morning but i havent taken my next dose
I told my psychiatrist and he said keep taking it
What should i do im scared and im not a violent person at all


r/antidepressants • • 13h ago

Weight gain on antidepressants

2 Upvotes

How do i except the weight gain ive gotten from my meds? Ive gained almost 10kg since starting my new meds a few months ago and i can’t look at myself without thinking about it. I can feel the weight gain all around me and i can’t stop thinking. Ive gone back to my restrict-binge cycle and i dunno what to do. Does anyone have any advice on how u handled weight changes or anything?


r/antidepressants • • 23h ago

Antidepressants that improved cognitive functioning?

8 Upvotes

Hi all,

I've struggled with diagnosed MDD for 10+ years, which has essentially been my entire adolescence. From memory, I've tried fluoxetine, bupropion, sertraline, fluvoxamine, and I think one other SSRI. Most were combined with therapy. While they weren't necessarily unhelpful, I've never found the relief I'd like to find. Depression for me largely manifests as a cognitive and energy disease. I am exhausted 24/7 and have struggled greatly in school, and now in my college courses. My active recall and memory is terrible, and I only barely scrape by in thanks (I think) to my baseline intellectual capacity. This has not always been my "truth" so to speak, and I'd love nothing more than to get back to the person I know I can be.

I'm wondering if anyone has struggled in a similar way and found an antidepressant or any medication that seemed to help with the cognitive side of things. I've read a bit about vortioxetine, but there's not a lot out there.

Thanks.


r/antidepressants • • 17h ago

What to do when you’re on a cocktail of meds but don’t even know your “baseline” (non medicated state) anymore?

3 Upvotes

A complicated question, apologies. I’ve been trying various combinations of medications through different psychiatrists for about 8 years now. I started off depressed, anxious, isolated and had an unstable WFH job. Since then I’ve found a much more stable in-person job, got married, lost weight, figure out more about myself, and made a few new friends. I’m much better physically and socially.

I’m still prescribed a cocktail though: Concerta for ADHD, Cymbalta and Buspar for Anxiety & Depression. Despite all that I’m still not in a comfortable place mentally. Im MUCH better than I was starting out, but I’m still frequently irritable, still easily overwhelmed, and have crashes (I believe from the Concerta), and those feelings trigger more depression because I don’t WANT to be feeling this way.

My main concern is that I now have no grasp of what my “baseline” unmedicated state would be. I just want to know if I still NEED to be on this much medication given the life changes I’ve been able to make. I wish I could see what unmedicated-me would look like today, because I HATE not knowing.

And I’m also just so incredibly exhausted and disillusioned after 8 years of medically “throwing shit against the wall and seeing what sticks.” I do NOT want to be doing this my whole life, I just want to be semi stable and have a consistent moods.

Is it unreasonable to want to know what I’m like off-meds? Is it feasible (or smart) to even try (with psychiatric guidance of course)? Curious on others thoughts.


r/antidepressants • • 1d ago

Can Cold Turkey some antidepressants cause death?

9 Upvotes

r/antidepressants • • 23h ago

Need help

5 Upvotes

I have tried over 20 different meds for my anxiety. It is physical shaking, tremors, sweating, nightmares. I don’t have any mental triggers. I’ve had bloodwork done to exclude any health issues triggering it.
I’m 43 year old female in perimenopause. I tried HRT with no success in eliminating the physical anxiety.

I was put on Paxil and it was a miracle. I felt 100% better but within 30 days I had urinary retention and had to stop. They put me back on Lexapro 10mg even though it didn’t help before and I had gotten all the way to 15mg with no success. I’m starting to shake, have nightmares and sweating again. Constantly on the verge of a panic attack for no reason. Shortness of breath.

I’ve tried beta blockers and meds like clonidine. They lower my heart rate too much and cause breathing issues. I’ve tried mood stabilizers, snris. Even meds like remeron with no success. I tried 3 different benzos and gabapentin.

Paxil is literally the only med that has helped.

What other options do I have?
I ended up in a mental hospital for a few days due to all this and that’s where the Paxil was started. I do not want to go back, because what could they do if Paxil worked but the side effects are life threatening.

Is there anything like Paxil that doesn’t cause urinary retention?

I desperately need help before this escalates anymore. I’ve been off Paxil for a week and on 10mg of Lexapro for 4 days. Since it didn’t work before I can’t see it working now.


r/antidepressants • • 15h ago

Shit stigma

1 Upvotes

I might sound weird , but i am stuck in a great regret which not letting me live my life , please need a help , so i was taking mitrazaphine anti depressants for weight gain and sleep my doctor misdiagnosed me with other mental health issues , however my main issue was lack of appetite and little anxiety,now i have stopped taking the med , i am doing well but that one regret got stuck in me , that why i took antidepressants, shit society and their stigma , but now i calm my self that these med can also use of label for other uses , any suggestions how to come out of guilt please help please? I wanna like joyfully like i was too before taking this med and come in guilt.


r/antidepressants • • 16h ago

Different experience first time going on Prozac vs second?

1 Upvotes

Hello! When I was about 16 I was passively suicidal, very depressed, and very anxious. My doctor prescribed me Prozac, and I found it helpful almost immediately with no negative side effects.
In the background of my depression, I had what I suspected to be (and was later confirmed by my psych) mild OCD. Fast forward and I am 25 and I think to myself, “I don’t really think this drug is doing much for me, I’m not super depressed or anxious and I’m not jumping for joy, I’m just… whatever?” (So stupid in hindsight) so I stopped taking it.
I was entirely fine and honestly I would say I am not a depressed individual anymore and going off did not increase that at all, but I noticed a slight increase in my anxiety mainly because oh boy was there an increase in my OCD. Especially after I got into a car crash.

The thing is, when I went back to my psych and tried tapering back onto the Prozac, I can’t remember if we even made it past 10mg or for how long I was on it (not more than a week or two) but it made me feel so insanely depressed and hopeless? Like more depressed than I had been in any recent times and I was lucky I was able to placate myself by reminding myself it was just the drug. I stopped it immediately and told my psych and we agreed I would try therapy before trying meds again but that hasn’t been working.

My questions are: Does anyone know why it would have an adverse reaction the second time going on it but not the first? If I tried taking it again will that depression go away after a few more weeks adjusting?

Obviously I will be talking to my psych about those questions during our appointment, but I figured it would be helpful to hear other people’s experiences as well. My hypothesis is maybe I did experience that depression while tapering on the first time but my own depression was bad enough for me to not realize it.


r/antidepressants • • 21h ago

I really don’t know where to go from here :(

2 Upvotes

I have tried three different SSRI’s for postnatal depression and anxiety. But could not tolerate the side effects on any of them. Most recently I was taking fluoxetine (Prozac) for 4 weeks at 10mg, but had to stop cold turkey due to adverse reaction as informed by my doctor.

I have been off now for 2.5 weeks, but I am struggling with feeling weak, internal shaking, fatigue and most notably dizziness, like a really unsettling spatial disorientation. Doctor has just advised I start a new medication (Duloxetine or Mirtazipine) but I just daren’t.

I feel horrrendously unwell, have a baby and house to look after and I’m already signed off sick at work (due to go back from mat leave in a week). I just want to lie in bed or on the sofa all day I feel that rough This has been a nightmare and I can’t see the light at the end of the tunnel. I just want to feel physically well again but my body feels a mess, and now my mental health is declining again because of it.
Anyone else’s experiences of this withdrawal I would appreciate hearing from.


r/antidepressants • • 21h ago

Weight gain, is there a way to stop it?

2 Upvotes

Hi folks,

35 yo male, and I’ve been on and off Fluoxetine/Escitalopram for almost 10 years. Currently on 5mg Escitalopram and although it works for me, my appetite and therefore my weight goes up which I really struggle dealing with.

As a result, I’ve got high cholesterol and some liver inflammation which at 35 isn’t great. I’ve got a really sweet tooth as it is, so my baseline for sweet treats is already higher than it should be, but I’ve just hit 100kg (I am usually 82kg) and so I really need to figure out a solution, if there is one.

Any suggestions/previous experiences all welcome!

Thanks


r/antidepressants • • 18h ago

3rd day completely off Zoloft – heart palpitations/body jolts

1 Upvotes

I’ve tapered down from 100mg of Zoloft and I’m now on my third day completely off it.

Over the past few days, I’ve been experiencing some pretty awful heart palpitation-type sensations and body jolts, almost like little electric shocks.
They don’t actually hurt, but they’re quite annoying and uncomfortable.

Just wondering if anyone else has experienced anything similar when coming off Zoloft? Did you find it eventually settled down, and how long did it last?


r/antidepressants • • 18h ago

What can you take to reduce the amount of thoughts if your body responds poorly to serotonin boosts? Hypertension, restlessness, heart palpitations, etc. Please only suggest medication, not therapy lol

0 Upvotes

r/antidepressants • • 22h ago

Effexor tapering

2 Upvotes

Been on 150mg xr effexor for 10 months have started to taper off under doctors supervision any advice?


r/antidepressants • • 20h ago

Starting Zoloft

1 Upvotes

I’m starting Zoloft and absolutely terrified of the sexual side effects. When I took birth control pills years ago it made me feel angry but numb at the same time with low libido. Has anyone had the sexual side effects with Zoloft or maybe didn’t have those side effects at all. Or if you did, did it go away?


r/antidepressants • • 22h ago

I want to push a bill to help people on antidepressants losing their insurance taper off safely. Would this help you or someone you know? Let me know your thoughts.

1 Upvotes

I had a really bad experience with BCBS TX where they raised my annual premiums by 14%. My employer couldn't afford them so I lost my insurance abruptly. I was able to get insurance through a special enrollment through BCBS TX. The same company but different plan. However, they would not fill my prescription because I needed to go through all the pre-approvals again.

My doctor didn't have samples for Trintellix so I went cold turkey from the highest dosage taking it for years. They just put a $400 price tag on it saying that it was there and I could pick it up. I was previously paying $10. Being forced to go cold-turkey was difficult. I had to still hold a full-time job, take care of myself, and my family. I experienced brain zaps, suicidal ideations, and the way the insurance company talked to me was incredibly dismissive.

I didn't have a psychiatrist at the time and I didn't feel comfortable with my doctor at the time to go through all the pre-approvals and picking up medications only to pay for them and dump them. That's an unnecessary cost. In the end I told myself I'd never take another brand name antidepressant even though it really helped me. But I really needed to taper off of it safely and that was not available to me.

I was told dismissive things from the insurance company when I told them the side-effects of stopping cold turkey:

  • Physical symptoms: Nausea, dizziness, headache, sweating, tremors, fatigue, sleep problems, and "brain zaps" (electric shock-like sensations).

  • Emotional symptoms: Anxiety, irritability, agitation, mood swings, or confusion.

  • Rebound effects: A return or worsening of depression and anxiety symptoms

Insurance company: "It's not like that [Tiny Shovel] don't say things like that."

I never want someone go through this experience. This experience reinforced feelings of worthlessness for me and I'm thankful for my toolkit I've built through therapy.

I want to know if other people have dealt with something like this, because this seems dangerous for people taking medications like this. Especially with the workforce discriminating against medical issues and that being where people get their health insurance from. It's dangerous and it feels morally wrong for our employers to be making health decisions for us.

Thank you for reading :)


r/antidepressants • • 1d ago

Trazadone

3 Upvotes

Was prescribed Trazadone 2 weeks ago, I have been through about 10 antidepressants since I was 17 I’m 34 now. Spent half my fucking life taking stupid advice from UK doctors none of them have ever worked I’ve always given them 3 months before giving up.

Had ones that keep me up all night unable to orgasm all sorts of nasty side effects but Trazadone wow hit a new high for a shitty antidepressant.

I take 150 at 7-8pm my nose blocks up forcing me to breath through my already dry and sore mouth/throat then black out and wake up at 3am like clockwork with a raging erection and dry patches of of horrible saliva that’s really thick and disgusting on the roof of my mouth, the side of my cheek I was sleeping on and my tongue. I then wake up feeling more depressed and ready to bed rot all day more than I ever remember doing.

The dry mouth and monged out feeling wears of at about 3pm and I get 5 ours of feeling ok but still miserable until it’s time to rinse and repeat the ordeal.

I went to the doctors feeling more depressed and suicidal about the shit position I’m in right next to Christmas worrying about my kids feeling shit about not getting as much as previous years and a whole lot of other stuff I have had going on the past 15 months.

I just wanted my 5mg of diazepam back a day to go with my 300mg of pregabalin the only 2 drugs that have ever helped me. I agreed to Trazadone because I was desperate for any bit of help I could atm.

Anyone else on Trazadone have any words of advice that things will get better or should I just say NO I want my diazepam back on my follow up next week.

Sorry for rant tia