Stopping a serotonergic antidepressant abruptly can cause dizziness, 'electric shock' sensations, irritability, sleep disturbance and flu-like symptoms, often within days. These are easily mistaken for relapse.
Short half-life drugs such as paroxetine and venlafaxine carry the highest risk. A planned taper, adjusted to symptoms, reduces it.
- Taper rather than stopping abruptly, especially with paroxetine and venlafaxine
- Warn patients what discontinuation symptoms feel like and that they usually pass
- Distinguish discontinuation (early, physical) from relapse (later, mood-led)
- Slow the taper if symptoms are troublesome rather than restarting at full dose
Why it matters
Discontinuation symptoms misread as relapse keep people on medication they no longer need.
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