Selective serotonin reuptake inhibitors (SSRIs) are used to treat depression. Withdrawal symptoms may occur after treatment with these drugs. It can start suddenly. It will manifest itself as symptoms of depression, anxiety. At the same time, patients believe that they are depressed again and ask to prescribe medications again.
Withdrawal syndrome depends on the half-life of the drug. The half-life is the time at which the active substance of the drug remains in the blood. Drugs with a short half-life require more frequent administration to maintain adequate drug concentration. If the drug has a long half-life, then it is stable in the blood for a long time and does not undergo changes in concentration. Fluoxetine has a long half-life. Therefore, after stopping its intake, its concentration in the blood decreases slowly. Other antidepressants in the SSRI group have a shortened half-life, so when you stop taking the drug, the patient experiences withdrawal.
In general, long-term use of SSRIs affects the biochemical processes in the brain. The number of serotonin receptors decreases, since the SSRI causes an increased secretion of serotonin – a serotonin burst. At the same time, the number of serotonin receptors in the brain decreases to prevent increased stimulation of brain neurons. After the end of treatment, the receptors become smaller and there is a decrease in serotonin activity.
20% of patients using cipralex , zoloft , paxil experience withdrawal symptoms after depression treatment. Withdrawal symptoms can last from one to seven weeks, and those who have been using SSRIs for many years have long-term withdrawal symptoms. Therefore, in order to avoid withdrawal syndrome, the dose of SSRIs is reduced slowly. If the drug has been used for less than 8 weeks, dose reduction should be carried out within one to two weeks. If the medication was taken for more than 6-8 months, then a dose reduction is required within 6-8 weeks.
Treatment of depression with SSRI drugs should be carried out while monitoring the concentration of the drug in the blood, and when deciding on drug withdrawal, one should also rely on objective criteria.