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Areas › Low mood and hard feelings › When everything feels flat
Timing is the giveaway. Withdrawal starts within days of the last dose and often has a particular feel to it: dizziness, odd electrical zaps, a flu-like heaviness. A genuine relapse builds back over weeks and looks like your depression rather than like a bug. Short acting drugs such as paroxetine and venlafaxine give the sharpest version, while fluoxetine tapers itself because it clears so slowly.
'Truly where there is hardship there is also ease' (Quran 94:6). A rough week that belongs to stopping is a passage rather than a verdict.
الشرح
إِنَّ مَعَ ٱلۡعُسۡرِ يُسۡرࣰ ا
truly where there is hardship there is also ease
Qur’an 94:6read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
An individual patient data meta-analysis found that delivering a psychological intervention while antidepressants were tapered was broadly comparable to staying on the medication for preventing relapse. That concerns planned, supported stopping rather than withdrawal symptoms themselves. It is worth knowing because coming off can be done as a proper plan with something in place, and that is when the difference between withdrawal and relapse is easiest to read.
Josefien Breedvelt; Fiona C Warren; Zindel V. Segal; Willem Kuyken; Claudi Bockting (2021). Continuation of Antidepressants vs Sequential Psychological Interventions to Prevent Relapse in Depression. JAMA Psychiatry doi
Strength of evidence: one line of research. A single study, or a theoretical account.
A body that adjusted to a steady dose needs time to readjust when it goes, and that is a different process from the illness returning.
The reason depression is mostly treated by GPs now is pharmacological. A drug you can start without an ECG, blood monitoring or a diet sheet is a drug that fits inside a ten minute appointment.
There are around twenty five antidepressants and nowhere near twenty five mechanisms. What comes next is decided mostly by side effects, other conditions, and what has already worked for you.
Most antidepressants share a family resemblance. Bupropion does not, so much of what you have read about the others simply does not apply to it.