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Areas › Low mood and hard feelings › When everything feels flat
Some, venlafaxine especially, leave the body fast enough that a missed dose is felt within a day: dizziness, strange electrical sensations, a mood that drops sharply. That is the body adjusting rather than the illness returning, although the two are easy to confuse from inside. A taper spread over weeks or months, with room to pause at a step that feels hard, is the ordinary way through.
Be steadfast: your steadfastness comes only from God (Quran 16:127). A slow taper asks for steadiness over weeks, and the verse says where that comes from.
النحل
وَٱصۡبِرۡ وَمَا صَبۡرُكَ إِلَّا بِٱللَّهِۚ وَلَا تَحۡزَنۡ عَلَيۡهِمۡ وَلَا تَكُ فِي ضَيۡقࣲ مِّمَّا يَمۡكُرُونَ
So [Prophet] be steadfast: your steadfastness comes only from God. Do not grieve over them; do not be distressed by their scheming
Qur’an 16:127read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
Coming off has been studied alongside what supports it. In an analysis of individual patient data, delivering a psychological intervention while antidepressants were tapered was broadly comparable to staying on the medication for preventing relapse. Support during the taper looks like part of the plan rather than an optional extra.
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 has adjusted to a drug needs time to adjust back.
Do not start a taper on your own, and if the drop in mood keeps deepening instead of settling, get back in touch quickly.
Four things carry most of the difference within the class: how much it sedates, how much it activates, what it does to weight, and what it does to sex.
Sometimes what is most missing is not mood but drive: the flat, cannot get started feeling. That can be named as the target in its own right.
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.