Summary: New research reveals that coming off antidepressants like Prozac can cause not only physical symptoms but also emotional, cognitive, and social difficulties.
The study involved in-depth interviews with 20 individuals who attempted to withdraw from SSRIs in the past year, highlighting the complex challenges they faced, including emotional overwhelm, reduced enjoyment in social situations, and a feeling of detachment.
Many participants managed their withdrawal with minimal medical support, emphasizing a need for more emotional support from GPs and flexible, patient-tailored tapering strategies.
While withdrawal often led to negative physical and social effects, some reported positive changes like a return to normal emotional states and improved physical health.
Key Facts:
- Withdrawal from SSRIs can cause emotional, cognitive, and social difficulties, not just physical symptoms.
- Participants often navigated withdrawal with limited medical guidance, underscoring a need for better support systems.
- Positive effects like emotional normalization and better physical health were also reported post-withdrawal.
Source: University of Bath
Coming off antidepressants is known to trigger physical symptoms, such as restlessness, fatigue and excessive sweating, but new research suggests people can also experience emotional and social difficulties, and changes in their thinking patterns when they stop taking antidepressants like Prozac.
This is especially true when people don’t ‘taper’ their medication but instead stop taking it suddenly, and when the process is not adequately supervised by a doctor.
For this study, researchers from the Universities of Bath and Bristol investigated the lived experiences of antidepressant withdrawal, and how it affects quality of life across multiple life domains.
They conducted in-depth interviews with 20 people who had attempted to withdraw from Selective Serotonin Reuptake Inhibitor (SSRI) antidepressants, such as Prozac, in the last year.
Raqeeb Mahmood, a PhD student in Psychology at the University of Bath and first author of the study, said: “From these interviews, it became clear that the lived experience of withdrawal significantly impacts individuals’ wellbeing. The participants emphasised that withdrawal is not just about physical side effects, but it also affected their emotional, cognitive, and social functioning.”
Challenges reported by study participants included feeling overwhelmed by their emotions, finding social situations less enjoyable, and feeling detached and less empathetic towards others.
“Some symptoms were so severe, family and friends of the person coming off medication encouraged them to go back on it,” said Mr Mahmood.
Some patients found the early stages of withdrawal – the first few days or weeks – most challenging, while others struggled more in the later stages, which might come several months after they started trying to come off their medication.
The study, which has been published in the journal Health Expectations, suggests patients often manage their withdrawal alone, due to limited GP involvement and a lack of NHS online resources or evidence-based guidance.
Mr Mahmood said: “The study participants expressed a desire for more emotional support from their GPs and emphasised the importance of flexible tapering, where the process of coming off medication happens at a pace tailored to them.
“They also mentioned the importance of people timing their withdrawal attempts for less stressful or busy periods in their lives, to give them a better chance of coming off them without experiencing significant difficulties.”
Dr Graeme Fairchild, Reader in Psychology at Bath, senior author on the study and project co-supervisor, said: “Some of the people described social situations as feeling like a chore – they felt as if they were just ‘going through the motions’ of regular life. They also talked about being more difficult to live with or felt that their partners or family members wanted them to go back on their medication.
“These impacts of antidepressant withdrawal on people’s social relationships are less widely known but need to be communicated to patients considering coming off their antidepressants.”
Dr Katherine Button, Senior Lecturer at Bath, study co-author and project co-supervisor, added: “Over half of the participants described withdrawal negatively affecting their relationships with others, with family members getting the brunt of their increased snappiness, for example.
“This is an important finding as family members are often a key source of social support so being prepared for these potential changes may help both the patient and their family navigate the withdrawal process.”
All of the participants encountered negative physical withdrawal symptoms – which were short-lived for some, but continued for several weeks or even months for others. However, some positive effects of withdrawal were also reported, such as people feeling like their emotions were returning to normal (rather than being ‘blunted’ by their medication).
Some participants reported positive changes in their thinking patterns and found it easier to recall positive memories. Some also experienced positive physical health effects, including weight loss, and identified exercise as a crucial protective factor and coping mechanism.
About this psychology and psychopharmacology research news
Author: Chris Melvin
Source: University of Bath
Contact: Chris Melvin – University of Bath
Image: The image is credited to Neuroscience News
Original Research: Open access.
“The lived experience of withdrawal from Selective Serotonin Reuptake Inhibitor (SSRI) antidepressants: A qualitative interview study” by Raqeeb Mahmood et al. Health Expectations
Abstract
The lived experience of withdrawal from Selective Serotonin Reuptake Inhibitor (SSRI) antidepressants: A qualitative interview study
Background
Our knowledge of the broader impacts of antidepressant withdrawal, beyond physical side effects, is limited. Further research is needed to investigate the lived experiences of withdrawal, to aid clinicians on how to guide patients through the process.
Aim
To explore antidepressant users’ experiences and views on the withdrawal process and how it affected their quality of life across multiple life domains.
Design and Setting
We conducted in-depth qualitative interviews with 20 individuals from the community who had attempted to withdraw from Serotonin Reuptake Inhibitor antidepressants in the past year.
Method
Semi-structured interviews were conducted online. A topic guide was used to ensure consistency across interviews. The interviews were audio-recorded and transcribed verbatim and analysed using inductive reflexive thematic analysis.
Results
Five themes were generated. The first highlighted the challenges of managing the release from emotional blunting and cognitive suppression following antidepressant discontinuation. The second related to the negative impact of withdrawal on close relationships and social interactions. The third showed that concurrent with negative physical symptoms, there was a positive impact on health (exercise was reported by some as a coping mechanism). The fourth theme focused on support from GPs and families, emphasising the importance of mental health literacy in others. The final theme underscored the importance of gradual and flexible tapering in enabling a manageable withdrawal experience, and the consideration of timing.
Conclusion
The lived experience of withdrawal significantly impacts individuals’ well-being. Participants emphasised that withdrawal is not just about physical side effects but also affects their emotional, cognitive, and social functioning.
Patient and Public Involvement (PPI)
Eight people attended individual online meetings to share their experiences of antidepressant withdrawal to help inform the study design and recruitment strategy. Insights from these meetings informed the development of the topic guide. Questions about GP involvement, family relationships, and mood and thinking changes were included based on this PPI work. This ensured the inclusion of topics important to antidepressant users and facilitated the researcher’s questioning during the interviews.
