Fluoxetine withdrawal Symptoms and what to expect
Fluoxetine withdrawal: Symptoms and what to expect Health ConditionsHealth ConditionsAlzheimer's & DementiaAnxietyArthritisAsthma & AllergiesBreast CancerCancerCardiovascular HealthCOVID-19Dermatology & SkincareDiabetesEnvironment & SustainabilityExercise & FitnessEye HealthHeadache & MigraineHealth EquityHIV & AIDSHuman BiologyInflammatory Bowel DiseaseLeukemiaLGBTQIA+Men's HealthMental HealthMultiple Sclerosis (MS)NutritionParkinson's DiseasePsoriasisSexual HealthWomen's HealthDiscoverNewsLatest NewsOriginal SeriesMedical MythsHonest NutritionThrough My EyesNew Normal HealthPodcastsHow to understand chronic painWhat is behind vaccine hesitancy?The amazing story of hepatitis C, from discovery to cureNew directions in dementia researchCan psychedelics rewire a depressed, anxious brain?Why climate change matters for human healthToolsGeneral HealthDrugs A-ZHealth HubsHealth ToolsBMI Calculators and ChartsBlood Pressure Chart: Ranges and GuideBreast Cancer: Self-Examination GuideSleep CalculatorHealth ProductsAffordable Therapy OptionsBlood Pressure MonitorsDiabetic SuppliesFitness TrackersHome GymsGreen Cleaning ProductsHow to Shop for CBDQuizzesRA Myths vs FactsType 2 Diabetes: Managing Blood SugarAnkylosing Spondylitis Pain: Fact or FictionConnectAbout Medical News TodayWho We AreOur Editorial ProcessContent IntegrityConscious LanguageNewslettersSign UpFollow UsMedical News TodayHealth ConditionsDiscoverToolsConnectSubscribe What to know about fluoxetine withdrawalMedically reviewed by Alyssa Peckham, PharmD, BCPP — By Jayne Leonard — Updated on July 31, 2022Stopping antidepressants, including fluoxetine, can give rise to withdrawal symptoms. The best way to prevent fluoxetine withdrawal is to taper the dosage slowly under medical supervision. Stopping fluoxetine (Prozac), a type of antidepressant, can cause some people to experience withdrawal symptoms. Some research indicates that withdrawal, or discontinuation, symptoms are common, affecting more than half of those who stop taking antidepressants. Fluoxetine withdrawal symptoms can vary in their onset, intensity, and duration. This article discusses fluoxetine withdrawal symptoms, including how long they last and what treatments and techniques can minimize or prevent them. It also looks at taking and discontinuing fluoxetine during pregnancy. What is fluoxetine Share on PinterestBesiki Kavtaradze/EyeEm/Getty ImagesFluoxetine is a medication that belongs to a class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). SSRIs work by increasing the amount of serotonin available to the brain. Serotonin is a neurotransmitter that promotes positive feelings and stabilizes mood. The Food and Drug Administration (FDA) has approved the use of fluoxetine in adults for the treatment of:major depressive disorder (MDD)obsessive-compulsive disorderbipolar depressionpanic disorderpremenstrual dysphoric disorderbulimia nervosatreatment-resistant depression, when people take it alongside other medications The FDA has also approved it for the treatment of MDD in children aged 8 years and older. It can take several weeks after beginning fluoxetine for the symptoms of these conditions to improve. Fluoxetine is a prescription drug that comes in the form of a capsule, tablet, or solution. In the United States, it is available as a generic drug or under the brand name Prozac. What is fluoxetine withdrawal Fluoxetine withdrawal symptoms may occur when a person stops taking the medication. These symptoms may develop because of the rapid changes in the brain’s serotonin levels following antidepressant cessation. A 2019 review of existing research reports that 56% of people experience withdrawal effects when stopping various antidepressants. About 46% of these individuals report “severe” symptoms. One of the studies in the review found that out of 95 people who abruptly stopped taking fluoxetine, 67% experienced withdrawal symptoms. Doctors do not recommend stopping antidepressant use abruptly because it may lead to more severe symptoms. Other research suggests that fluoxetine may be “particularly unproblematic” when people stop taking it because of its especially long half-life of 96–144 hours, which equates to 4–6 days. A drug’s half-life refers to the time it takes for the amount of the medication’s active substance to reduce by half in the body. Antidepressants with a long half-life tend to cause fewer withdrawal symptoms than those with a shorter half-life. Signs and symptoms Fluoxetine and other SSRIs may cause the following withdrawal symptoms when a person stops using them:a feeling of detachmenta loss of balance or coordinationa sensation that resembles an electric shock in the head, which people may describe as “brain zaps”anxietydepressiondiarrheadifficulty concentratingdizziness or vertigofatigueflu-like symptoms, such as chills or body achesinvoluntary movementsmood changesnausea and vomitingringing in the ears, or tinnitussensory disturbances, such as smelling odors that are not actually theresleep issues, including vivid dreams and nightmaresstomach crampssuicidal thoughts Call 911 if suicidal thoughts occur Call 911 if someone is having thoughts of immediate suicide or urges to attempt suicide. The National Suicide Prevention Lifeline, at 800-273-8255, can also support those having thoughts of suicide. This service is available 24/7. Withdrawal vs a return of depressive symptoms Some of the mood-related symptoms that experts associate with fluoxetine withdrawal may resemble the symptoms of depression or another mental health condition. Experiencing these symptoms does not necessarily mean that someone is having a recurrence of depression. To help distinguish between withdrawal symptoms and a return of depressive symptoms, it is important to consider when the symptoms first occurred and how they developed. Discontinuation symptoms appear within a few days or weeks of stopping antidepressants, whereas returning depressive symptoms develop after some weeks and tend to come on gradually. Discontinuation symptoms will improve as the body adjusts, but returning depressive symptoms will persist or worsen as time passes. How long does fluoxetine withdrawal last The severity and duration of fluoxetine withdrawal can vary. Doctors and professional organizations often say that antidepressant withdrawal symptoms are self-limiting and typically resolve within a couple of weeks. However, a 2019 review of existing research indicates that this may not always be the case. Sometimes, symptoms can persist for several weeks or months. In a small number of cases, people may experience withdrawal symptoms for more than a year. One of the studies in the review found that 40% of people who abruptly stopped taking fluoxetine still experienced symptoms 6 weeks after discontinuation. The researchers did not follow up with the participants after this time, so it is impossible to say how long these effects lasted. Most people, however, will likely feel better within a few weeks. Treatments and self-care Several treatments and self-care practices may help those who wish to stop taking fluoxetine to do so safely and in a way that minimizes discomfort. These options include:Discussing discontinuation with a doctor: It is important to discuss stopping antidepressants with a doctor before making any changes. Suddenly stopping a medication increases the risk of severe symptoms.Tapering slowly: Usually, doctors advise that people reduce their dosage slowly, typically over 4 weeks or longer — particularly if they are taking higher dosages or have been taking the medication for an extended period.Managing withdrawal symptoms with other medications: A doctor may sometimes prescribe treatments for nausea, flu-like symptoms, sleep problems, or other withdrawal effects.Visiting a doctor for regular follow-ups: Undergoing regular checkups during the withdrawal process can help the person manage their symptoms and allow the doctor to monitor for a recurrence of depression.Attending psychotherapy: Trying psychotherapies such as cognitive behavioral therapy or mindfulness-based cognitive therapy may help a person discontinue antidepressants without experiencing a return of symptoms.Making healthy lifestyle choices: Getting regular exercise, eating a nutritious diet, practicing stress relief techniques, and getting adequate rest and sleep can help a person manage the symptoms of depression and some of the effects of discontinuing antidepressants. Pregnancy A person who is pregnant or thinks that they might be should speak with a doctor to determine whether fluoxetine is right for them. Research on animals has shown that the drug can have adverse effects on the fetus. There have not been enough studies on humans to be certain how the drug might affect a developing baby. People should take the drug during pregnancy only when the potential benefit justifies the possible risk to the fetus. For some people, fluoxetine and other SSRIs are important treatments that they must continue during their pregnancy to prevent the return of depressive symptoms. The National Alliance on Mental Illness advises that people who become pregnant while taking this drug should inform a doctor. Withdrawal symptoms in pregnant people are likely to be the same as those in the general population, and the management techniques are also likely to be similar. When to seek help A person should contact a doctor if they:are experiencing unwanted side effects from antidepressant use and wish to discuss other optionswish to stop taking fluoxetine in a safe manner and under medical supervisionexperience withdrawal symptoms after stopping fluoxetine People should call a doctor if the side effects are severe but call 911 if they feel life threatening. Long-term treatment Long-term use of fluoxetine is safe if a person takes it as the prescribing doctor directs. However, it may also cause side effects with long-term use. These side effects may include sexual dysfunction, nausea, a loss of appetite, and sleep issues. These issues may cause some people to want to stop treatment with fluoxetine. Other people may wish to stop using it because they feel better or become pregnant. Stopping antidepressants following long-term use may increase the risk of having withdrawal symptoms. Some research indicates that all antidepressants can cause withdrawal symptoms if a person takes them for longer than 6 weeks — particularly if they stop or rapidly reduce their dosage. Those who have been taking fluoxetine in the long term should work with a doctor to find treatments and strategies to minimize the potential withdrawal effects. It is also important to monitor for a return of depressive symptoms. Summary Stopping fluoxetine can cause several withdrawal symptoms, including flu-like symptoms, digestive issues, sleep problems, and mood changes. However, several strategies and treatments can reduce or prevent such discontinuation symptoms. People should work with a doctor to come up with a plan that best meets their needs. Last medically reviewed on July 31, 2022DepressionMental HealthAnxiety / StressPsychology / PsychiatryDrugs 13 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Antidepressants. (2020). https://www.mind.org.uk/information-support/drugs-and-treatments/antidepressants/about-antidepressants/Davies, J., et al. (2019). A systematic review into the incidence, severity and duration of antidepressant withdrawal effects: Are guidelines evidence-based? https://www.sciencedirect.com/science/article/pii/S0306460318308347Fluoxetine (Prozac). (2020). https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Fluoxetine-(Prozac)Henssler, J., et al. (2019). Antidepressant withdrawal and rebound phenomena.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6637660/Keks, N., et al. (2016). Switching and stopping antidepressants. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4919171/Kroeze, Y., et al. (2015). Long-term consequences of chronic fluoxetine exposure on the expression of myelination-related genes in the rat hippocampus. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5068807/Label: Fluoxetine capsule. (2021). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=9de65da4-73f8-4c88-8198-c92e63224ddbLabel for Prozac (fluoxetine). (2017). https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/018936s108lbl.pdfMaund, E., et al. (2019). Managing antidepressant discontinuation: A systematic review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6342590/Psychiatric medication. (2021). https://www.mind.org.uk/information-support/drugs-and-treatments/medication/explaining-the-half-life/Sohel, A. J., et al. (2022). Fluoxetine. https://www.ncbi.nlm.nih.gov/books/NBK459223/Stopping or coming off antidepressants. (2021).https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/medicines-and-psychiatry/stopping-or-coming-off-antidepressants/Weir, K. (2020). How hard is it to stop antidepressants?https://www.apa.org/monitor/2020/04/stop-antidepressantsFEEDBACK:Medically reviewed by Alyssa Peckham, PharmD, BCPP — By Jayne Leonard — Updated on July 31, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? New clues arise Related CoverageWhat is fluoxetine Medically reviewed by Femi Aremu, PharmD Fluoxetine oral capsule is a prescription medication used to treat conditions such as depression, obsessive-compulsive disorder (OCD), eating…READ MOREIs there a cure for depression?Medically reviewed by Timothy J. Legg, PhD, PsyD Depression is a lifelong mental health condition. There is no cure for depression, but many different treatments are available to manage the symptoms.READ MORESeasonal affective disorder (SAD): How to beat it this fall and winter Three medical experts offer insights on how to spot the symptoms of seasonal affective disorder (SAD), or seasonal depression, and better manage the…READ MOREWhat to know about antidepressants that cause weight lossMedically reviewed by Alana Biggers, M.D., MPH Most antidepressant medications cause weight gain as a side effect. Bupropion is an example of an antidepressant that may lead to weight loss in some…READ MORELSD-like compounds may have antidepressant effect without hallucinations Researchers identified two psychedelic compounds that can reduce depression symptoms but do not produce hallucinations like psychedelics such as LSD…READ MORE