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One in nine U.S. adults took antidepressants in 2023; most (75%) are prescribed by non-psychiatrists.

SSRIs and SNRIs aren't addicting—but if stopped, withdrawal symptoms may occur. They may be distressing.

Antidepressant withdrawal may feel deeply distressing even when complications are not medically dangerous.

Approximately one in nine American adults takes an antidepressant (AD), the prescriptions written not by psychiatrists but by primary-care clinicians, internists, family physicians, and nurse practitioners. Treatment is often long-term; many patients stay on the medications five years or more.

Depression is far more than ordinary sadness. For many patients, antidepressants are genuinely helpful. Before modern ADs became widely available, severe depression often led to prolonged disability, psychiatric hospitalization, suicide, and greater reliance on electroconvulsive therapy (ECT).

Despite the benefits, ADs remain controversial. One of the most common complaints is that patients may say they feel “addicted” because ADs can be difficult to stop. Some patients discontinuing SSRIs or serotonin-norepinephrine reuptake inhibitor (SNRI) ADs say the experience is worse than withdrawing from drugs of abuse. As a result, many conclude that these medications must be addictive. Clinicians generally disagree.

Why Patients May Feel “Addicted”

Let’s say a medication is taken daily for months or years. A dose is missed, and distressing symptoms appear. The medication is restarted, and symptoms improve. The patient concludes, “If I get sick when I stop and better when I restart, I must be addicted.” But difficulty stopping a medication is not the same thing as addiction.

Over time, ADs produce adaptive changes in serotonin- and norepinephrine-related brain circuits. When treatment stops, withdrawal symptoms can occur as the brain readjusts to functioning without those adaptations.

SSRIs and SNRIs can produce what patients call withdrawal symptoms, but they are more accurately called discontinuation symptoms—when stopped abruptly or tapered too quickly.

Many commonly prescribed drugs can produce significant withdrawal or rebound phenomena when stopped abruptly, including corticosteroids, beta-blockers, clonidine, baclofen, and antiepileptics. Some withdrawal syndromes can be medically dangerous and occasionally life-threatening.

ADs belong in this broader category of medications: They may require tapering because physiologic adaptation develops during treatment.

What makes AD withdrawal particularly distressing is that many symptoms are unusual and difficult to describe.

The symptoms may include dizziness, disequilibrium, nausea, flu-like symptoms, anxiety, irritability, insomnia, emotional lability, sensory disturbances, and the so-called “brain zaps” many patients describe as brief electric-shock sensations.

Such experiences can be frightening and may create the impression that something is seriously wrong.

In some cases, symptoms appear within days of stopping treatment or, in extreme cases, missing a pill or two. Certain ADs with shorter half-lives—notably venlafaxine,........

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