The truth about antidepressant withdrawal

One in eight people in the US take an antidepressant. Stopping this medication can be hard, but researchers can't agree on the risks

- by SOPHIE FREEMAN

Dr Mark Horowitz knows how hard it can be to come off antidepressants. “When I got down to a very low dose – not even off the drugs – my entire world exploded,” the London-based doctor tells BBC Science Focus. “I had trouble sleeping and I would wake up in the mornings in a full-blown panic, like I was being chased by a wild animal, then that would go on for 10 or 11 hours of the day.”

He felt far worse – and had entirely different symptoms – compared to when he had been originally prescribed the Selective Serotonin Reuptake Inhibitor (SSRI) escitalopram, 12 years earlier at the age of 21.

Antidepressants are widely viewed as a huge success in the world of mental health treatment. Around a fifth of the population of the UK and the US use an antidepressant each year, and a 2025 study by King’s College London found 75 per cent of people who took SSRIs (the most common type of antidepressants, which include citalopram, fluoxetine, paroxetine and sertraline) thought they were helpful.

They’re often used long term: an investigation by BBC Panorama in 2023 found around two million people in England had been on antidepressants for more than five years (this figure is even higher now). And in the US, figures from the Center for Disease Control and Prevention suggest it’s at least 25 million.

STOPPING THE MEDICATION

But what happens when we feel like we don’t need them anymore?

According to the UK’s Royal College of Psychiatrists, symptoms of antidepressant withdrawal can include anxiety; low or rapidly changing moods; difficulty sleeping (including nightmares); an electric-shock feeling (‘zaps’) in the head and limbs; loss of coordination; suicidal thoughts; dizziness; and a feeling of inner restlessness (akathisia) – a symptom some of Dr Horowitz’s patients have described as feeling like “their nervous system on fire”. People pace the room and are flooded with a sense of terror.