Stopping SSRIs Can Be Hard. Researchers Are Unsure Why

More than 1 in 10 people in the United States take an antidepressant. And the most commonly prescribed type of antidepressant are SSRIs https://my.clevelandclinic.org/health/treatments/24795-ssri — or selective serotonin reuptake inhibitors. That includes drugs like Zoloft, Prozac and Lexapro. But what happens when some patients decide they want to stop taking their SSRIs? While doctors know stopping SSRIs can sometimes cause unpleasant short-term side effects – like dizziness, anxiety, insomnia and nausea – some people report symptoms that last months, even years. So, with investigative reporter Emily Corwin https://www.apmreports.org/profile/emily-corwin and professor of clinical psychology Michael Hengartner https://www.researchgate.net/profile/Michael-Hengartner, we’re diving into the research around the long-term effects of going off your antidepressants – what it shows and its limits. Read more of Emily Corwin’s reporting on the topic here https://www.npr.org/sections/shots-health-news/2025/07/09/nx-s1-5460018/antidepressant-ssri-side-effects-withdrawal-symptoms. Want more stories on mental health? Email us at [email protected] mailto:[email protected]. Listen to every episode of Short Wave sponsor-free and support our work at NPR by signing up for Short Wave+ at plus.npr.org/shortwave http://plus.npr.org/shortwave. See pcm.adswizz.com https://pcm.adswizz.com for information about our collection and use of personal data for sponsorship and to manage your podcast sponsorship preferences. NPR Privacy Policy https://www.npr.org/about-npr/179878450/privacy-policy

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Speaker 00

  This message comes from NPR sponsor, Viori, featuring the Sunday Performance Jogger. Receive 20% off your first purchase at viori.com/NPR on any US orders over $75 and free returns. Exclusions apply. Visit the website for full terms and conditions.

• 0:19Emily Kwong?

  You're listening to Short Wave from NPR.

• 0:25Emily Kwong?

  More than 1 in 10 people in the US take an antidepressant.

• 0:31Emily Kwong?

  They're very common, and the most commonly prescribed type are SSRIs, or selective serotonin reuptake inhibitors. That's a class of drugs that includes Zoloft, Prozac, Lexapro.

• 0:43Speaker 02

  I started using antidepressants when I was in my early 20s.

• 0:48Emily Kwong?

  Emily Corwin is one of millions of people who have taken an SSRI. She was prescribed Lexapro.

• 0:54Speaker 02

  And I went on them really because of circumstantial reasons, probably had mild depression.

• 1:02Emily Kwong?

  And she stayed on the drug for about 15 years.

• 1:05Speaker 02

  Because it was like, nobody ever suggested I do anything else.

• 1:08Emily Kwong?

  Until around 2022, Emily decided she wanted to stop taking Lexapro. She talked to her doctor, and they made a plan to taper, to slowly decrease her dose over the course of one month, which can be a pretty common timeline.

• 1:24Speaker 02

  And I, just for the first time in my life, experienced a kind of excruciating existential dread that didn't make any sense to me. I'd never had anything like that before. I felt a kind of out-of-body experience.

• 1:42Emily Kwong?

  Now, stopping SSRIs can cause unpleasant side effects. Doctors have long acknowledged this. There are symptoms like dizziness, anxiety, insomnia, and nausea.

• 1:53Emily Kwong?

  But what Emily experienced was different. After a few weeks, she went back to her original dose.

• 1:59Speaker 02

  Everything got better.

• 2:00Emily Kwong?

  But Emily is an investigative journalist. She decided to look into the experience. Was anyone else having long-term problems getting off of their SSRIs?

• 2:09Speaker 02

  And suddenly, an entire internet of information about withdrawal opened up to me.

• 2:16Emily Kwong?

  Ever since, as an investigative journalist for APM Reports, Emily has been looking into people's experiences stopping antidepressants. And she's discovered tens of thousands of people who've turned to online forums to discuss health problems and nonprofit groups calling for more psychiatric research. Because some people are struggling with symptoms for months, even years.

• 2:39Speaker 03

  The whole problem starts with a lack of definition. And so actually, we're left quiet in the void.

• 2:49Emily Kwong?

  To understand this growing concern among patients about long-term SSRI withdrawal, we called up Michael Henkardner. He's a professor of clinical psychology at Kalitos University of Applied Sciences in Zurich, Switzerland. And he says this is a symptom of missing research. In fact, experts and psychiatrists disagree on how common this problem is, how to prevent it, and even what to call it.

• 3:17Emily Kwong?

  Today on the show, what we do and don't know about the long-term effects of going off an antidepressant, and how this patient movement has caught the attention of psychiatry. I'm Emily Kwong, and you're listening to Short Wave, the science podcast from NPR.

• 3:40Speaker 00

  Stay tuned for the following announcements and messages from our sponsors. This message comes from Mint Mobile. Ditch overpriced wireless and get premium wireless for less. Go to mintmobile.com/switch to see which plan works for you. This message comes from Quo. You run a job, in a meeting, slammed, and a customer calls. If nobody picks up, they- They go to your competitor. That's why over 90,000 companies choose Quo, the business phone system built for busy teams. Smart call routing sends calls to the right person. Shared numbers let your team cover for each other, and an AI agent picks up when nobody can, capturing every lead so nothing falls through the cracks. Always say hello with Quo.

• 4:24Speaker 00

  Try it free at quo.com/NPR.

• 4:29Speaker 04

  This message comes from Jerry. Noticing your car insurance rate creep up even without tickets or claims? You're not alone. That's why there's Jerry. Jerry handles the legwork by comparing quotes side by side from over 50 top insurers so you can confidently hit buy. No spam calls, no hidden fees. Jerry even tracks rates and alerts you when it's best to shop. Drivers who save with Jerry could save over $1,300 a year. Don't overpay. Download the Jerry app or visit jerry.ai/NPR today.

• 5:01Emily Kwong?

  OK, short waivers. I'm here with Michael Hengartner to talk about some people's experiences getting off their SSRIs long term. And right off the bat, we wanted to state something important. People should not suddenly stop taking their SSRI.

• 5:14Speaker 03

  This is absolutely not recommended, of course. Abruptly stopping a drug is probably the worst thing you could do.

• 5:21Emily Kwong?

  Is there any, like, rule of thumb?

• 5:23Speaker 03

  Yeah, there's no rule of thumb. There is not one single answer to that. But it should be individually tailored towards the needs of every individual patient. There are some people, even if they were on the drugs, let's say, for two, three, four years, they can stop the drugs quite quickly. Let's say in two or four weeks. For some people, it has to go very slowly over a long time, and others can stop rather quickly. But to find out who needs what, we, of course, need more research. And we're not there yet, not at all.

• 6:01Emily Kwong?

  OK, so there's all these patient stories. What kind of symptoms are a certain subset of people experiencing long term?

• 6:09Speaker 03

  Yeah, so there are many different symptoms like you can broadly categorize into somatic symptoms and like sensory neurological symptoms like dizziness or gate instability, brain zaps, this kind of things.

• 6:30Emily Kwong?

  Yeah, I've heard brain zaps described like electrical shocks in the head. Yeah, go on.

• 6:35Speaker 03

  So it's not a formal medical term. It's more like people with lived experience chose that term. Yeah. Then we have like flu-like symptoms, like general somatic symptoms, like sleep problems, changes in appetite or diarrhea, that kind of stuff. And a lot of psychological symptoms, affect, mental symptoms, like affective symptoms, mood changes, irritability, panic. Yeah.

• 7:07Emily Kwong?

  Yeah. So a study came out last month in the journal JAMA Psychiatry where the authors did an analysis of previous research and they found there were no significant withdrawal symptoms long term for SSRIs. Can you talk about that paper and what you thought of it?

• 7:27Speaker 03

  This study, the first part of the analysis looked at studies where there was a systematic assessment of withdrawal symptoms and they found a few studies. The problem is that these were mostly short-term studies, so eight weeks duration. The majority of these studies were eight-week efficacy studies. Then there were a few 12-week studies and one 26-week study, which is nothing compared to the months and years most people are on antidepressants. We know that withdrawal is a result from

• 8:06Speaker 03

  From neurophysiological adaptations to a substance or something that develops slowly over time. And you cannot expect that when you look at the eight-week studies, or if when people stop a drug after eight weeks, that this is informative or tells me something about what happens if someone stops a drug after five years. So, of course, they found rather small effect sizes.

• 8:33Emily Kwong?

  Yeah. Now, most of the research out there regarding long-term withdrawal symptoms is survey studies, anecdotal information coming from patients, some of whom have formed online communities and even nonprofits calling for more research. If you could wave a magic wand, what kind of SSRI research would you want to see done?

• 9:01Speaker 03

  If you really want an honest study that really wants to know what happens long-term, you have a large diverse samples of rather short-term users, let's say, six months, and then you've got people who were on the drugs for 12 months, 24 months, and so on. Okay? And then what you do, then you randomize those. Abrupt discontinuation, possibly then a slow taper, a faster taper, and a very slow hyperbolic taper. You can also control with people who are abruptly switched to placebo, for instance.

• 9:44Speaker 03

  So, and then you follow up those people for several months.

• 9:50Emily Kwong?

  Yeah.

• 9:52Speaker 03

  But such a study has never been done.

• 9:53Emily Kwong?

  Why do you think that is?

• 9:55Speaker 03

  Well, most...

• 9:59Speaker 03

  Drug trials, of course, they are they are sponsored by the pharmaceutical industry. The vast majority are efficacy trials. No one is interested in studying something that they actually, they could find something that they do not want to see, you know, so the best way to avoid this problem is you don't study it. And drug regulators don't require such studies, that's the problem.

• 10:25Emily Kwong?

  Got it, okay. Not to mention, it would be like a tricky ethical question to give some long-term SSRI patients placebo suddenly, but I hear you that there's there's not enough research, basically, um in into the long-term impacts of tapering from an SSRI. And and you've done some research, what does your research show?

• 10:45Speaker 03

  Well, how do we know that? Let's say if someone experiences like mood disturbances or that kind of stuff, anxiety, panic, that this is not a return of of of um the mental disorder.

• 11:01Emily Kwong?

  So relapse, so depression or anxiety symptoms coming back. Um, how did you look into that?

• 11:07Speaker 03

  So what we did is we looked at at relapse prevention trials, for instance, and then we tried to figure out what happens when people discontinue their drugs as compared to people who go on with the drugs. And what would we expect if if this is in most cases or largely a withdrawal reaction? Of course, you would expect that that symptoms appear quite rapidly and quite instantly after drug was discontinued.

• 11:38Emily Kwong?

  Hmm.

• 11:38Speaker 03

  And then after that early risk period, actually, there's not much difference to the those patients who remain on the drug. And that's actually what we're seeing in the data. So actually, that challenges the notion that that that the the drug actually prevents the reoccurring or the relapse into a mental disorder, because then we would see that the risk of relapse actually constantly increases with time, which we would expect, and not that the large bulk of relapses or event coded as relapses occur quite quickly after discontinuation and thereafter, there's mostly salience.

• 12:24Emily Kwong?

  As for Emily Corwin, the investigative journalist we met in the beginning of the story, she wants to see more research, too. In her reporting, she reached out to Dr. Alan Schatzberg, a Stanford psychiatrist and consultant to the American Psychiatric Association, a prestigious group that represents psychiatry. He told Emily that the APA's Research Council has begun to review the existing literature on long-term problems with antidepressants and plans to publish their results. In an email to Short Wave, APA spokesperson Erin Connors confirmed this is true. And Emily thinks that's great.

• 13:00Speaker 02

  I think it's a real credit to the patients who have been organizing and lobbying on their own behalf that the APA is paying attention. I very much hope that the APA, when they do their literature review, that they recognize that the literature has overwhelmingly looked at short-term use of antidepressants. And I hope that they recognize that most of the people who are complaining to them, asking for more research, have used these drugs for many, many years before they experienced debilitating withdrawal experiences. So I just hope that the APA is aware of that and considering that when they do their review.

• 13:44Emily Kwong?

  And until then, Emily plans to keep going with this reporting.

• 13:52Emily Kwong?

  This episode was produced by Rachel Carlson and edited by our showrunner Rebecca Ramirez. Tyler Jones checked the facts. Jimmy Keeley was the audio engineer. Special thanks to John Hamilton. Beth Donovan is our senior director and Colin Campbell is our senior vice president of podcasting strategy. I'm Emily Kwong. Thank you for listening to Short Wave from NPR.

• 14:31Speaker 04

  Stay tuned for the following announcements and messages from our sponsors.