Phillipa Munari’s journey with antidepressants began in 2003 when her physician suggested them for her fatigue. Despite feeling no improvement, Munari continued the medication until deciding to stop a decade later, a process her doctor guided her through.
Initially, discontinuing the drug seemed uneventful. However, within six to nine months, Munari began experiencing severe symptoms such as nerve pain and heightened anxiety—issues she had never encountered before.
Based in New Brunswick, Canada, Munari faced such extreme exhaustion and physical weakness that maintaining her job became challenging. She spent two years mostly bedridden and eventually returned to Effexor to qualify for disability benefits, later tapering off the medication more slowly.
While the nerve discomfort and fatigue slightly improved, Munari’s anxiety worsened. She described a state of “complete panic,” where leaving the house was impossible, and car rides were unbearable without closing her eyes. It was two more years before she noticed any improvement.
Munari is among many who have taken to online platforms to discuss enduring health issues post-antidepressant use. Many claim their doctors failed to warn them of such possibilities and dismissed their concerns.
Medical professionals have long recognized short-term withdrawal symptoms associated with stopping antidepressants, including dizziness, anxiety, insomnia, and nausea, as documented in medical literature.
British psychiatrist Mark Horowitz notes the lesser-known fact that symptoms can persist long after discontinuation. A study analyzing patient narratives found that individuals with prolonged withdrawal symptoms suffered for an average of eight years.
Despite decades of psychiatric documentation, large-scale studies on long-term withdrawal are lacking, and experts remain divided over the condition’s prevalence and prevention.
“It should be very concerning to the medical system and the public that there are tens of millions of people walking around on drugs whose long-term exposure and withdrawal effects we do not understand,” Horowitz emphasized.
Activists and those affected by antidepressant withdrawal are rallying for greater awareness and research. They urge prescribers to educate themselves and inform patients of potential long-term effects before prescribing or continuing the drugs.
“Before I took it, I had feelings”
Sven Huber turned to the internet in 2009 after media reports on a soccer player’s suicide prompted him to research depression symptoms, which he found relatable. For the next 13 years, the 35-year-old from western Germany was on antidepressants.
Initially, Huber’s medication alleviated his depression but caused drowsiness. Switching to escitalopram (Lexapro) led to more severe side effects, including emotional blunting and blurred vision.
When Huber attempted to withdraw from escitalopram under medical guidance, he encountered “brain zaps,” anxiety, and suicidal thoughts—recognized symptoms of antidepressant withdrawal.
Returning to escitalopram, Huber faced a dilemma: endure adverse side effects or the withdrawal symptoms. After several failed attempts, he ceased the medication a year and a half ago. Although some symptoms subsided, others, including emotional numbness, persisted.
Huber expressed a longing to reconnect emotionally, stating, “Before I took it, I had feelings – bad feelings often – but I felt something. And now I do not feel anything at all.” This emotional void, he shared, is the most challenging aspect.
Side effects that may never go away
Nassir Ghaemi, a renowned psychiatrist at Tufts University, suggests that long-lasting withdrawal effects like Huber’s are rare, affecting a minority of patients. However, specialists in antidepressant withdrawal argue that the true risk may be underestimated due to the many failed attempts by patients to discontinue the drugs.
“I’ve never seen anybody come off long-term Effexor or Cymbalta and not have years of trouble,” stated Horowitz. He notes that even medications with a lower risk profile, such as fluoxetine (Prozac) and escitalopram, can lead to severe withdrawal issues.
Horowitz and other experts have proposed terms like “serotonin-induced neurological dysfunction” to describe these prolonged symptoms, which can manifest either after stopping the drug or as side effects that worsen post-discontinuation.
Research by Horowitz indicates a higher likelihood of severe withdrawal issues the longer a person uses antidepressants. Both Ghaemi and Horowitz advise against abrupt cessation, advocating for a gradual tapering process.
While antidepressants can provide short-term relief, Ghaemi notes that they are most effective within the first six months of use and should not be prescribed indefinitely. In some cases, such as obsessive-compulsive disorder, long-term use may be justified.
Attempts to contact drug manufacturers for comment were largely unsuccessful. Eli Lilly, the maker of Cymbalta and Prozac, as well as AbbVie, which produces Lexapro, declined to comment, and Viatris, the manufacturer of Effexor, was unreachable.
“That’s historic”
Huber found solace in online communities, discovering others with similar experiences. Reddit and various forums have seen significant growth, becoming platforms for sharing stories of withdrawal symptoms and seeking support.
Pages dedicated to PSSD (post-SSRI sexual dysfunction) on Reddit have expanded from 700 to 16,000 subscribers over five years. Other groups on different platforms are also thriving.
Due to insufficient research on the negative effects of antidepressants, advocacy groups are lobbying for more studies. The nonprofit PSSD Network has raised over $200,000 for research, and the Canadian government has started funding PSSD studies in response to pressure from advocacy groups.
“That’s historic,” said Nick Alves, a spokesperson for the PSSD Network, about the Canadian government’s involvement. “That’s huge.”
Another organization, the Antidepressant Coalition for Education, encourages people to report their withdrawal experiences to the U.S. Food and Drug Administration.
“People don’t learn this stuff in medical school”
Adele Framer founded the Surviving Antidepressants forum in 2011 after enduring seven years of withdrawal symptoms. The platform offers advice on tapering, often referencing a handbook by Horowitz. His gradual tapering method contrasts with standard medical practices.
Framer’s work involves converting patient stories from the forum into analyzable data, contributing to published studies on withdrawal symptoms.
“There’s a hidden public health problem in people experiencing withdrawal symptoms because they and their doctors don’t know how to gradually reduce the dosage,” Framer stated.
Framer’s recent focus is on a nonprofit, the Psychotropic Deprescribing Council, established in 2023 to develop guidelines for safely discontinuing psychotropic medications.
The American Psychiatric Association (APA) is acknowledging these issues. Dr. Alan Schatzberg from Stanford University and APA consultant remarked on the importance of antidepressants for depression but noted the APA’s research council is reviewing literature on PSSD and other antidepressant-related issues.
Horowitz welcomes the APA’s interest but cautions that a literature review may not suffice, as it only examines existing research. He advocates for government-funded studies that track long-term antidepressant users post-discontinuation.
The future of such research in the U.S. is uncertain. While Health Secretary Robert F. Kennedy Jr. criticizes antidepressants, federal funding for biomedical research has been reduced under the Trump administration.
Horowitz views the APA’s review as a positive step, indicating that patient voices are being heard. “It means that pressure has got somewhere,” he concluded.
This story was produced by APM Reports, the investigative reporting unit at American Public Media.
Copyright 2025 NPR
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