Discontinuation of Antidepressants
Hello, doctor.
My mother has been taking a medication called Yuankang for depression for the past ten years, at a dosage of two pills a day.
Towards the end, it seemed like she developed symptoms similar to bipolar disorder, becoming easily angered, experiencing rage, and feeling excessively sleepy, as if she could never get enough rest.
Two months ago, she switched to a new doctor, who advised that Yuankang should not be taken and helped my mother taper off the medication.
It has now been almost two months since she stopped taking it.
Initially, she experienced withdrawal symptoms such as vomiting and crying, but those discomforts have subsided.
However, now she seems to be devoid of spirit, lacking emotions like joy, anger, sadness, or happiness, and spends her days in a daze without speaking and has lost her ability to move.
Is this truly a withdrawal phase? If it is just a transitional period, how long should we expect it to last before she recovers? I am really worried about her.
Thank you.
Ms. Tseng, 20~29 year old female. Ask Date: 2017/04/21
Dr. Dai Wanxiang reply Psychiatry
Ms.
Tseng: Hello, Wellbutrin is an effective medication for treating depression.
Since your mother has been taking it for 10 years, it is difficult to determine whether her anger, irritability, and excessive sleepiness are related to this medication.
Generally, side effects do not manifest after such a long duration.
Common side effects of Wellbutrin include nausea, dizziness, drowsiness, and insomnia.
In addition to side effects, there is a small possibility that this medication can induce hypomania or mania, particularly in individuals with bipolar disorder.
Of course, abruptly discontinuing Wellbutrin after long-term use may lead to withdrawal symptoms, which commonly include anxiety, agitation, nausea, vomiting, and insomnia.
The occurrence of withdrawal symptoms is related to the dosage and duration of use.
When taking a higher dose for an extended period, special attention is needed when discontinuing the medication.
A gradual tapering approach can help minimize withdrawal symptoms.
The duration of withdrawal symptoms varies by individual but may last for 2-3 weeks.
Given your mother's situation, the withdrawal symptoms should have subsided.
Based on your description, we should consider the possibility of a recurrence of depression.
I recommend discussing the treatment plan further with your mother and her physician, and I hope this information is helpful.
Reply Date: 2017/04/21
More Info
Withdrawal symptoms after stopping antidepressants can be a challenging experience, both for the individual and their loved ones. In your mother's case, it appears she has been on a medication called "Yuekang" (likely a brand name for an antidepressant) for a decade, and her recent switch to a new doctor has led to a cessation of this medication. The symptoms you describe—nausea, crying, and a general sense of emotional numbness—are not uncommon during the withdrawal process.
Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) and other classes of antidepressants, can lead to physical dependence. When these medications are suddenly discontinued or tapered too quickly, withdrawal symptoms may manifest. These symptoms can include mood swings, irritability, anxiety, fatigue, sleep disturbances, and physical symptoms like nausea or headaches. In some cases, individuals may experience a "discontinuation syndrome," which can be characterized by flu-like symptoms, sensory disturbances, and emotional instability.
The emotional numbness and lack of motivation your mother is experiencing could be a result of several factors. First, it could be a continuation of withdrawal symptoms, as the body and brain adjust to the absence of the medication. This adjustment period can vary significantly from person to person, depending on factors such as the specific medication, the duration of use, the dosage, and individual biological differences. Some people may begin to feel better within a few weeks, while others may take several months to fully recover.
It's also important to consider that the symptoms your mother is experiencing may not solely be due to withdrawal. After long-term use of antidepressants, some individuals may find that their underlying mental health conditions, such as depression or anxiety, resurface or change in nature. The transition from a medication that has been managing symptoms for years can reveal underlying issues that may need to be addressed through therapy or other forms of treatment.
In terms of what to expect moving forward, it is crucial to maintain open communication with her healthcare provider. If your mother is feeling emotionally flat or lacking motivation, it may be beneficial to discuss these symptoms with her doctor. They may recommend a gradual reintroduction of medication or alternative treatments, such as psychotherapy, to help her navigate this challenging period.
Additionally, supportive measures can be beneficial during this time. Encouraging her to engage in light physical activity, maintain a balanced diet, and establish a regular sleep routine can help improve her overall well-being. Mindfulness practices, such as meditation or yoga, may also provide some relief from anxiety and help her reconnect with her emotions.
In conclusion, while it is possible that your mother is experiencing withdrawal symptoms, it is equally important to consider the potential resurgence of her underlying mental health condition. The timeline for recovery can vary, and ongoing support from healthcare professionals is essential. If her symptoms persist or worsen, it is crucial to seek medical advice promptly to ensure she receives the appropriate care and support she needs during this transition.
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