Long-Term Effects of BZD and SSRI Medications: What to Expect After Stopping

What are the side effects associated with BZD or SSRI medications?

Hello Doctor: Three years ago, I was diagnosed with depression, and since then I have been on medication until I stopped at the beginning of this year.
During this time, I also developed Parkinson's Disease (PD) and Bipolar Affective Disorder (BAD), so my doctor prescribed me some benzodiazepines (BZD).
I would like to ask if stopping medications such as SSRIs (the ones I previously took include Zoloft, Wellbutrin, Seroxat, Effexor, Ludiomil, Prozac, Lexapro) and benzodiazepines (the ones I have taken include Xanax, mostly this one, Ativan, Erispan) will cause significant long-term side effects, such as memory loss?

LITTLE GIRL, 10~19 year old female. Ask Date: 2007/05/25

Dr. Chen Meizhu reply Psychiatry

Hello Little Girl,
Suffering from depression and anxiety can indeed affect memory.
The medication you previously took, benzodiazepines (BZD), is more likely to cause withdrawal symptoms such as insomnia and night sweats, or a return of original symptoms (rebound effect) after discontinuation.
Therefore, it is recommended that you find a physician you trust to monitor your condition over the long term, ensure regular treatment, and discuss your medication regimen with your outpatient physician.
(Dr.
Chen Mei-Chu is currently on leave, and this response is provided by Dr.
Chen Chih-Tsai, the head of the Child Psychiatry Department at our hospital.)

Reply Date: 2007/05/25

More Info

The long-term effects of discontinuing benzodiazepines (BZD) and selective serotonin reuptake inhibitors (SSRIs) can vary significantly among individuals, influenced by factors such as the duration of use, dosage, individual physiology, and the presence of underlying mental health conditions.
When it comes to SSRIs, which include medications like Zoloft (sertraline), Effexor (venlafaxine), and Prozac (fluoxetine), the withdrawal symptoms are generally milder compared to those associated with BZDs. However, some individuals may experience discontinuation syndrome, which can manifest as flu-like symptoms, insomnia, irritability, and mood swings. These symptoms are often temporary and can last from a few days to several weeks. Importantly, SSRIs do not typically cause significant cognitive impairment or memory loss upon discontinuation, although some patients report a temporary decline in cognitive function during the withdrawal phase.

On the other hand, benzodiazepines, such as Xanax (alprazolam) and Ativan (lorazepam), are known for their potential for dependence and withdrawal symptoms. After stopping BZDs, individuals may experience a range of withdrawal symptoms, including anxiety, insomnia, tremors, and in some cases, cognitive issues like memory impairment. The risk of cognitive decline is particularly pronounced in those who have used BZDs for an extended period or at high doses. Memory problems can also be exacerbated by the underlying conditions for which these medications were prescribed, such as depression or anxiety disorders.

Regarding your specific concerns about memory loss, it is essential to recognize that both depression and anxiety can independently affect cognitive function. Therefore, it may be challenging to determine whether any cognitive issues you experience after stopping medication are due to the discontinuation of BZDs or SSRIs, or if they are a result of the underlying mental health conditions.
To mitigate the risks associated with discontinuing these medications, it is crucial to work closely with a healthcare provider. A gradual tapering of the medication, rather than abrupt cessation, can help minimize withdrawal symptoms and reduce the likelihood of cognitive impairment. Additionally, incorporating non-pharmacological interventions, such as cognitive behavioral therapy (CBT), mindfulness practices, and lifestyle modifications (like regular exercise and a balanced diet), can support mental health and cognitive function during and after the withdrawal process.

In summary, while discontinuing SSRIs may lead to mild and temporary withdrawal symptoms, the long-term cognitive effects are generally minimal. In contrast, stopping BZDs can result in more significant withdrawal symptoms, including potential memory issues. It is essential to have open communication with your healthcare provider about your concerns and to develop a tailored plan for discontinuation that considers your unique circumstances and mental health history.

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