Clinical guidelines are vague, so we asked psychiatrists what to consider when deciding whether to continue taking these medications.
Antidepressants are known to have adverse effects that often fade as your body adjusts. But some side effects, like weight gain and sexual dysfunction, can linger.
Certain antidepressants have been associated with increases in blood pressure, heart rate and cholesterol. They can also lower sodium levels and increase the risk of blood clots.
Any downsides have to be balanced against the very real risks of avoiding medication, psychiatrists stress.
“I’m still of the opinion that, in people who have real depression, the benefits outweigh the risk,” Dr. Nestadt said.
Alice, 34, who lives in Massachusetts and asked to be referred to only by her first name to protect her privacy, stayed on citalopram for two years before deciding to quit.
She found it helpful for treating her panic attacks. But citalopram, a selective serotonin reuptake inhibitor, also caused her to gain weight and gave her a feeling of “artificial stability,” she said. Her therapist wanted her to continue taking it. Alice disagreed. So she stopped taking the drug cold turkey — a harrowing process — and now uses methods like meditation and journaling to manage her symptoms.
What do clinicians recommend?
For major depression, clinical guidelines suggest taking medication until patients feel “virtually back to themselves,” said Dr. Jonathan E. Alpert, chair of the department of psychiatry at Montefiore Einstein in New York.
After that, it’s important to continue treating them for at least four to nine months to “anchor in” their recovery, he added. Research suggests that going off the drugs earlier than this can increase the odds of relapsing.
Patients may then continue taking the medications for at least one or two additional years — what is known as maintenance treatment.
Know Thyself 