Flu-Like Symptoms When You Discontinue Antidepressants

If you've recently discontinued an antidepressant, you might experience flu-like symptoms as part of withdrawal (known as antidepressant discontinuation syndrome, or ADS). You may have symptoms after missing only a single dose or taking it late. Or, symptoms may come on several days after you stopped your medication, making it harder to connect the dots.

Causes of Flu-Like Symptoms

Symptoms such as fatigue, nausea, chills, and muscle aches can indicate the flu. If it is flu season (October through March) you may indeed have influenza. However, flu-like symptoms occur with many infections.

You can have similar symptoms due to colds (rhinoviruses), COVID-19 or other coronaviruses, human respiratory syncytial virus, adenoviruses, human parainfluenza virus, viral and bacterial pneumonia, Legionella, measles, acute HIV infection, herpes, hepatitis C, Lyme disease, and many others. Withdrawal symptoms from opioids can also mirror some of the symptoms of influenza.

Discontinuing an Antidepressant

Because any single antidepressant may be only 50% effective, you might think it isn't working and that stopping it won't have any effects. Or, you may not have refilled a prescription. You may simply have forgotten to take it.

However, even if you aren't getting the desired effects, antidepressants change your body chemistry. Suddenly removing the drugs will result in a flip-flop of chemical reactions, resulting in withdrawal symptoms.

Symptoms of ADS

If you stop taking your antidepressant abruptly, without tapering your dosage, you can experience symptoms that range from mild to severe. You can experience discontinuation syndrome a few days or weeks after you stopped taking your medication, or even when tapering your doses, missing a dose, or taking a dose late. You might experience these symptoms for a few weeks.

Some will experience only minor symptoms and miss the connection with their antidepressant. For others, the symptoms are so debilitating that they feel they cannot stop their antidepressant for fear of how it will interfere with their lives.

Symptoms of antidepressant discontinuation syndrome include:

• Fatigue
• Nausea
• Myalgia (muscle aches)
• Insomnia
• Anxiety
• Agitation
• Dizziness
• Hallucinations
• Blurred vision
• Irritability
• Tingling or electric shock sensations
• Vivid dreams
• Sweating

Medications Associated With ADS

Discontinuation syndrome is most common with those drugs that have a short half-life, which is how long it takes for half the drug to clear from the body. Serotonin-norepinephrine reuptake inhibitors such as Effexor (venlafaxine), tricyclic antidepressants, and monoamine oxidase inhibitors (MAOIs) can cause symptoms.

Most selective serotonin reuptake inhibitors (SSRIs), including Zoloft (sertraline), Paxil (paroxetine), Celexa (citalopram), and Lexapro (escitalopram) have a short half-life. That can result in withdrawal symptoms when stopping abruptly.

Prozac (fluoxetine) is the one SSRI which generally does not cause problems because it has a half-life of two to four days and its primary metabolite (breakdown product) has a half-life of four to 16 days. This long half-life gives it a built-in tapering off.

Preventing ADS

If you are planning to discontinue your antidepressant, seek your doctor's approval and advice. When you stop your antidepressant, you run the risk of withdrawal symptoms as well as a possible return of the condition you are taking the antidepressant for. If your doctor has given you the green light to stop, discuss how you should proceed in gradually decreasing your dosage.

Tapering schedules can be quite variable. If your treatment has lasted less than six weeks, tapering is often done over one to two weeks. If you've been treated for six to eight months, tapering is done over six to eight weeks.

A Word From Verywell

By gradually decreasing your dose over time, as directed by your doctor, you will allow your body time to slowly adjust as the medication leaves your body. But you also should take normal precautions for preventing the flu and other infectious diseases. Stay up to date on vaccinations and practice good handwashing habits.