How Long Does Withdrawal From Prozac Last?

Prozac is a well-known antidepressant that is used to treat a variety of disorders, including major depression, obsessive-compulsive disorder (OCD), panic disorders, and some eating disorders. Prozac (fluoxetine) belongs to a class of medications known as selective serotonin reuptake inhibitors (SSRIs). These drugs increase the amount of serotonin in your brain, which helps improve your mental health. When you stop taking an SSRI like Prozac, you may experience withdrawal symptoms while your brain adjusts to lower levels of serotonin. 

Antidepressants like Prozac are among the most commonly prescribed medications in America. In a given month, more than 40 million people take an antidepressant. As antidepressant use grew over the past two decades, more and more people began to realize how hard it is to quit. About one in four people on antidepressants have been taking them for ten years or more.

One of the reasons long-term antidepressant use is so common is that people are afraid to stop taking them. These concerns center around the potential for relapse of symptoms and possible withdrawal.

These fears are not entirely unfounded. SSRI withdrawal is a well-established condition. More than half (56%) of people who quit antidepressants experience withdrawal symptoms such as irritability, dizziness, nausea, and prickling sensations. Going off antidepressants can also increase your risk of relapse, including the return of symptoms of depression anxiety. Quitting also increases your risk of suicidal behavior.

 It is important to work with your doctor to weigh these risks against the potential risks of continuing Prozac. Prozac has a number of side effects that can have a negative impact on your life. While many of Prozac’s side effects dissipate over time, the sexual side effects tend to continue as long as you remain on the drug. Sexual side effects are a common motivator for people to stop taking Prozac.

The good news is that among the SSRIs, Prozac is the least likely to cause withdrawal symptoms. The reason for this is Prozac’s long half-life. A drug’s half-life is the time it takes for 50% of the drug to be effectively eliminated from your body. Most antidepressants are half out of the body in under 24 hours, but Prozac’s half-life is four to six days.

 Withdrawal symptoms typically begin when a drug is about 90% out of your body. With Prozac, this can take up to 25 days.

Prozac is unique among the antidepressants because withdrawal symptoms typically don’t appear for several weeks. Unfortunately, it’s a bit of a double-edged sword, because Prozac withdrawal symptoms also tend to last longer—about two months.

The longer timeline associated with Prozac withdrawal increases the risk of misdiagnosis. Because withdrawal symptoms appear later and last longer, it is often mistaken for a relapse. This may lead people to unnecessarily start taking antidepressants again.

Recognizing the signs of Prozac withdrawal, along with the extended timeline on which they occur, can help you distinguish withdrawal symptoms from relapse.

 Symptoms associated with SSRI withdrawal are varied, affecting many different systems.

• Digestive. You may experience nausea, vomiting, cramps, diarrhea, or appetite loss.
• Balance. You may become dizzy or lightheaded, sometimes making it difficult to walk.
• Sleep problems. You may have nightmares, unusual dreams, excessive/vivid dreams, or insomnia.
• Overall. You may have flu-like symptoms including headache, muscle pain, weakness, and tiredness.
• Mood. You may have extreme anxiety, agitation, panic, suicidal ideation, depression, irritability, anger, mania, or mood swings.
• Bizarre sensations. You may experience brain zaps (like an electrical shock or shiver in your brain), pins and needles, ringing in the ears, strange tastes, or hypersensitivity to sound.
• Motor control. You may have tremors, muscle tension, restless legs, unsteady gait, or difficulty controlling speech and chewing movements.

Prozac withdrawal symptoms can range from mildly bothersome to severe and incapacitating. The Discontinuation-Emergent Signs and Symptoms Scale, or DESS, is a checklist you can use to evaluate your symptoms and their severity.

Quitting Prozac doesn’t have to be a nightmare. If you are worried about withdrawal, your doctor may recommend tapering your dose. When you taper your dose, by taking progressively smaller doses over a period of time, you can often prevent or reduce withdrawal symptoms.

Your doctor may recommend a short taper of one to two weeks (as given the long half life of prozac, in some respects it tapers itself) or a longer taper that plays out over the course of several weeks or months. Recent research suggests that a longer taper (at least one month) that continues until your dose is down to zero, is the best way to minimize SSRI withdrawal. 

 If you are currently experiencing withdrawal symptoms, there are ways to ease your discomfort, including:

• Therapy. Psychotherapy can help you better manage anxiety, and even reduce your chances of relapse.
• Social support. Tell your friends and family that you are experiencing withdrawal symptoms, this can help prevent conflict and discord.
• Fitness. A healthy amount of physical activity, about 45 minutes of moderate activity three times a week, can reduce stress and irritability. 
• Herbal remedies. Over-the-counter (OTC) supplements like valerian root and melatonin can help relieve insomnia.
• OTC medications. Headaches and stomachaches can be treated with OTC pain relievers and anti-nausea medications. 

When quitting Prozac, there is a risk that symptoms of major depression will return in spades. Studies have shown that when your dose is changed or stopped, you may be at an increased risk for suicidal thoughts, behaviors, and actions. The risk may be greater for children, teens, and young adults.

Prozac comes with a black box warning (the FDA’s most serious warning) stating that children, teens, and young adults are at increased risk of suicidal ideation when starting these medications. They may also recommend close observation during, changing, or discontinuing their dose.  

In the weeks and months following Prozac discontinuation, it is important to look out for suicidal behaviors. Signs of suicidal ideation include:

• Planning how you would commit suicide if you were going to do it
• Talking or thinking about suicide more than normal, for example, “I wish I were dead”
• Gathering the means to commit suicide, such as bullets or pills
• Feeling hopeless or trapped
• Having intense mood swings
• Engaging in risky or self-destructive activities, such as driving drunk
• Becoming preoccupied with death, dying, or violence
• Getting affairs in order or giving away belongings
• Saying goodbye to people as if it were the last time 

There are also risks of Prozac overdose, so make sure you seek immediate care.

After you stop taking Prozac, your long-term outlook will depend on your particular circumstances. If you are quitting Prozac because you find the side effects to be intolerable, then you will want to work with your doctor to find an alternative medication. There are many other antidepressants with lower rates of side effects that may be equally or even more effective at improving your moods.

About 50% of people who recover from one episode of depression will have more depressive episodes in their lifetime.  You may want to take other actions to reduce your risk of relapse.

Psychotherapy (talk therapy) is an evidence-based treatment for depression, anxiety, OCD, and PTSD. Researchers at Harvard Medical School and other universities have found that people who participate in psychotherapy while discontinuing antidepressants are less likely to relapse than those who do not. 

If you or someone you love is experiencing suicidal thoughts, call the National Suicide Prevention Lifeline (1-800-273-8255). You will be connected with staff or volunteers at a crisis center near you. The people on the other end of the line can help you calm down and figure out what to do next.

If your doctor isn’t helping, consider finding a new psychiatrist, psychologist, or therapist in your area. The Substance Abuse and Mental Health Services Administration (SAMHSA) has a searchable directory of qualified providers. You can also call them at 1-800-662-HELP (4357).

If you have health insurance, you can also search the company’s list of local providers who accept your insurance.

When Prozac first arrived on the scene, it helped a lot of people. Today, there are many alternative antidepressants, so if you need to come off Prozac, there are ways to do this with your doctor safely and effectively.