Prozac Withdrawal: Timeline, Symptoms, and Coping

Prozac (fluoxetine) is an antidepressant used to treat a variety of disorders, including major depression, obsessive-compulsive disorder (OCD), panic disorders, and some eating disorders. You may experience Prozac withdrawal for a couple of months after stopping this drug, while your brain adjusts to lower levels of serotonin.

Prozac Withdrawal Timeline

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 removed from your body. Most SSRIs have a half-life of approximately one day, but Prozac’s half-life is four to six days. This is important because withdrawal symptoms typically begin when a drug is about 90% out of your body.

Prozac is unique among antidepressants because its withdrawal symptoms typically don’t appear for several weeks. Unfortunately, this is 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.

Prozac Withdrawal Signs and Symptoms

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 bodily 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. They generally begin between 1.5 to 10 days after a decrease in dosage or discontinuation of the drug. The Discontinuation-Emergent Signs and Symptoms Scale, or DESS, is a checklist you can use to evaluate your symptoms and their severity.

Effects of Stopping Prozac Use

Antidepressants like Prozac are among the most commonly prescribed medications in America. In a given month, more than 40 million people take an antidepressant. About one in four 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. And these fears are not entirely unfounded.

More than half of people (56%) 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 or anxiety. Quitting is also associated with a 60% increase in suicide attempts.

It is important to work with your healthcare provider 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 these dissipate over time, sexual side effects may continue even after you have stopped taking the drug.

How to Prevent Prozac Withdrawal

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

Your provider may recommend a short taper of one to two weeks (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.

Coping With Prozac Withdrawal

If you are currently experiencing Prozac 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. 

Warnings When Stopping Prozac

When quitting Prozac, there is a risk that symptoms of major depression will return. Studies show that Prozac can increase the risk of suicidal thinking and behavior (suicidality) in those diagnosed with major depressive disorder (MDD), especially children and adolescents.

As a result, the U.S. Food and Drug Administration (FDA) issued a black box warning (the FDA's most serious warning) that Prozac usage may increase the risk of suicidality. The FDA goes on to urge patients, families, and health professionals to closely monitor warning signs of suicidality in children and adolescents who take the antidepressant, especially at the beginning of treatment or when doses are changed.

Signs of suicidality to be on the lookout for 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.

Importance of Long-Term Treatment

Your long-term outlook will depend on your particular circumstances, such as why you stopped taking Prozac and what symptoms you are currently experiencing. If Prozac didn’t help or you had to stop taking it because of unwanted side effects, you will need to develop a long-term plan to treat your depression. This may include trying different antidepressants or combinations of antidepressants.

More than 40% of people who have a depressive episode will go on to have at least one more episode in their lifetime. For this reason, maintenance treatment is vital. Maintenance treatment is essentially a long-term treatment designed to prevent relapse. It can include medication, psychotherapy, or a combination of the two.

Research suggests that people who participate in psychotherapy while discontinuing antidepressants are less likely to relapse than those who do not. Therefore, the American Psychological Association (APA) recommends various forms of psychotherapy, including cognitive behavioral therapy, mindfulness-based cognitive therapy, or interpersonal psychotherapy, to reduce your chances of relapse.

Resources

The National Suicide Prevention Lifeline connects you 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.

A Word From Verywell

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 safely and effectively—with your healthcare provider's help.