Yes. Some mental health medicines can cause withdrawal or discontinuation symptoms when a dose is reduced, doses are missed, or treatment is stopped. The symptoms depend on the medicine, dose, how long it has been used and the individual. They can sometimes resemble a return of the original mental health condition, which is one reason it is important not to diagnose the cause yourself.
Antidepressants, benzodiazepines and some sleeping medicines are particularly associated with withdrawal symptoms. Some antipsychotics can also cause symptoms after sudden discontinuation, while stopping them abruptly may increase the risk of the original psychiatric symptoms returning.
If you are considering reducing or stopping a prescription medicine, speak to the doctor or other healthcare professional responsible for your treatment first. A gradual, individually planned reduction may be needed. Do not suddenly stop a mental health medicine simply because you think it is causing withdrawal symptoms.
For information about unwanted effects while taking these medicines, visit the Mental Health Medication Side Effects hub.
Get urgent medical help if you have a seizure, severe confusion, hallucinations that make you unsafe, suicidal thoughts, an urge to harm yourself or someone else, severe agitation, fainting, chest pain or difficulty breathing. Seek emergency care even if you are unsure whether medicine withdrawal is responsible.
How mental Health Medication Withdrawal Symptoms can be linked to medicines or supplements
Withdrawal symptoms can develop when the body has adapted to the presence of a medicine and its dose is then reduced or stopped. They may also occur after missed doses with some medicines.
Withdrawal is not the same thing as addiction. For example, antidepressants are not generally classified as dependence-forming medicines, but they can still cause withdrawal symptoms. Benzodiazepines and Z-drugs, on the other hand, can cause physical dependence as well as withdrawal.
Timing clues
The timing of symptoms can help a healthcare professional assess whether withdrawal may be involved.
Possible clues include:
- symptoms beginning after a dose reduction, missed doses or stopping treatment;
- symptoms appearing relatively soon after the change;
- new symptoms that were not part of the original condition;
- symptoms that feel noticeably different or more intense than those experienced before treatment; or
- symptoms changing when the medicine reduction plan is adjusted.
NICE notes that withdrawal can be difficult to distinguish from a return of the underlying condition. Rapid onset after a reduction, symptoms that feel different from the original illness, and new symptoms can all provide useful clues, but they do not prove the cause.
If symptoms followed a forgotten dose rather than a planned reduction, see the guide to missed antidepressant dose side effects.
Herbal remedies and supplements should also be included when you discuss symptoms with a doctor or pharmacist. Some products can interact with mental health medicines. For example, St John’s wort can interact with antidepressants. Do not assume that a supplement is harmless or that stopping it is necessarily responsible for new symptoms.
Medicines and product categories that may be associated with this symptom
Possible medicine categories
Antidepressants
Antidepressant withdrawal can occur after stopping treatment, reducing the dose or, with some medicines, missing doses. Possible symptoms include headache, nausea, sweating, dizziness, sleep disturbances, tiredness, irritability, anxiety, low mood, difficulty thinking, palpitations and unusual sensory feelings sometimes described as “electric shocks” or “brain zaps”.
The risk, timing and severity vary between medicines and individuals. A doctor will usually help plan a gradual reduction rather than an abrupt stop. For more focused information, read about stopping antidepressants side effects and antidepressant discontinuation symptoms.
Benzodiazepines
Benzodiazepines used for anxiety, sleep problems or other conditions can cause physical dependence. Abrupt withdrawal or reducing them too quickly may cause anxiety, insomnia, tremor, sweating, palpitations, poor concentration and other symptoms. More severe withdrawal can include confusion or seizures, particularly in higher-risk circumstances.
Because potentially serious withdrawal can occur, benzodiazepines should not be suddenly stopped without professional guidance.
Sleeping medicines
Some prescribed sleeping medicines, particularly Z-drugs such as zopiclone and zolpidem, are also associated with dependence and withdrawal. Symptoms after stopping may include rebound insomnia, anxiety or restlessness. NICE recommends that withdrawal from Z-drugs and similar dependence-forming medicines is generally managed through an individualised, stepwise reduction rather than abrupt discontinuation.
Antipsychotic medicines
Antipsychotics require medicine-specific stopping advice. Suddenly stopping treatment may lead to the return of the condition being treated, and some medicines can also produce discontinuation symptoms. For example, sudden discontinuation of quetiapine can cause nausea, vomiting and difficulty sleeping.
Do not assume that anxiety, insomnia, agitation or changes in thinking after stopping an antipsychotic are simply withdrawal. They may also represent a recurrence of the underlying condition and should be assessed by the treating healthcare professional.
If your prescription has recently been changed rather than stopped, see changing mental health medication side effects. Symptoms that appeared after a prescribed dose increase may also be better covered by the guide to increasing antidepressant dose side effects.
Red flags: when this symptom may need urgent medical attention
Red flags
Seek urgent medical help if withdrawal or a medication change is accompanied by:
- a seizure or convulsion;
- suicidal thoughts or an urge to self-harm;
- thoughts of harming someone else;
- severe confusion or disorientation;
- hallucinations, severe paranoia or behaviour that makes you or another person unsafe;
- extreme agitation or a significant, rapidly worsening change in mental state;
- fainting or loss of consciousness;
- severe chest pain;
- difficulty breathing; or
- any rapidly worsening symptoms that you cannot safely manage.
Abrupt benzodiazepine withdrawal can, in some circumstances, cause serious neurological or psychiatric symptoms, including seizures. Suddenly stopping an antipsychotic can also increase the risk of relapse.
Do not wait to establish whether withdrawal is definitely responsible before seeking emergency help.
You should also contact a doctor or pharmacist promptly if symptoms are worsening, preventing you from functioning normally, continuing longer than expected, or making it difficult to follow an agreed medicine-reduction plan.
What to track before speaking to a doctor or pharmacist
What to track
A simple record can make it easier for a healthcare professional to work out what may be happening.
Write down:
- the exact name of each prescription medicine you take;
- the strength and usual dose;
- when you last took it;
- whether any doses were missed;
- when the dose was reduced or treatment was stopped;
- whether the change was planned with your prescriber;
- when symptoms began;
- what each symptom feels like;
- whether symptoms are improving, worsening or fluctuating;
- sleep changes;
- changes in anxiety, mood, concentration or behaviour;
- any physical symptoms such as nausea, dizziness, tremor, sweating or palpitations;
- other prescription or over-the-counter medicines;
- vitamins, herbal remedies and supplements;
- alcohol or other substances that might affect symptoms; and
- anything that makes the symptoms noticeably better or worse.
The medicine packet, dispensing label and patient information leaflet can also be useful when speaking to your pharmacist or doctor.
This information does not confirm that withdrawal is the cause. It helps your healthcare professional distinguish possible withdrawal from medicine side effects, interactions, a recurrence of the original condition or an unrelated health problem.
For other symptom-based information, use the side effect symptoms A-Z.
What not to do without medical advice
What not to change without advice
Do not try to manage suspected withdrawal by making repeated unsupervised changes to a prescription.
Unless a qualified healthcare professional has specifically instructed you to do so:
- do not suddenly stop a prescribed mental health medicine;
- do not skip doses to make the medicine last longer;
- do not halve, crush or split tablets unless the medicine can safely be taken that way;
- do not increase the dose because withdrawal symptoms have appeared;
- do not restart an old prescription without checking first;
- do not use someone else’s medicine;
- do not replace the medicine with alcohol, sedatives, herbal products or another drug; and
- do not copy another person’s withdrawal schedule.
There is no single reduction schedule that is appropriate for everyone. NICE advises that withdrawal planning should take factors such as the specific medicine, dose, duration of treatment, previous withdrawal symptoms, other medicines and the person’s individual circumstances into account.
If you are pregnant or breastfeeding, the medicine is being used by a child or older adult, or you have several medical or psychiatric conditions, discuss any proposed medicine change with an appropriate healthcare professional.
Related side-effect guides and reporting options in South Africa
Related symptom guides
If you are trying to work out whether symptoms are related to a medicine, the Mental Health Medication Side Effects hubis the main starting point for this topic.
You can also explore broader medication side effects information or use the side effect symptoms A-Z to look at a particular symptom.
If you suspect that a medicine caused an adverse reaction, you can also report side effects in South Africa. SAHPRA’s Med Safety App allows members of the public and healthcare professionals to submit suspected adverse drug reaction reports. Reporting a suspected reaction helps medicine-safety monitoring, but it does not replace medical assessment or treatment.
Frequently asked questions
Is mental health medication withdrawal a common side effect?
Withdrawal can occur with several mental health medicine categories, but the likelihood differs considerably between medicines and individuals. Antidepressants can cause withdrawal symptoms, while benzodiazepines and Z-drugs are recognised as medicines associated with dependence and withdrawal. Some people experience few or no symptoms, while others have more significant difficulties.
How long can mental health medication withdrawal symptoms last?
There is no single timeline. It depends on the medicine, dose, duration of treatment, how quickly it was reduced and the individual.
For antidepressants, symptoms commonly begin within days of reducing or stopping and may last several weeks, although some people experience later, more severe or longer-lasting symptoms. Other medicines have different withdrawal patterns.
Contact your doctor or pharmacist if symptoms persist, become severe or are difficult to manage.
Should I stop the medicine if I think it is causing withdrawal symptoms?
No. Withdrawal symptoms generally occur because a medicine has already been reduced, missed or stopped, and making further unsupervised changes may make the situation harder to assess or potentially unsafe.
Speak to the prescriber or pharmacist about what has happened and what to do next. Do not suddenly stop prescription mental health medication unless a qualified healthcare professional has advised you to do so.
When should I seek help?
Speak to a doctor or pharmacist if symptoms appear after missing doses, lowering a dose or stopping a mental health medicine, particularly if they are troublesome, worsening or affecting your daily life.
Get urgent medical help for seizures, suicidal or self-harm thoughts, severe confusion, dangerous hallucinations, extreme agitation, fainting, chest pain, breathing difficulty or any other rapidly worsening symptoms.
Medical information notice: This information is for general education and cannot determine whether your symptoms are caused by medicine withdrawal. Do not use it to diagnose yourself or to make prescription changes. Check possible medicine-related causes, keep a record of your symptoms and medicine changes, and speak to a doctor or pharmacist if you are concerned.