Discontinuation: Help with Stopping or Changing Medications

An Introduction to SSRI/SNRI Discontinuation Syndrome

“Antidepressants broadly, and SSRIs/SNRIs specifically, are among the most commonly prescribed medications providing benefit to millions of people suffering from depressive and anxiety disorders. Unfortunately, many medications will have some potential side effects that often need to be managed, and antidepressants are not immune from that possibility.”

– Adrian Kress, MD, Psychiatrist and Pharmacologist

 

Russell Carr, MD Middle Schoolers and above	Brent Donmoyer, PMHNP Middle Schoolers and above	Adrian Kress, MD Ten year-olds and above

Are you thinking about stopping or reducing a psychiatric medication?

You’re not alone—and you don’t have to go through it without expert support. At Kentlands Psychotherapy, we specialize in helping individuals navigate the often-complex process of discontinuing, reducing, or changing psychiatric medications safely and thoughtfully.

People seek this service for many reasons: some feel better and want to see how they do without medication; others struggle with side effects, feel stuck, or simply question whether their current medication is still helping. No matter the reason, we’re here to help you make a change in the most stable, informed, and supported way possible.

Request an Appointment

What Is Discontinuation Assistance?

Discontinuation assistance is a specialized service designed to support people as they reduce, stop, or transition between psychiatric medications. It’s a delicate process—often misunderstood or oversimplified—that can bring real risks if not managed carefully. Withdrawal symptoms, emotional instability, or the return of distressing mental health symptoms are all possibilities when medication is changed too quickly or without adequate support.

At Kentlands Psychotherapy, our psychiatric providers use a thoughtful, evidence-informed approach to guide the process. We develop personalized tapering plans that minimize risk, support neurological stability, and respect your goals—whether you’re stepping off a medication entirely or transitioning to a different one.

Understanding the Symptoms

SSRI Discontinuation Syndrome can occur when individuals stop their medication at higher doses, and sometimes even if they gradually lower the doses. For example, the abrupt stopping sertraline, venlafaxine, or duloxetine can cause symptoms that can be distressing and, at times, overwhelming. To help you recognize and understand these symptoms, we use the mnemonic FINISH:

1. F – Flu-like Symptoms: Patients may experience flu-like symptoms, such as fatigue, muscle aches, and headaches.
2. I – Insomnia: Sleep disturbances, including trouble falling or staying asleep, are common during discontinuation.
3. N – Nausea: Many people experience gastrointestinal discomfort, including nausea and vomiting.
4. I – Imbalance: Discontinuation syndrome can lead to dizziness, vertigo, or unsteadiness.
5. S – Sensory Disturbances: Patients might encounter sensory disturbances, like tingling, “electric shock” or “brain zap” sensations, or heightened sensitivity to stimuli.
6. H – Hyperarousal: Increased anxiety, irritability, and heightened emotional states are often reported.

Our Approach to Avoiding These Outcomes

Reducing or stopping psychiatric medication is not simply a matter of cutting pills in half or skipping doses. Each person’s brain, body, and history with medication is different. Without a personalized plan and expert oversight, even small changes can lead to big problems, including withdrawal symptoms that mimic or worsen the very symptoms the medication was initially treating.

At Kentlands Psychotherapy, we take these concerns seriously. Our approach is slow, intentional, and grounded in current best practices—so you can make changes with clarity, stability, and confidence.

Therefore, our strategy revolves around the following:

1. Comprehensive Informed Consent: We firmly believe that informed decisions are the best decisions. We provide thorough informed consent sessions to ensure that you understand the potential risks, benefits, and alternatives when considering medication changes.

2. Customized Tapering Plans: We don’t believe in “one-size-fits-all” plans when it comes to reducing or discontinuing psychiatric medication. Instead, we design personalized taper protocols that take into account your medication type, dosage, length of use, and overall mental and physical health.

One evidence-informed approach we often use is hyperbolic tapering, which recognizes that a drug’s effects on the brain don’t decrease in a straight line as the dose gets smaller. Instead, lower doses often have disproportionately greater impact—so making the same size cut at the end of a taper can lead to more severe withdrawal symptoms than at the beginning. Hyperbolic tapering slows the reduction rate toward the end of the taper, giving your brain more time to adapt and reducing the likelihood of withdrawal symptoms or emotional destabilization. It’s a gentle, neuroscience-informed strategy that prioritizes long-term success and patient comfort.

Whether we’re helping you step down from antidepressants, mood stabilizers, stimulants, or benzodiazepines, our prescribers use thoughtful, gradual methods to support both your physical and emotional well-being throughout the process.

3. Holistic Team-Based Approach: We understand that medication discontinuation can be challenging. Our integrated medical and psychological support team is here every step of the way, providing emotional support, coping strategies, and psychotherapy to help manage the emotional and psychological aspects of the process

We also consider the complete picture of your well-being. In some cases, we may recommend adjunctive supports—like therapy, nutritional guidance, lifestyle strategies, or mind-body techniques—to ease the transition and help you build new internal resources as medication is reduced.

Preventing Problems from the Start

In addition to helping individuals who are already on medications through the discontinuation process, we emphasize prevention. When working with clients just starting psychiatric medications, we will carefully select medications, set realistic expectations, and establish personalized titration protocols. We aim to minimize the risk of experiencing discontinuation syndrome from the outset.

Ready to Talk?

If you’re thinking about stopping or changing a psychiatric medication, let’s talk. We’ll help you explore your options, weigh the risks and benefits, and create a plan that respects your autonomy and well-being.

Reach out today to schedule a consultation with one of our experienced expert prescribers. You don’t have to navigate this alone—and with the right support, meaningful change is possible. Call 204-252-3349 for details and assistance with booking a consultation.

Our office is in the heart of the Kentlands, in Gaithersburg, Maryland. So we are close for most North Potomac, Potomac, Poolesville, Clarksburg, and Rockville, Montgomery County residents. Map the drive time from your house to our office and see for yourself!

Patient Resources

Learn more about Antidepressant Discontinuation Syndrome from the National Library of Medicine.f

Learn more about Clinical Practice Guideline Recommendations on Tapering and Discontinuing Antidepressants for Depression: A systematic review from the National Library of Medicine.