cross tapering antidepressants

Cross-Tapering Antidepressants

The word “addiction” and its derivatives are often used loosely, as in, “I’m practically addicted to golf” or “Social media is designed to be addictive.” That’s unfortunate, because describing every habit as an “addiction” belittles the pain of the nearly 20 million Americans with genuine substance use disorder, who live daily with irresistible cravings that are slowly destroying their careers, their health, and their families—and who can’t seem to quit no matter how hard they try. How does addiction differ from a dependence on drugs like antidepressants?

It’s Not Addiction, It’s Dependence

Part of the problem is that people confuse dependence with addiction. It’s entirely possible to develop physical dependence on a medication without ever being literally addicted.

The difference is that the negative effects of dependence begin and end with temporary physical symptoms (“discontinuation symptoms” in medical terminology) if you quit a prescription cold. Addiction, by contrast, is completely life-consuming: focus on the drug pushes everything else (including human relationships and self-care) to the side. And even after someone gets off an addictive drug, an intense pull to relapse can be generated by any sight, sound, or smell that triggers memories of the “good old days” when the drug offered easy escape from cold, hard reality.

Dependence is a minor problem by comparison, but that doesn’t mean it’s harmless—or that “just quitting” is a good idea. Consider antidepressants, one of the least addictive drug categories. If you’ve been taking antidepressants and abruptly stop, discontinuation symptoms may include:

  • Poor balance
  • Dizziness
  • Confusion
  • Anxiety
  • Extreme fatigue
  • Insomnia
  • Nausea
  • Headaches, or a feeling that “electric shocks” are surging through your head.

To avoid the discontinuation-symptoms problem, doctors recommend tapering off (taking gradually smaller doses) over several weeks. This gives physical dependence a chance to also taper off, as the brain adjusts to life without the antidepressant.

Cross-Tapering Antidepressants: A Search for the Best Medicine

Unfortunately, a different “tapering” concern surfaces for many antidepressant consumers barely after they start medication. Antidepressants are notoriously difficult to match with any individual patient’s brain chemistry: many people have to try several medications before finding one that really works. What happens if an antidepressant isn’t working for you after several weeks, your doctor recommends switching to another—and your body has already built up physical dependence on the first antidepressant?

One answer is cross-tapering: slowly decreasing doses of the first medication while simultaneously increasing doses of the second. Cross-tapering isn’t always the best approach—some antidepressant types generate unpleasant interactions when “crossed,” and with two similar medications it’s often easier to simply stop the old and begin the new—but cross-tapering can be a highly effective way to discontinue a less effective medication without suffering discontinuation symptoms. And when the right antidepressant for you is finally pinpointed, relief from the symptoms of major depressive disorder makes all the trouble worth it.

If You Feel Ready to Discontinue Antidepressants

Helpful as the right antidepressant can be, there are potential concerns with taking them indefinitely. Side effects such as insomnia or weight gain can arise with long-term use. Some people report becoming emotionally numb or losing personal initiative.

If you want to get off antidepressants altogether, the first rule is: Always consult your doctor for a second opinion on whether you’re really ready to stop. Many people stop taking antidepressants (and other medical drugs) because they feel better and assume they’re cured. In fact, they feel better becausethe medicine is still working, and stopping it may have worse consequences than discontinuation symptoms: the original problem, no longer restrained by the drug, may come surging back full force. Following your doctor’s advice on when and how to quit antidepressants is your best protection against that scenario.

Contact Recovery Without Walls for Prescription Drug Addiction Treatment

Antidepressants aren’t addictive, but many other prescription drugs are—and many opioid and benzodiazepine addictions start with attempts to medicate depression. If you have a substance use disorder of any kind, and especially if your responsibilities preclude a lengthy inpatient stay, Recovery Without Walls may be the program you need. We are also prepared to help you discontinue or change antidepressants.

Contact us today to learn more about our holistic approach to detox and recovery. (We also offer treatment for chronic physical pain.)