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Key Takeaways
- If you miss a single dose of antidepressants, you may experience mild, short-term symptoms like nausea and dizziness due to a drop in medication levels in your body.
- Take it as soon as you remember, unless it’s close to the time of your next dose; then just skip it and take your next dose as scheduled to avoid doubling up.
- Taking your medication consistently and talking to your doctor before making any medication changes can help you avoid uncomfortable discontinuation symptoms.
Missing a dose of your antidepressant can lead to flu-like symptoms such as upset stomach, achiness, and dizziness. These temporary symptoms are known as antidepressant discontinuation syndrome (ADS), which happens when your body reacts to a sudden dip in the medication levels. While skipping one pill usually isn’t harmful, some people may feel the effects more strongly than others.
How Missing One Dose of Antidepressants Can Affect You
Missing a dose of Zoloft or another antidepressant may be enough to trigger symptoms of discontinuation syndrome in some people. For many people, discontinuation syndrome symptoms may be quite mild, but others may find them particularly difficult to cope with. Some of the most common symptoms include the following.
- Agitation
- Anxiety
- Blurred vision
- Chills
- Dizziness
- Fatigue
- Headache
- Insomnia
- Irritability
- Muscle pain
- Nausea
- Runny nose
- Sweating
- Tingling sensations
- Tremor
- Vivid dreams
Less common symptoms are:
- Electric shock sensations
- Hallucinations
- Hypertension
- Lack of coordination
How long do these symptoms last?
Rest assured that these symptoms:
- Generally tend to be mild
- Usually go away within one to two weeks
- Are easily treatable if they become moderate or severe
Why You Might Have These Symptoms After Missing a Dose
There are several different causes of discontinuation syndrome. Here is an overview of the most common causes of your symptoms.
- Suddenly stopping your antidepressant: If you’ve been taking an antidepressant for a month or more and you suddenly quit taking it, you’re far more likely to have discontinuation symptoms than if you had tapered off slowly. It may take one to four days before you notice symptoms. For example, missing a Lexapro dose (or a few doses) might cause you to begin experiencing symptoms over the next few days.
- Tapering off of your antidepressant too quickly: Especially if you’ve been taking a high dose or you’ve been on an antidepressant for an extended period of time, a slow and gradual tapering schedule is necessary to prevent discontinuation symptoms.
- Missing or skipping a dose or two of your antidepressant: It’s estimated that up to 70% of people who take antidepressants skip doses here and there. However, doing this increases your risk of developing discontinuation symptoms, especially if you’re taking an antidepressant with a short half-life. These types are eliminated from your body so rapidly that discontinuation symptoms may appear fairly soon after a missed dose, sometimes within hours.
- Switching to a different formulation: Though this isn’t common, if you’re going from a brand-name antidepressant to a generic or from one generic to another made by a different company, the formulation may be different enough to experience discontinuation symptoms.
Suddenly discontinuing or significantly and quickly lowering your dose of any type of antidepressant puts you at risk for discontinuation symptoms.
The most common culprit seems to be immediate-release Effexor (venlafaxine) because it has a half-life as short as three to five hours, and it’s also the most likely antidepressant to cause these symptoms when you miss a dose or take it late.
Other more common culprits of discontinuation syndrome include:
- Paxil (paroxetine)
- Pristiq (desvenlafaxine)
- Zoloft (sertraline)
- Elavil (amitriptyline)
- Tofranil (imipramine)
- All monoamine oxidase inhibitors (MAOIs)
How common is it to have symptoms?
Research suggests that around 70% of people who are prescribed antidepressants miss doses occasionally. Around 40% of those who suddenly stop taking their medication experience symptoms of antidepressant discontinuation syndrome.
How to Feel Better After You Miss a Dose
Treatment for discontinuation syndrome may involve restarting the medication and then slowly tapering. In some cases, however, people may be unwilling or unable to restart the medication, particularly if they experienced severe or significant side effects.
Discontinue syndrome is less frequent and severe when taking Prozac (fluoxetine), so your doctor may recommend switching to that drug before you stop taking your medication.
If restarting and tapering the medication is not an option, withdrawal symptoms will typically resolve within one to two weeks. The most severe symptoms often begin to improve within one to three days. During this time, supportive self-care can help people manage symptoms until they recover.
How to Stop It From Happening Again
So how can you prevent discontinuation symptoms from happening?
- First, if you do miss a dose of your antidepressant, don’t panic. It happens to the best of us.
- Go ahead and take it as soon as you remember, unless it’s close to time for your next dose.
- In that case, don’t double up; just skip the missed dose and take your next dose as usual.
Here are some other ways to prevent discontinuation syndrome.
Take Medicine on Time
The best way to avoid having these symptoms is to be very careful with properly timing your medication dose. Taking your medication as prescribed also makes it as effective as possible in treating your depression symptoms.
One good way to make sure you take your medicine at the right time is to set alarms in your calendar or clock on your smartphone or computer.
If you’re not a techie, consider using an old-fashioned alarm clock, writing yourself notes, leaving your medicine out where you can see it, setting an alarm on your watch, and/or getting a pill box for each day of the week.
Think About Switching
If you’re finding taking your medication on time difficult to manage, consider asking your doctor about trying a different antidepressant with a longer half-life or an extended-release formula so you don’t have to take it as often.
For instance, Prozac (fluoxetine) has a half-life of four to six days, so it takes longer to completely clear out of your body than other antidepressants. This means that the likelihood of having discontinuation symptoms if you miss a dose is pretty low.
Missing a dose of Prozac would result in fewer symptoms than missing a dose of Zoloft or Effexor.
Talk to Your Doctor Before Stopping
If you ever need to stop taking your antidepressant altogether, you should always consult with your doctor first.
Don’t ever stop your antidepressant without your doctor’s knowledge.
Depending on what you’re taking, how long you’ve been taking it, and the dosage, they can help you avoid discontinuation syndrome by creating a plan to gradually and slowly taper you off your medication if needed.
Does This Mean I’m Addicted to Antidepressants?
Discontinuation syndrome is quite common. Although many experts refer to this phenomenon as withdrawal, experiencing antidepressant discontinuation syndrome doesn’t mean that you’re addicted.
Antidepressants are rarely habit-forming and don’t create the cravings, euphoric effects, tolerance, or drug-seeking behavior that are seen with drugs of abuse. Another difference is that symptoms of discontinuation syndrome are generally milder and last for less time than symptoms of illicit drug withdrawal.
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