I have been on Prozac for over 35 years. I am a high risk patient. About 20 years ago I did try to taper off and went into a deep depression. Since that time I’ve accepted the fact that Prozac keeps me from going into deep depression. However, a part of me would really like to not take any drug. But this might be my ego speaking. Prozac has seemed to work for me, but I do believe that my brain has been permanently altered. I wish there was some way of finding out if it has. I’m 75 now and I don’t plan on going off Prozac in my last 10 to 20 years of life. But your article is very interesting even though I don’t understand a lot of it. I will continue to talk to my psychiatrist about this, but he has felt that I need to continue taking Prozac. At this time, I agree with him. But I sure wish there was some way of knowing how the Prozac use of 35 years has altered my brain. Thank you for the information.
How do people differentiate return of natural symptoms and delayed withdrawal? I believe many are like me and still have anxiety and depression even while on an ssri, so would that be a sign that return of symptoms on discontinuation is a reflection of an underlying default state? Maybe as well as withdrawal. I’ve tried to come off ssris a few times over the years and always had to go back on. Two of the times it all seemed like it was going well until the 6 month mark. I feel like 6 months was a time when something changed. Thanks for the article, the technicalities are over my head but I get the gist and do believe withdrawal must be possible. Sorry to hear about your journey w mirtazapine, hope you’re ok.
Brilliant, vital. Two thoughts: first, thank you for the gentle blade insertion re: how one should look broadly at institutions when considering the dearth of research on w/d. Second, you mention winnowing to people at high-risk people prior to w/d studies to enrich the sample and decrease the noise. Tricky, that, no? But I think there might be such a group, just based on clinical experience, viz people living with bipolarity, especially those already in a mixed state on an antidepressant. It seemed to me that nearly everyone in that group was highly vulnerable to withdrawal -- versus my primary care colleagues' experience, where so few had major problems that the PCPs didn't even routinely prescribe the lowest available dose (Phelps et al, 2025).
Thank you for your work, and this essay, and sorry to hear about what you've had to go through to learn about all this so directly. JP
This is interesting but also quite terrifying. I was thinking of tapering from Venlafaxine, and this article might have given me enough anxiety that I probably still need Venlafaxine
I have been on Prozac for over 35 years. I am a high risk patient. About 20 years ago I did try to taper off and went into a deep depression. Since that time I’ve accepted the fact that Prozac keeps me from going into deep depression. However, a part of me would really like to not take any drug. But this might be my ego speaking. Prozac has seemed to work for me, but I do believe that my brain has been permanently altered. I wish there was some way of finding out if it has. I’m 75 now and I don’t plan on going off Prozac in my last 10 to 20 years of life. But your article is very interesting even though I don’t understand a lot of it. I will continue to talk to my psychiatrist about this, but he has felt that I need to continue taking Prozac. At this time, I agree with him. But I sure wish there was some way of knowing how the Prozac use of 35 years has altered my brain. Thank you for the information.
How do people differentiate return of natural symptoms and delayed withdrawal? I believe many are like me and still have anxiety and depression even while on an ssri, so would that be a sign that return of symptoms on discontinuation is a reflection of an underlying default state? Maybe as well as withdrawal. I’ve tried to come off ssris a few times over the years and always had to go back on. Two of the times it all seemed like it was going well until the 6 month mark. I feel like 6 months was a time when something changed. Thanks for the article, the technicalities are over my head but I get the gist and do believe withdrawal must be possible. Sorry to hear about your journey w mirtazapine, hope you’re ok.
Brilliant, vital. Two thoughts: first, thank you for the gentle blade insertion re: how one should look broadly at institutions when considering the dearth of research on w/d. Second, you mention winnowing to people at high-risk people prior to w/d studies to enrich the sample and decrease the noise. Tricky, that, no? But I think there might be such a group, just based on clinical experience, viz people living with bipolarity, especially those already in a mixed state on an antidepressant. It seemed to me that nearly everyone in that group was highly vulnerable to withdrawal -- versus my primary care colleagues' experience, where so few had major problems that the PCPs didn't even routinely prescribe the lowest available dose (Phelps et al, 2025).
Thank you for your work, and this essay, and sorry to hear about what you've had to go through to learn about all this so directly. JP
Hello!
This is interesting but also quite terrifying. I was thinking of tapering from Venlafaxine, and this article might have given me enough anxiety that I probably still need Venlafaxine