The Withdrawal and Damage I Was Never Warned About

Part 1: Personal History and First Withdrawal Injury

I was prescribed antidepressants at age 31 following an unexpected divorce and postpartum depression after the birth of my daughter in 2001. That crisis was situational. I had no prior history of anxiety or depression requiring medication. This marked the beginning of over two decades on psychiatric drugs.

The first time I was injured by antidepressant withdrawal occurred in 2006. I discontinued Paxil 20 mg over a couple of weeks under my GP’s supervision.

Months later, in September 2006, I experienced what I now recognize as post-acute withdrawal syndrome and akathisia. It felt like being trapped at the peak of a panic attack that would not end—an extreme state of agitation accompanied by compulsive movement, twitching, pacing, involuntary head movements, and an overwhelming sense of doom and dread. The world around me suddenly felt alien and threatening.

I was hospitalized and placed back on multiple medications. I was told I should never have discontinued antidepressants. No one mentioned akathisia or withdrawal. I was discharged on Effexor, Wellbutrin, and Clonazepam.

Part 2: Long-Term Use and Sensitization

After that hospitalization, I remained on antidepressants for 15 years, believing they were necessary to prevent another breakdown. I cycled through Effexor, Paxil, and Citalopram under the assumption that I had a “chemical imbalance.”

What I was not told was that long-term use can lead to emotional blunting and that withdrawal can be mistaken for relapse.

Over time, I became emotionally flat and increasingly detached. I lost the ability to feel joy, connect deeply with others, or respond emotionally to my daughter. I also lost motivation and a sense of meaning. This gradual decline went unrecognized as a medication effect.

In 2018, Citalopram stopped working. While still taking it, I began experiencing symptoms I now recognize as withdrawal-related: fatigue, cognitive slowing, heat and cold intolerance, presyncope, and worsening emotional blunting. Multiple medication trials between 2018 and 2019 failed to resolve these issues. I returned to Effexor in 2019, but my system had become increasingly sensitive.

Despite this, my life was stable. I had a supportive marriage, a steady career, and no major depressive episodes. I decided I wanted to discontinue medication.

My psychiatrist discouraged this, citing a high risk of relapse based on my 2006 hospitalization. The possibility that my prior episode was withdrawal-related was never considered.

I tapered slowly over eight months in 2021. During the taper, I experienced manageable symptoms. By late summer, I was functioning reasonably well.

Part 3: The Second Withdrawal Injury

On October 1, 2021, I experienced an abrupt and severe onset of symptoms.

Without warning, I was plunged into an unbearable panic-like state that did not let up, with a powerful urge to escape my own body and a relentless sense of doom, dread, and hopelessness. I recognized it immediately as the same phenomenon I had experienced in 2006: akathisia.

This time, however, it was primarily mental rather than outwardly physical. I did not have the same degree of pacing or involuntary movement, but the internal experience was every bit as severe.

This episode was accompanied by physical symptoms including severe fatigue, gastrointestinal distress, cognitive impairment, and complete loss of appetite resulting in significant weight loss.

I reinstated Effexor, gradually returning to 75 mg, and stabilized by March 2022.

Since then, I have been tapering extremely slowly, generally reducing my dose by only 3–5% every 8–10 weeks. Avoiding another severe withdrawal episode is critical to maintaining my ability to function. In 4 years and 5 months I have tapered down to 11 mg, with each taper becoming harder and harder.

Part 4: Long COVID — Another Layer of Injury

In September 2022, while I was still recovering and tapering, I contracted COVID-19. After that infection, many of my existing problems became significantly worse.

Before COVID, my sense of smell was exceptionally strong. It is now profoundly diminished, and my sense of taste has changed as well. The fatigue, cognitive problems, sensory intolerance, and other neurological symptoms I was already experiencing also worsened following the infection.

I believe I may also be suffering from Long COVID. Because many Long COVID symptoms overlap with antidepressant withdrawal—including fatigue, cognitive dysfunction, autonomic and sensory symptoms—it is impossible for me to cleanly separate the contribution of each.

What I do know is the sequence: many of these problems began years before COVID, during long-term antidepressant treatment and withdrawal, and then became substantially worse after my September 2022 infection. I believe the two conditions may now be compounding one another.

Part 5: Message to the FDA and Other Patients

I am sharing my experience because current guidance around SSRI use and discontinuation does not adequately reflect the risks.

At no point in over 20 years of treatment was I informed about the potential for protracted withdrawal, post-acute symptoms, or akathisia.

My experiences in 2006 and 2021 were not simply relapses of depression. The timing, symptoms, and nature of these episodes were profoundly different from the situational depression for which I was originally prescribed antidepressants.

SSRIs are widely presented as safe and relatively easy to discontinue. In practice, discontinuation can be underestimated, poorly managed, and sometimes devastating.

Patients are not consistently given informed consent regarding the risks of withdrawal. Withdrawal symptoms may also be misinterpreted as relapse, leading patients back onto medications without recognizing what actually happened.

If I had been adequately informed of these risks, I would have made different choices.

I am asking the FDA and the medical community to:

• Update antidepressant labeling to explicitly warn about severe and protracted withdrawal syndromes, including akathisia and symptoms that may persist for months or longer.
• Provide patients with meaningful informed consent about dependence and withdrawal before beginning antidepressants and before discontinuation.
• Support research into protracted antidepressant withdrawal, nervous-system sensitization, and evidence-based tapering strategies.
• Recognize that antidepressant withdrawal can be severe, prolonged, disabling, and easily mistaken for psychiatric relapse.

Part 6: The Real Cost

The most significant impact has been the loss of cognitive and functional capacity.

I am a federal contracting officer, managing complex negotiations with detail-intensive responsibilities. I can no longer sustain attention for complex documents, process and retain new information as I once did, or consistently perform tasks that were previously routine.

My tolerance for stimulation has also changed. Noise, crowds, and other sensory input can now become overwhelming and exhausting.

I am now pursuing disability retirement because I can no longer reliably meet the cognitive demands of my job.

I cannot say with certainty how much of my current impairment comes from long-term antidepressant exposure and withdrawal, how much comes from Long COVID, or how the two may interact. But the severe withdrawal and akathisia occurred before I ever had COVID, and my decline became substantially worse after the infection.

Even now, when I raise the possibility of antidepressant withdrawal, I am often met with skepticism or told that my symptoms are anxiety. That dismissal adds another layer of harm.

People considering antidepressants deserve to know that severe and prolonged withdrawal can occur. They deserve informed consent before starting these medications, careful medical support if they decide to stop, and clinicians who recognize that withdrawal symptoms are not automatically evidence that the original psychiatric illness has returned.

I am sharing my story anonymously because I want other patients to have information I did not have. I’m not sure I will ever be able to totally taper off Effexor. I’m not sure if I’m going slow enough that my post-taper withdrawal will be minimal. I will then have to taper a long-term benzo. I try to maintain hope, but the past 8 years have been very painful.

If this helps someone avoid antidepressants altogether or recognize the real effects of antidepressants sooner than I did, telling this story will have been worthwhile. This will be the informed consent that I never got.