Withdrawal Symptoms

July 27, 2006 7:58 PM

What is the name of the condition caused by abrupt discontinuance of anti-depressent medications like Xanax... said condition is described as a feeling of immense internal physical pressure/stress/twisting...

and could you have the same symptoms from stopping taking 20mg of ritalin a day?

I saw a wikipedia artical on withdrawal that mentions rebound "An unsupervised acute withdrawal from the use of an antidepressant can deepen the feel of depression significantly (see "rebound" below), and some specific antidepressants can cause a unique set of other symptoms as well when stopped abruptly. A combination of these factors has been reported by many patients to be quite horrible to endure." but what I am thinking of had a specific name and its symptoms were closer to what I tried to describe.

posted by kaytrem to health & fitness (10 comments total)

Is Xanax used as an anti-depressant? It's a benzodiazepine, mainly used as an anti-anxiety medication. It is highly addictive, and if taken long-term must be stopped slowly and carefully.

The usual SSRI is not addictive in the same sense that Xanax is. Sudden discontinuation can cause problems, but for different reasons. Unlike something like Xanax, I don't think the possibility of "withdrawal" symptoms is certain with an SSRI (but it can trigger another depressive episode, so it's serious).

Ritalin is not addictive taken at the prescribed doses. I know from direct experience (and advice of doctors), that starting and stopping it at whim is completely safe. (Although some pharmacists will be super cautious and tell you not to stop it suddenly without your doctor's advice). I've never noticed any problems from stopping Ritalin, even when I went from 40-50 mg a day over weeks to 0 mg a day.
posted by teece at 8:13 PM on July 27, 2006

Are you talking about delirium tremens? It's often associated with benzo withdrawal, but is usually associated with hallucinations. Still, other symptoms include tremors and anxiety similar to what you are describing.
posted by brina at 8:18 PM on July 27, 2006

People coming on and off Effexor report "the zaps." It is, in a word, horrible.
posted by five fresh fish at 10:43 PM on July 27, 2006

The common one people experience with antidepressants is often referred to as SSRI discontinuation syndrome. Neither Xanax nor Ritalin operate on the same neurotransmitters though (GABA and dopamine respectively).
posted by Freaky at 12:12 AM on July 28, 2006

Discontinuing SSRIs and other antidepressants (like effexor and wellbutrin) without a taper can give you some really unpleasant withdrawal symptoms. People often feel jittery and have headaches and stomach upset, among other things. It's generally uncomfortable rather than dangerous.

Xanax, as teece said, is a benzodiazepine, which have a mechanism very similar to alcohol. Withdrawal from either benzos or alcohol is a medical emergency, as it can lead to DTs and seizures.

Ritalin is methylphenidate, which is quite different from either antidepressants or benzos. Although there's some controversy about exactly how it works, the general idea is that ritalin increases dopamine release and blocks its reuptake. There is not generally a problem with withdrawal at therapeutic doses (and 20mg is a very reasonable dose), but you can ask your doctor to taper you if you're uncomfortable.

Last thing: if you're on the SR, don't try to cut or crush the tablets to get a lower dose.
posted by LittleMissCranky at 12:21 AM on July 28, 2006

also, benzos (like xanax) have the longest withdrawal period. Not a lot of insurance plans cover benzo detox because it takes so much longer...perhaps what you are looking for is "benzodiazepine withdrawal syndrome." I don't know anything about ritalin withdrawal, but it's a completely different class of drug as many have already pointed out.
posted by chelseagirl at 5:00 AM on July 28, 2006

Cold turkey?
posted by Thorzdad at 6:34 AM on July 28, 2006

I'm in the throes of withdrawal from a tricyclic antidepressant this month. I haven't been able to eat right since I started tapering at the end of June. Finally, when three days had passed since my last dose, I started having complete flu-like symptoms. My psychiatrist asked detailed questions about them and here's what she came up with:

The achy head, achy bones, writhing pain and poor temperature regulation were all symptoms of serotonin withdrawal. She prescribed a single 20 mg pill of prozac, and those symptoms went away within an hour. Magic! Prozac has a longer half-life, so I didn't withdraw from that one dose.

The twisty, nervous, upset stomach symptoms sounded like it had to do with acetylcholine to her, which she had no drug for. I took some ativan (benzodiazepine) for a couple days to help with the anxiety and nausea, but the withdrawal symptoms from ativan are the same ones it treats, so I quit that after a couple days out of fear.

I can sleep now and go to work, but I almost always still have the pressure in my gut. Apparently there are a lot of serotonin receptors there, and anything that affects the vagus nerve will make these symptoms, too, which is where I think the acetylcholine part comes in. I'm eating foods that are easy to digest.

What I can't believe is how little information there is online about this. I'd love to know if it has a name.

On the bright side, I've lost the ten pounds that I've been hating for a few years.
posted by aimless at 8:50 AM on July 28, 2006 [1 favorite]

I have been through something like this. It was an extremely unpleasant side effect of withdrawal from medication. This sounds like the same thing, and the term for it is Akathisia.
posted by jefeweiss at 9:05 AM on July 28, 2006

It's a real syndrome - it will pass - feels like you are going to jump out of your skin - but a slower discontinuance would have helped. Really slow -across 6 -8 months. On some SSRI's you can't completely avoid it - so plan for it if you are going to discontinue. Just part of the package. Some other SSRI's like Prozac with a shorter half life might help. Just know it will end.
posted by trii at 4:56 PM on July 29, 2006