Antidepressants and psychiatric medication: side effects, timing, addiction worries, stopping

Antidepressants are medicines that help mental health conditions such as depression and anxiety; they can cause side effects and affect other medicines you take. Besides selective serotonin reuptake inhibitors (SSRIs), the most widely used type, there are several classes, including serotonin-noradrenaline reuptake inhibitors (SNRIs) and the older tricyclic antidepressants. The classes differ in who can take them and in their side effects, but they generally work about as well as each other for the symptoms of depression (NHS, 2025). Korea’s official mental health portal likewise says no antidepressant has consistently been shown to be better than the others (National Mental Health Information Portal, 2020). This guide is mainly about antidepressants; other psychiatric medicines, such as sleeping pills and tranquillisers, medicines for schizophrenia and mood stabilisers, come up only where it matters whether they can cause dependence, with links to the guides that cover them.

We do not know for certain how antidepressants work (Royal College of Psychiatrists, 2025). In its 2026 review, the UK medicines regulator (MHRA) decided to remove the phrase “correcting certain chemical imbalances” from patient leaflets (MHRA, 2026). So be wary of any one-line explanation of how these medicines work.

Who is offered them varies a little between countries and bodies. The UK guideline (NICE) groups symptoms below the diagnostic threshold and mild depression as “less severe depression”, and says antidepressants should not routinely be offered as the first treatment then, only if that is the person’s informed preference, because the evidence suggested that some psychological therapies were more effective than antidepressants, and because of the potential for side effects. For “more severe depression”, which covers moderate and severe depression, the first option it lists is individual cognitive behavioural therapy (CBT) combined with an antidepressant, and among antidepressants SSRIs are usually considered the first choice for most people (NICE, 2022). The World Health Organization says psychological treatment is the first treatment for depression, antidepressants are not needed for mild depression, and the two can be combined in moderate and severe depression (WHO, 2026).

The French health authority (HAS) recommends not prescribing an antidepressant for a mild depressive episode; medicines do not replace psychotherapy, but one can be prescribed from the first visit if the symptoms are severe enough. The first-line classes are SSRIs, SNRIs and “other antidepressants”, and tricyclics come second because of their risk of heart and blood-vessel toxicity (HAS, 2017). French national health insurance also says antidepressants are prescribed for moderate to severe depressive episodes, together with psychotherapy (Assurance Maladie, 2026).

Korea’s official portal says psychotherapy alone is sometimes enough for mild depression, but medicine is almost essential from moderate depression upwards (National Mental Health Information Portal, 2020), and the Korea Disease Control and Prevention Agency says mild depression can improve with psychotherapy alone while severe depression is treated with both (Korea Disease Control and Prevention Agency, 2026). A Korean medication algorithm built from a survey answered by 139 psychiatrists (KMAP-DD 2025) put a single antidepressant first even for mild to moderate depressive episodes (Korean Society for Affective Disorders & Korean College of Neuropsychopharmacology, 2025). When the same group compared it with four other guidelines, from Canada, the UK, Australia and New Zealand, and the British Association for Psychopharmacology, all four recommended non-drug treatment such as psychotherapy or exercise first for mild depression. The authors explain that the algorithm rests on expert consensus rather than an evidence review, and that it reflects a Korean setting where national health insurance makes care easy to reach and quick symptom relief is prioritised (Choi et al., 2026).

The 2025 guideline of the Japanese Society of Mood Disorders says mild depression should first get basic support: listening, easing everyday burdens and explaining the illness. A newer antidepressant is one option, as are CBT-based programmes and exercise, and whether to start one depends on the person’s wishes, how much the symptoms affect their life, past response to treatment and common side effects (Japanese Society of Mood Disorders, 2025).

Medicine and psychological therapy are not an either-or choice. In an analysis of 101 randomised controlled trials (11,910 people, mostly with moderate or more severe depression), people who received both were more likely to have improved at the end of treatment than people who received only one, and there was no clear difference between therapy alone and medicine alone (Cuijpers et al., 2020). If you have ever had a high period, such as mania or hypomania, tell your prescriber before you start. Korean approved product information warns that, although this has not been shown in controlled trials, an antidepressant used during a depressive episode in people with bipolar disorder may trigger a manic episode (Ministry of Food and Drug Safety, 2024). See bipolar disorder for more.

In a network meta-analysis of 522 randomised controlled trials (116,477 people) on the short-term treatment of adults with major depression, all 21 antidepressants studied were more effective than placebo, and the effects were mostly modest. “Effective” here meant the share of people whose depression score, rated by a clinician, fell by at least half. The trials mostly lasted around 8 weeks, most participants had moderate or more severe depression, 409 of the 522 trials (78%) were funded by drug companies, and the certainty of the evidence ranged from moderate to very low. Because the effects are modest, some people will not respond (Cipriani et al., 2018).

An analysis of individual data from 232 placebo-controlled trials (73,388 people, mostly adults) submitted to the US Food and Drug Administration (FDA) found an average difference between drug and placebo of 1.75 points on the Hamilton depression scale. But responses varied widely. A large improvement was seen in 24.5% of people on the drug and 9.6% of people on placebo, and the authors read this as the drug raising the chance of substantial benefit by about 15%. About two thirds of people in both groups had a similar, moderate improvement (Stone et al., 2022). That does not mean the medicines “only work for 15%”; it means that about 15 more people in every 100 improve substantially than on placebo.

Is medicine pointless if depression is mild? The studies disagree. An analysis of individual data from 6 trials (718 people) found a large drug-placebo difference in people whose symptoms were very severe at the start, and a small or no average difference in people with mild or moderate symptoms (Fournier et al., 2010). By contrast, an analysis of individual data from 6 trials run in Japan (2,464 people) found that the drug’s effect did not depend on how severe the symptoms were at the start (Furukawa et al., 2018), and an analysis of 28 SSRI trials (8,262 people) that looked only at core symptoms such as low mood found similar effects in less severe and severe depression; in the same analysis, though, the 17-item total score showed a larger effect in more severe depression once a few extreme values were left out (Hieronymus et al., 2019). In the FDA data above, the difference grew with initial severity, but only slightly (Stone et al., 2022). The Japanese Society of Mood Disorders reviewed four individual-data meta-analyses published since 2018: in 2 of the 4, the milder the depression, the smaller the difference between drug and placebo; in the other 2, there was no link (Japanese Society of Mood Disorders, 2025).

One medicine may help where another did not, so some people try two or more treatments before finding one that works (NHS, 2023). The Royal College of Psychiatrists says antidepressants help to reduce the symptoms of moderate and severe depression, particularly when it is more severe, but some people get better over time without them, some find the symptoms ease but the side effects are hard, and some find they do not work. Remember too that a medicine cannot remove the outside circumstances that may have led to depression (Royal College of Psychiatrists, 2025).

Antidepressants usually start to have an effect after 1 to 2 weeks and can take up to 8 weeks to work fully (NHS, 2025). The UK guideline says that if one is going to work, the benefit is usually felt within 4 weeks, and the first review is usually within 2 weeks (NICE, 2022). Sleep, appetite and concentration often improve before mood does (NIMH, 2024). In an analysis of 28 trials (5,872 people), the drug’s effect on average started to show in the first week and kept building for at least 6 weeks, and reaching key goals such as remission took several weeks (Taylor et al., 2006).

The timings given vary a little between countries. Korea’s official portal says you need to take the medicine for at least 2 to 4 weeks to judge its effect (National Mental Health Information Portal, 2020), and the Korea Disease Control and Prevention Agency says it usually takes about 4 to 6 weeks of regular use for the effect to begin (Korea Disease Control and Prevention Agency, 2026). The Japanese Society of Mood Disorders advises a first assessment of the effect 2 to 4 weeks after starting and judging improvement at around 4 weeks (Japanese Society of Mood Disorders, 2025), and French national health insurance says it takes two to four weeks for symptoms to start easing (Assurance Maladie, 2026). One analysis found that people whose clinician-rated score had not fallen by at least 20% in the first 2 weeks were unlikely to improve later, but it pooled one company’s trials of a single medicine (Szegedi et al., 2009). If the medicine does not seem to be working, do not stop or switch on your own; review the treatment with your prescriber.

Side effects often appear before the benefit, which is why the French guideline asks doctors to explain them in advance (HAS, 2017). The new patient wording adopted by the UK regulator in 2026 also says antidepressants take time to work and that you may get side effects before your symptoms improve (MHRA, 2026). In the UK, when you first start an antidepressant you see a doctor every 1 to 2 weeks (NHS, 2025).

You will usually keep taking the medicine for at least 6 months after you feel better (NHS, 2025). The UK guideline says treatment might need to continue for at least 6 months after symptoms go, but should be reviewed regularly (NICE, 2022). The Japanese Society of Mood Disorders strongly recommends (1A) that people whose depression went into remission on an antidepressant continue it for 6 months after remission; after that, continuing or stopping is decided together with the doctor, weighing the risk of relapse, side effects and the person’s wishes (Japanese Society of Mood Disorders, 2025). The French guideline considers 6 months to 1 year after remission desirable (HAS, 2017), and the Korea Disease Control and Prevention Agency says maintenance treatment for about 6 months to 1 year after improvement is needed (Korea Disease Control and Prevention Agency, 2026). If this is your first or second time on an antidepressant, it is best to continue for at least 6 months after you feel better; if you have had many episodes of depression, you may need to take it for longer (Royal College of Psychiatrists, 2025).

Continuing after you improve can reduce relapse. In an analysis of 31 randomised controlled trials (4,410 people) in people who had improved on medicine, the relapse rate was 41% in those switched to placebo and 18% in those who kept taking the medicine (Geddes et al., 2003). In 40 trials (8,890 people) comparing people in remission who continued the same medicine with people switched to placebo, relapse was 20.9% versus 39.7%, and in the trials that randomised people after more than 6 months of treatment in remission it was still 20.2% versus 37.2%. However, this analysis could not separately assess discontinuation symptoms in the first 4 to 8 weeks after stopping, and the definition of relapse varied between trials (Kato et al., 2021).

What about people who have taken them for a long time? In a trial of 478 adults in UK primary care who had had at least two episodes of depression or had taken antidepressants for 2 years or more, and who felt well enough to consider stopping, relapse within a year occurred in 56% of the group who tapered and stopped and 39% of the group who stayed on the medicine (Lewis et al., 2021). In the full report of the same trial, the researchers estimated that for every 6 people who stopped, 1 would relapse who might not have done so on maintenance treatment. Meanwhile, about one third of the stopping group managed the year without antidepressants. Most relapses came 4 to 18 weeks after the medicine was tapered, and telling withdrawal symptoms from depressive symptoms at that stage was left as a question for further research (Duffy et al., 2021). People can relapse while staying on medicine, and not everyone who stops will relapse.

Many people worry they will have to take medicine for life. Some people need to take antidepressants for a long time to stay well, but you may be able to stop again in the future, and that does not mean you have “failed” (Royal College of Psychiatrists, 2025). French national health insurance says that in severe depression, treatment is sometimes continued for several years to prevent relapse (Assurance Maladie, 2026). The UK guideline explains that for people at higher risk of relapse, such as those whose depression has come back often or within the last 2 years, continuing treatment may reduce the risk of relapse. It also asks that the risks of long-term use, such as side effects including an increased risk of bleeding or long-term effects on sexual function, and difficulty stopping, be weighed against the risk of relapse, and that continuing treatment be reviewed at least every 6 months (NICE, 2022).

In the first few weeks, side effects such as nausea, trouble sleeping or sleepiness, dizziness and headaches are common. Many ease within a few weeks as the body gets used to the medicine, but some carry on while you take it (NHS, 2025; NICE, 2022). Korea’s official portal also says that in the first 2 to 3 weeks side effects such as nausea, diarrhoea, anxiety, headache, insomnia, sweating and yawning can occur, and often go away with time (National Mental Health Information Portal, 2020). Feeling agitated, shaky or anxious at the start is also common. It is often why people stop, especially if they were not warned about it, but it usually eases a couple of weeks after starting (Royal College of Psychiatrists, 2025). If side effects are hard to manage, do not just put up with them or stop on your own; talk to your doctor (NHS, 2025).

How common are they? In the tables of an analysis of 131 trials (27,422 people) comparing SSRIs with placebo, pooling the trials that reported nausea, about 21% of people on the medicine and about 9% on placebo had nausea. Headache was reported by 21.5% on the medicine and 18.3% on placebo, a small difference (Jakobsen et al., 2017). People on placebo also report quite a few side effects, and what people expect can shape what they report (Rief et al., 2009). That does not mean side effects are all in the mind. In a Dutch study of long-term use in everyday care, 64% of 927 episodes of taking a single antidepressant came with side effects, 2.9 on average, and more when depression was more severe (Bet et al., 2013).

Weight is another common worry. In a study following 294,719 adults for 10 years through UK primary-care records, gaining 5% or more of body weight happened 11.2 times per 100 person-years in people prescribed antidepressants, more often than the 8.1 in people not prescribed them (adjusted rate ratio 1.21). The risk was highest in the second and third years of treatment, and from year 7 there was no evidence of an increased risk. As an observational study, it may not show cause and effect, depressive symptoms themselves may have changed weight, and the medicines differed widely (Gafoor et al., 2018). The Korea Institute of Drug Safety and Risk Management also says that depending on the type, antidepressants can raise or lower weight, and people respond differently (Korea Institute of Drug Safety and Risk Management, 2024).

Sexual side effects are common but often go unmentioned. In an analysis of studies that asked about sexual function directly with questionnaires, 26 to 80% had sexual problems depending on the medicine, and patients rarely reported them unless asked (Serretti & Chiesa, 2009). In a Spanish study of psychiatric outpatients, only 838 of 2,066 (41%) reported sexual problems on their own, and the psychiatrists most often switched to another antidepressant (34%) or waited for the problem to resolve (33%) (Montejo et al., 2019). Depression itself often affects sex, so the illness and the medicine can both play a part (Winter et al., 2022). Rarely, people have reported sexual problems that carried on after stopping, but more research is needed to understand why this happens and how common it is (Royal College of Psychiatrists, 2025). A review of the studies could not reliably estimate how often it happens or establish that the medicine causes it (Tarchi et al., 2023). In 2026, the UK regulator decided to add to the leaflets of some antidepressants that some people use the term “PSSD” for these symptoms (MHRA, 2026). Even if it feels awkward, tell your prescriber, and do not cut down or stop on your own.

Some people say medicine makes them feel “flat” or emotionally blunted. The NHS lists mood changes such as feeling more angry or emotionally numb among the common side effects (NHS, 2025). In an online survey of 669 people taking antidepressants for depression, 46% reported emotional blunting; it was more common in those with more depressive symptoms, so the researchers saw it not only as a side effect but also as a symptom of depression (Goodwin et al., 2017). Doctors usually deal with it by lowering the dose or switching to another medicine (Ma et al., 2021). If you feel this way, do not adjust the medicine yourself; talk to your prescriber.

It is not common, but some people have suicidal thoughts or an urge to self-harm when they start an antidepressant, and people aged 24 or under, or who have had these thoughts before, may be most at risk (NHS, 2025). This warning comes from short placebo-controlled trials. In the US Food and Drug Administration’s pooled analyses of 24 trials in children and adolescents (over 4,400 people) and 295 trials in adults (over 77,000 people), which Korean approved product information also reproduces, per 1,000 people treated, suicidal thoughts and behaviour were 14 cases more common than on placebo under 18 and 5 more at 18 to 24, and there was 1 fewer case at 25 to 64 and 6 fewer at 65 and over. No one died by suicide in the paediatric trials, and depression itself is linked to a higher risk of suicide. So, in the first months and when the dose is changed, people are watched closely for suicidal thoughts, self-harm or hostility appearing or getting worse (Ministry of Food and Drug Safety, 2024). The UK regulator decided to put a boxed warning at the start of the leaflet, saying the risk is highest under 25 but applies at all ages (MHRA, 2026), and the UK guideline advises a first review 1 week after starting for people aged 18 to 25 or when there is particular concern about suicide risk (NICE, 2022). Japan also revised the precautions in antidepressant labelling in 2007, adding that the risk of suicidal thoughts and suicide attempts rises at 24 or under and that families should be told about it fully (Ministry of Health, Labour and Welfare, 2007). If you have thoughts of dying after starting or changing the dose, do not carry them alone: tell your prescriber straight away, and call or text 988 in the US and Canada, or call Samaritans on 116 123 in the UK and Ireland.

Children and adolescents need separate consideration. The World Health Organization says antidepressants should not be used to treat depression in children, are not the first treatment for adolescents and should be used with extra caution in them (WHO, 2026). The UK guideline also says antidepressants should not be used as the initial treatment for mild depression in young people, and for moderate to severe depression only together with psychological therapy (NICE, 2019). The Japanese Society of Mood Disorders notes that Japanese trials in children and adolescents did not confirm the efficacy of any newer antidepressant and that none is approved for this age group (Japanese Society of Mood Disorders, 2025).

There are also rare side effects worth knowing about. Combining an antidepressant with other medicines that act on serotonin, or with supplements such as St John’s wort, can rarely cause serotonin syndrome, which can be life-threatening; for most people the risk is low (NIMH, 2023). It should be suspected when several symptoms appear together after starting or increasing a medicine that acts on serotonin, such as sudden restlessness, twitching, sweating and a fast pulse; then contact a doctor or pharmacist and get seen promptly (Ministry of Health, Labour and Welfare, 2021). With treatment, symptoms usually go away in less than 24 hours, but untreated it can be deadly (MedlinePlus, 2026). St John’s wort can interact in dangerous, sometimes life-threatening ways with a variety of medicines (NCCIH, 2025). The UK guideline does not recommend it for depression because of uncertainty about the right dose, variation between preparations and potential serious interactions with other drugs (NICE, 2022). Before taking a new medicine, herbal remedy or supplement, check with a doctor or pharmacist that it is safe to take together (Korea Institute of Drug Safety and Risk Management, 2024).

Drinking alcohol while taking an antidepressant can make your symptoms worse, or make you feel sleepy or dizzy (NHS, 2025). Most antidepressants do not react with alcohol, but some can make you sick or drowsy or increase the effects of alcohol, so talk to your doctor about drinking (Royal College of Psychiatrists, 2025); the Korean leaflet advises avoiding alcohol where possible and talking to your care team first if you drink often. If you feel drowsy or cannot concentrate, do not drive or operate dangerous machinery (Korea Institute of Drug Safety and Risk Management, 2024). If drinking worries you, see alcohol use. In older people, the risk of falls and fractures and of low blood sodium needs extra attention (NICE, 2022). If you are pregnant or breastfeeding, weigh the benefits and risks with your prescriber (NHS, 2025; Royal College of Psychiatrists, 2025). Depression around birth is covered in postpartum depression.

Antidepressants are not addictive in the sense of causing craving, a high or loss of control. Addiction generally means feeling an urge or craving to use a substance, losing control over its use and getting pleasure or a “high” from it, and it can happen with substances such as alcohol, nicotine and benzodiazepines. Finding it hard to stop an antidepressant is more accurately described as physical dependence, meaning the body has adapted to the medicine, and a drug does not need to produce a high to cause dependence (Royal College of Psychiatrists, 2025). The Korean patient leaflet also says that stopping suddenly can bring on a discontinuation syndrome, but that this differs from addiction, which is marked by strong craving, use that cannot be controlled and harmful consequences (Korea Institute of Drug Safety and Risk Management, 2024).

This wording has changed over time. The older NHS page on treating depression, reviewed in 2023, said antidepressants are not addictive and that withdrawal symptoms are usually quite mild and last no longer than 1 or 2 weeks, though occasionally they can be quite severe (NHS, 2023). The revised 2025 medicines page drops that phrase and explains that withdrawal symptoms are common and often stop within a few weeks, but can be severe for some people, start weeks or months later and last for months or longer (NHS, 2025). In 2019 the Royal College of Psychiatrists had said that guidelines and patient information should better recognise that, while withdrawal is often mild, it can last much longer and be more severe for some. The same statement explained that a clinical diagnosis of a dependence syndrome requires more than withdrawal symptoms, such as a compulsive desire, difficulty controlling use despite harm and tolerance, and that in these terms antidepressant use is not associated with dependence (Royal College of Psychiatrists, 2019). The same word, “dependence”, is used both for a diagnosis and for the body’s adaptation.

Researchers disagree too. One view holds that antidepressants are not among the substance classes in the DSM-5 diagnostic manual, unlike sedatives, hypnotics and anxiolytics, that withdrawal during medical treatment does not count towards a substance use disorder, and that there is minimal evidence to class antidepressants as addictive. This view also acknowledges that some people have long-lasting withdrawal that affects their functioning (Jauhar et al., 2019). Another analysis found that withdrawal from SSRI antidepressants and from benzodiazepines was described in very similar terms for 37 of 42 symptoms, and argued that calling only one of them a dependence syndrome is not rational (Nielsen et al., 2012).

So are all psychiatric medicines the same? No. Public Health England’s review grouped medicines such as benzodiazepine tranquillisers, “z-drug” sleeping pills and opioid painkillers as carrying a risk of dependence and withdrawal, and antidepressants as associated with withdrawal (Public Health England, 2019). Korea’s official portal says benzodiazepine anxiety medicines carry a risk of tolerance or dependence, so they are best taken only in the amount and for the time needed, as prescribed by a specialist (National Mental Health Information Portal, 2020), and that sleeping pills clearly can cause dependence but are not a cause for concern when a specialist prescribes and monitors them alongside cognitive behavioural therapy for insomnia, with short-term use as the rule (National Mental Health Information Portal, 2021a). Sleeping pills are covered further in insomnia: what helps and drug addiction. For medicines for schizophrenia, the portal says they do not cause dependence, and that symptoms returning after stopping are a relapse of the illness, not dependence (National Mental Health Information Portal, 2021b). Medicines for schizophrenia and mood stabilisers are covered in schizophrenia and bipolar disorder.

How common are symptoms on stopping? In a meta-analysis of 79 studies (21,002 people), 31% of people who stopped an antidepressant had at least one discontinuation symptom; 17% of people stopping a placebo did too, so allowing for that it was about 15%, and severe symptoms affected 2.8% (0.6% after placebo) (Henssler et al., 2024). Another review, by contrast, reported rates from 27 to 86% in 14 studies, with a weighted average of 56%, and in four large surveys of severity, 46% of those with withdrawal effects chose the most severe rating on offer (Davies & Read, 2019).

The figures differ mainly because of which studies were pooled. When the same data were re-pooled by study type, rates measured by surveys were higher than in randomised controlled trials, the severity figures came only from surveys, and two of those surveys were of people who identified themselves as having withdrawal that needed treatment (Jauhar & Hayes, 2019). Conversely, a reanalysis points out that most of the data in the first meta-analysis came from drug-company efficacy trials in which withdrawal was a minor consideration, with observation periods usually as short as two weeks (Moncrieff et al., 2025). An analysis limited to 50 randomised controlled trials (17,828 people) found that, in the 11 trials (3,915 people) that used a discontinuation-symptom scale, people who stopped an antidepressant had about one extra symptom on average a week later compared with those stopping a placebo or staying on the medicine, and that compared with stopping a placebo, dizziness was the most common symptom. It noted that the time people had taken the medicine in the trials was probably shorter than in real life (Kalfas et al., 2025). Both sides agree that withdrawal symptoms are real; which figure is closer to the experience of people who take the medicine for a long time is still debated.

Symptoms that can come with reducing or stopping include feeling dizzy or unsteady, a sensation like an electric shock in the head, sleep problems or strange dreams, restlessness and irritability, anxiety, and tearfulness or low mood (NHS, 2025; NICE, 2022). They usually begin within a few days of starting to come off and last a few weeks, but for some people they are severe, start weeks or months later or last for months or longer (NHS, 2025). The UK guideline likewise says they usually go away within 1 to 2 weeks but sometimes last several weeks, occasionally several months, and can be severe particularly if the medicine is stopped suddenly (NICE, 2022). At the moment we cannot predict who will get the more serious symptoms (Royal College of Psychiatrists, 2024). They may be more likely the longer you have taken the medicine, the higher the dose or if you have had withdrawal before, but the data behind this are still limited (NHS, 2025; Horowitz et al., 2023).

How do withdrawal and relapse differ? On average, withdrawal symptoms start soon after the medicine is reduced or stopped, while the return of depression or anxiety usually takes weeks or months. Withdrawal symptoms also often improve quickly, in days or even hours, if the medicine is restarted (Royal College of Psychiatrists, 2024). But the two can look alike, and withdrawal symptoms are easily mistaken for signs of relapse (Fava et al., 2015). A Cochrane review of studies on ways of stopping long-term antidepressants named the mixing up of withdrawal and relapse symptoms as its main limitation (Van Leeuwen et al., 2021). So do not try to decide which it is on your own; look at it with your prescriber.

That is why antidepressants should not be stopped suddenly. If you want to stop, talk to your prescriber first and agree a plan to reduce the dose gradually, usually over several weeks or months (NHS, 2025). The UK regulator’s new wording also says never to stop suddenly without first talking to a healthcare professional (MHRA, 2026), and the French guideline says patients and families should not stop on their own initiative without medical support, but gradually, over several weeks or months (HAS, 2017). Korean approved product information also says patients or carers must not stop on their own without consulting the prescriber, and recommends reducing the dose gradually over weeks or months (Ministry of Food and Drug Safety, 2024), and Japan’s health ministry has warned that stopping or cutting down on your own can bring mental symptoms such as anxiety, agitation, excitement and confusion, or sensory disturbances such as ringing in the ears and electric-shock-like feelings, so you should follow your doctor’s advice (Ministry of Health, Labour and Welfare, 2013). Missing doses or taking less than the prescribed amount can also cause withdrawal symptoms (NICE, 2022).

How fast to reduce differs from person to person. The principles the UK guideline sets out are these: reduce step by step, each time by a proportion of the previous dose; let the person taking the medicine lead and agree the speed and length; and move to the next step only once withdrawal symptoms have gone or are tolerable. Coming off can take weeks or months. If withdrawal symptoms are severe, consider going back to the previous dose and, once they have settled, reducing more slowly in smaller steps (NICE, 2022). Dose reductions usually get smaller as the dose decreases (Royal College of Psychiatrists, 2024). This guide does not give a tapering schedule. It depends on the medicine and the person, so agree the schedule with your prescriber.

The evidence on slow tapering is still thin. The UK guideline committee found some limited evidence that tapering may reduce withdrawal effects, and recommended more research on how often withdrawal happens and how severe it is (NICE, 2022). The 33 trials (4,995 people) in a Cochrane review were all at high risk of bias, and most involved people with recurrent depression. Most tapers lasted four weeks or less, and no trial used a very slow taper beyond a few weeks. In 3 trials (690 people) where people also received preventive cognitive therapy or mindfulness-based cognitive therapy while tapering, 40 to 75% of those trying to stop managed to do so, but the certainty of this evidence was very low (Van Leeuwen et al., 2021). The suggestion to go more slowly towards the end comes from an interpretation of brain-imaging data showing that, at low doses, small reductions cut the medicine’s action a great deal (Horowitz & Taylor, 2019). It has not yet been tested in trials, so decide on it with your prescriber.

Getting withdrawal symptoms does not mean you cannot stop (Royal College of Psychiatrists, 2024). The UK guideline says most people stop antidepressants successfully by tapering, and that fears about withdrawal or about depression coming back are concerns that clinicians should recognise (NICE, 2022). The researchers of the UK trial suggested that if people who want to stop are monitored regularly for the first 6 months, relapse might be prevented with other treatments such as psychological therapy (Duffy et al., 2021). A French public mental health information site also says it is generally better to plan stopping with the help of health professionals and those around you than alone (Psycom, 2026).

Ask your prescriber first. Ask about the possible side effects of a medicine and what to expect when you start it (NIMH, 2023); the UK guideline also asks prescribers to check which side effects you would particularly like to avoid, such as weight gain, sedation or effects on sexual function, and to explain withdrawal effects too (NICE, 2022). Let your prescriber know if side effects last more than a few weeks or are hard to bear, if you want to stop, or if you start another medicine or supplement. The harder a side effect is to talk about, such as sexual problems, the more it is worth raising. You can also ask a pharmacist whether medicines are safe to take together, and in the UK, people aged 18 or over prescribed one of the most commonly used antidepressants for the first time can get extra advice from a pharmacist through the NHS New Medicine Service (NHS, 2025).

In Korea, talk to the psychiatrist or other doctor who prescribed the medicine, or to a pharmacist. You can look up the approved information and safe-use information for your medicine on the Ministry of Food and Drug Safety’s medicine information site (National Mental Health Information Portal, n.d.). If you suspect a side effect, after talking to a doctor or pharmacist you can report it to the adverse-drug-reaction reporting and relief counselling centre of the Korea Institute of Drug Safety and Risk Management (1644-6223). This number is for reporting and advice on side effects; it is not a crisis line (Korea Institute of Drug Safety and Risk Management, 2024). If you are worried about psychiatric records, insurance or what a first appointment involves, see seeing a psychiatrist for the first time.

In Japan, talk to your attending doctor about any worries during treatment; a second opinion from another specialist is also possible, and you can consult your regular doctor, such as an internist, a public health centre or a mental health and welfare centre (National Center of Neurology and Psychiatry, n.d.). The medicine consultation line of the Pharmaceuticals and Medical Devices Agency (PMDA; 03-3506-9425, weekdays 9:00 to 17:00, except public holidays and the New Year period) takes phone questions on how prescribed medicines work, taking them together and how to take them, but not on diagnosis or treatment; it is not a crisis line either (Pharmaceuticals and Medical Devices Agency, n.d.). If you need continuing outpatient care, the Medical Care for Services and Supports for Persons with Disabilities scheme (outpatient psychiatric care) cuts the co-payment for outpatient care, including outpatient medication, from 30% to 10%, with a monthly cap based on income; it applies only at designated providers (Ministry of Health, Labour and Welfare, n.d.).

mind.io has no test of medicines or side effects. The depression check-in (PHQ-9) looks back at your mood over the past 2 weeks, so it can help you note what to raise at an appointment, but do not start, change or stop a medicine because of a score. Hypomania or mania can appear while taking an antidepressant, so Korean approved product information says to tell the doctor straight away if such changes appear (Ministry of Food and Drug Safety, 2024). What a high period looks like is described in bipolar disorder. If you suddenly feel anxious and shaky and develop a fever after starting or increasing a medicine that acts on serotonin, contact a doctor or pharmacist and get seen promptly (Ministry of Health, Labour and Welfare, 2021).

If you have thoughts of dying or of hurting yourself while taking or reducing your medicine, do not wait. The Royal College of Psychiatrists says that suicidal thoughts that start while reducing and stopping an antidepressant could be a withdrawal symptom or the return of depression, so speak to your prescriber immediately (Royal College of Psychiatrists, 2024). Please reach out to a crisis line right away: call or text 988 in the US and Canada, call Samaritans on 116 123 in the UK and Ireland, or find a line at findahelpline.com elsewhere. If you are in immediate danger, contact your local emergency services. There is also a guide on self-harm.

Q. Are all psychiatric medicines addictive? A. It depends on the medicine. Antidepressants are not addictive in the sense of causing craving, a high or loss of control (Royal College of Psychiatrists, 2025), but physical dependence, where the body adapts to the medicine and stopping can bring symptoms, can happen. That is why they are tapered gradually with your prescriber when you stop (Royal College of Psychiatrists, 2024). Benzodiazepine tranquillisers carry a risk of tolerance or dependence, so they are used only as prescribed and for as long as needed (National Mental Health Information Portal, 2020).

Q. Once I start, will I have to take them for life? A. Not necessarily. You usually keep taking them for at least 6 months after you feel better, and after that you decide with your doctor whether to continue, weighing the risk of relapse, side effects and your own wishes (Japanese Society of Mood Disorders, 2025). The Korea Disease Control and Prevention Agency also says that once treatment has done its work, the medicine can be adjusted and stopped in consultation with your doctor (Korea Disease Control and Prevention Agency, 2026). People whose depression has come back several times may take them for longer, but even after long use it may be possible to stop (Royal College of Psychiatrists, 2025).

Q. Will medicine change my personality or make me feel flat? A. The Korea Disease Control and Prevention Agency says antidepressants are not medicines that artificially change a person’s personality (Korea Disease Control and Prevention Agency, 2026). Emotional blunting can occur as a side effect, though, and is also a symptom of depression (Goodwin et al., 2017). The French guideline asks doctors to recognise and discuss worries such as dependence or a change of personality when prescribing (HAS, 2017). If you feel this way, do not adjust the medicine yourself; tell your prescriber.

Q. Is medicine only for people with weak willpower? A. No. Depression is not a personal weakness or failing but an illness that needs treatment (National Mental Health Information Portal, 2020). The Korea Disease Control and Prevention Agency also says depression is not a matter of willpower or attitude (Korea Disease Control and Prevention Agency, 2026). Public Health England’s review said that people who want to stop a medicine must be able to get appropriate medical advice and treatment, and must never be stigmatised (Public Health England, 2019).

Q. Should I stop as soon as side effects appear? A. Do not stop on your own. Side effects that appear at the start often ease within a few weeks as your body gets used to the medicine (NHS, 2025). The Korean leaflet says to talk to your doctor if discomfort lasts more than a few days, and not to stop or change the dose without talking to your doctor (Korea Institute of Drug Safety and Risk Management, 2024). If side effects continue, your doctor can adjust the dose or try another medicine (National Mental Health Information Portal, 2020).

Q. Can I stop as soon as I feel better? A. Do not stop straight away. Antidepressants should not usually be stopped suddenly; doing so can bring withdrawal symptoms and makes it more likely that you become unwell again (Royal College of Psychiatrists, 2024). Korea’s official portal likewise says it is best to keep taking the medicine for a while even when your mood and daily life feel much better, that stopping suddenly without a plan can bring hard withdrawal effects, and that you should reduce it slowly with your doctor. How much longer to take it depends on how many episodes of depression you have had, whether others in your family have had depression and how severe it was (National Mental Health Information Portal, 2021c).

Q. It does not seem to be working. Is it the wrong medicine? A. First check whether enough time has passed. Antidepressants usually start to have an effect after 1 to 2 weeks and can take up to 8 weeks to work fully (NHS, 2025). If you still have not improved, one medicine may help where another did not, and an antidepressant combined with CBT usually works better than either alone; some people try two or more treatments before finding one that works (NHS, 2023). Do not stop or increase it yourself; discuss the next step with your prescriber.

Q. I have thoughts of wanting to die while taking or reducing my medicine. A. Please do not carry this alone, and tell your prescriber straight away too. Reach out to a crisis line right away: call or text 988 in the US and Canada, call Samaritans on 116 123 in the UK and Ireland, or find a line at findahelpline.com elsewhere. If you are in immediate danger, contact your local emergency services.

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