When withdrawing from any antidepressant, most would agree that it’s best to taper. Tapering reduces the likelihood that you’ll endure protracted withdrawal symptoms, and gives your nervous system a slower readjustment to homeostatic functioning from being under the influence of a drug. Taking steps such as: maintaining a good diet for mental health, staying productive, getting light exercise, enrolling in therapy, and staying socially connected – are all likely to help.
However, some people may need a little bit more help in coping with their withdrawal symptoms and returning original symptoms. Certain supplements are well-known to buffer the effects of withdrawal. Most people don’t really know what supplements to take, so they resort to taking a multivitamin or something recommended in a forum.
Factors to consider before using supplements
If you plan on taking a supplement (or stack) after you’ve discontinued an antidepressant, there are some factors that you should consider. Things to consider include: whether you’ve fully withdrawn, are taking other medications (or using other drugs), the dosage of the supplement(s) you plan on taking, as well as other interactions.
1. Fully withdrawn vs. still tapering
Someone who has fully withdrawn from an antidepressant is more likely to need supplements compared to someone who is still taking the medication. Although you may be tempted to take a supplement during the tapering phase, be sure that the supplement(s) you decide to take do not have an interaction with your medication. For more information on potential contraindications, talk to your doctor.
Withdrawal symptoms tend to hit hardest when a person is fully withdrawn, not when they’re still tapering. Although it may be difficult to taper, during the tapering process your body is still getting some of the drug. Once you’ve fully discontinued, there’s no more drug to stimulate the nervous system, leaving you with full-blown withdrawals.
2. Other medications
If you are taking other medications, these generally will help buffer the effects of withdrawal. Many people who don’t notice any (severe) withdrawals from antidepressants are on another medication (or cocktail of them). By taking other medications, these serve to mask many of the severe withdrawal symptoms from the antidepressant that you’ve discontinued.
All that said, before you consider taking a supplement, you’ll want to make sure that the other medications will not interact with it. Many drugs do have interactions with supplements, which could theoretically create an entirely new set of symptoms from the contraindication. Talk to your doctor to verify that there will be no interaction before supplementing.
3. Severity of withdrawal symptoms
Next you’ll want to analyze your need to take supplement vs. want. Don’t convince yourself that you need to take a supplement when withdrawal is going alright. Supplementation should be used for only the people that really need it. Think of supplements as additional tools to help you cope with certain difficult symptoms of withdrawal, not a cure for your particular condition.
4. Supplement dosage
Assuming you’re going to take a supplement, it is important to take the proper dosage that works to minimize the withdrawal symptoms. Sometimes people take a supplement, but aren’t taking enough, while in other cases, people are taking too much and end up with unwanted side effects (that become confusing when you’re already dealing with withdrawal). Take the minimal effective dose of whatever supplement(s) you find beneficial.
If you are confused about dosing, be sure to talk to your doctor and ask for some advice. Realize that dosing may require some individual experimentation to find what is most effective for withdrawal symptom reduction.
5. Supplement interactions & side effects
Before blindly throwing a supplement stack down the hatch, make sure you aren’t taking multiple supplements that have detrimental interactions. Additionally in order to minimize potential side effects and interaction effects, you’ll want to remain on the smallest dose of each that provides you with benefit. If you aren’t sure whether supplements interact with each other, look them up online and talk to a medical professional. It’s better to err on the side of caution as you won’t want more crazy side effects emerging with already-present withdrawal symptoms.
10 Best Supplements for Antidepressant Withdrawal (List)
Below is a comprehensive list of the best supplements to consider when withdrawing from an antidepressant. Understand that not everyone will benefit from all the supplements listed below. Some people may not find any supplement on this list helpful, and find them nothing but a waste of money. If you’re really struggling to recover from your withdrawal, the right supplements can make a huge difference in expediting your recovery.
Assuming you have taken your final dose of an antidepressant, you may want to consider taking activated charcoal to clear your body of potential drug-related toxins. Most people that take pharmaceutical drugs for a long-term (e.g. months or years) on a daily basis may end up with some drug-induced toxicity circulating throughout their body. To be on the safe side, you may want to consider taking some activated charcoal to help clear these.
Accumulated toxins can have detrimental effects on brain activity as well as general health. Activated charcoal has been around for thousands (upon thousands) of years and used as a way to improve the health of intestines. It functions through a mechanism referred to as “adsorption” which means “binding to,” which is different than “absorption.” While most people know activated charcoal is used to help clear the body of poisons and drugs (in the event of an overdose), it is a healthy supplement for detoxification.
Taking activated charcoal prevents poisons from being absorbed by the stomach, and inhibits the circulation of drugs, toxins, and all of their metabolites throughout the body. The activated charcoal is created by burning a carbon source (e.g. wood) and the high temperature eliminates all oxygen, activating it with gases. As a result an “adsorbent” material is created that contains millions of tiny pores that bind to any toxins within your body.
These pores have thousands of times more weight than the actual charcoal. Just a couple grams of this stuff has the same surface area as a football field. Numerous medical studies show that taking activated charcoal is completely safe for humans. You need not take activated charcoal frequently unless exposed to toxins.
Also, it probably shouldn’t be taken with other supplements as it may affect their absorption. Therefore you may want to supplement this within one or two days after your final antidepressant dose. It should help clear the body of any chemically toxic leftovers.
There are numerous benefits associated with taking omega-3 fatty acids (DHA and EPA). The DHA serves as an essential building block for your brain, and EPA helps reduce inflammation. There is scientific evidence supporting that omega-3 fatty acids can help increase brain volume, grey matter, and healthy brain processes. During withdrawal from an antidepressant, one of the quickest ways to help the brain heal is to supplement high-quality omega-3s.
You could consider taking either fish oil or krill oil – each has its pros and cons. I would recommend fish oil vs. krill oil simply because you’re getting significantly more omega-3s per serving than in krill oil. There is less research of krill oil’s benefits, particularly in regards to brain health. Therefore, pick a high-quality fish oil supplement, try it, and determine whether you get any benefit.
The nice thing about fish oil is that you can generally take them with your antidepressant (assuming you aren’t on any anticoagulants). Therefore you could begin supplementing omega-3s and let them build up in your system before you are completely off of your antidepressant.
Omega-3s may improve the following withdrawal symptoms:
- Aggression: Some people notice that after continuous supplementation of omega-3 fatty acids, they become significantly less aggressive. This could be due to changes in neurotransmission (both levels and efficiency) as well as a result of increasing activity in the prefrontal cortex.
- Anxiety: Some studies have demonstrated that omega-3 fatty acids are capable of reducing production of the hormone “cortisol” which is directly tied to stress, anxiety, and the fight-or-flight response. For some people, omega-3s may significantly improve symptoms of anxiety.
- Brain zaps: One of the most effective treatments for the dreaded electrical shock sensations a.k.a. “brain zaps” is omega-3 fatty acids. While it is unclear as to how omega-3s help these, many people have documented significant reductions in the frequency and number of zaps they experience during withdrawal as a result of supplementation.
- Concentration problems: There is some scientific evidence in support of the idea that omega-3 fatty acids can help improve symptoms of inattentiveness and attentional deficits. Most people can’t think clearly when they discontinue an antidepressant, and the DHA contained within omeag-3s usually helps a little.
- Depression: Some would argue that omega-3 fatty acids (particularly EPA) are capable of treating depression. While they may not be quite as potent as an antidepressant, they can be effective when taken at the right dose. (Read: Fish oil for depression).
- Irritability: Many people become highly irritable during withdrawal from antidepressants. While omega-3s will likely not cure the irritability, they may help improve it. The improvement is likely a result of changes in brain activity and neurotransmission.
Note: It’s important to understand that although fish oil may help or not have a profound effect for certain people, others find that fish oil makes depression or anxiety worse. If you notice a worsening of your symptoms after taking fish oil, do not hesitate to discontinue. This may be caused by increased acetylcholine and/or a sensitivity to amines.
Glutathione is considered among the most potent antioxidants in the human body. Every single cell contains glutathione, which helps reduce accumulation of toxins and prevents inflammation. Some speculate that as we age, the endogenous glutathione production within the body decreases. If you aren’t making enough, it could compromise your immune system and/or cause cellular damage.
Those who were taking an antidepressant daily for a long-term may have experienced liver problems. In fact, many antidepressants have a warning about the possibility to cause hepatotoxicity or liver damage. While most people won’t end up with damaged livers as a result of taking antidepressants, you may want to help your liver properly heal and your immune system stay strong upon discontinuation.
For some people, glutathione makes a huge difference in improving their health during the withdrawal process. If you’re already eating an optimal diet for mental health, you may not need to worry as much about supplementation because your body will be making it from eating greens (e.g. asparagus). If you suspect you have accumulated a significant amount of toxins, your body’s natural gluathione production may not cut it and supplementation should be considered.
Do you have ridiculous insomnia now that you’ve stopped taking your antidepressant? Most people do and don’t know how to cope with the inability to get sleep. Lack of sleep is not only problematic for physical health, but increases unwanted stress hormones like cortisol, which can lead to heightened levels of anxiety and depression. If you aren’t getting adequate, restful sleep during withdrawal, it’s going to be much tougher for your physiology to restore homeostasis.
Your body is responsible for endogenous production of melatonin, which helps regulate your sleep-wake cycle. Whenever you notice yourself feeling tired at night, it’s a result of your circadian rhythm stimulating the production of melatonin to tell you that your body needs some sleep. Unfortunately antidepressant withdrawal generally throws a monkey wrench into the circadian rhythm and melatonin production becomes abnormal.
Those with abnormally low levels of serotonin, probably aren’t getting sufficient melatonin. Serotonin is necessary for the production of adequate melatonin. During withdrawal, your brain is attempting to fix itself from an antidepressant-induced chemical imbalance. You had been taking the drug for so long, that now your serotonin level is abnormally low, which affects a variety of other functions, including that of melatonin.
There is evidence that exogenous supplementation of melatonin can help restore your body’s circadian rhythm and that it could even improve your brain health. Some speculate that melatonin acts as a neuroprotective agent with significant antioxidant properties. Melatonin is certainly something to consider if your sleep cycle has become problematic.
Many people consider magnesium to be an anti-stress mineral, and a deficiency can cause a variety of symptoms including anxiety. A lot of people notice that when they increase their magnesium levels, they start to feel more calm, and in a better mood. A considerable number of people are likely magnesium deficient as well, which can cause mood swings and unnecessary stress.
There’s no harm associated with supplementing a little magnesium, so consider adding it to your regimen. During withdrawal magnesium may help with anxiety, insomnia, restoring homeostatic brain functions, and may even reduce heart palpitations. Low levels of magnesium also inhibit your ability to absorb Vitamin D – low levels of this vitamin are associated with depression.
Make sure that your magnesium intake is adequate during withdrawal; supplements are not a bad option. Some even speculate that increasing magnesium will help the adrenals heal when they’ve been overtaxed by prolonged medication usage. Keep in mind that there are different types of magnesium as well, some of which are formulated specifically to help you stay calm.
6. 5-HTP or L-Tryptophan
Assuming you were taking an SSRI (serotonergic antidepressant), your serotonin levels are likely abnormal upon discontinuation. The drug rewires your brain to become dependent on it to create sufficient serotonin. When you discontinue the drug, the brain is still expecting to receive the serotonin boost that it got from your antidepressant.
It takes the brain a little while to figure out that it’s no longer getting any serotonin from the medication. Things can then get chaotic as the brain attempts to reset its normal functioning. By taking L-tryptophan or 5-HTP, you’ll be increasing the level of serotonin within the brain. This helps reduce anxiety, can improve mood, and decrease all withdrawal symptoms related to low-serotonin.
The dosage will vary, but some experts recommend taking 50 to 100 mg of 5-HTP or 500 to 1000 mg of L-tryptophan (twice per day); once in the afternoon and once before bed. Obviously you won’t want to take both 5-HTP and L-tryptophan together, but if one doesn’t work, try the other. Some people find that for targeting insomnia, the L-tryptophan is the more potent option.
You should not be taking these while still on any serotonergic medication as this may result in a dangerous condition known as “serotonin syndrome.” Understand that the dosages of these supplements will likely need to be adjusted based on whether you’re getting any benefit. If you don’t feel any benefit, you may need to do some personal experimentation to find out what works best. If you’re unsure about the dose to take, always talk to a professional.
Understand that L-tryptophan and 5-HTP both increase serotonin, but not everyone has the same reactions to them. One person may find L-tryptophan more beneficial, and another may prefer 5-HTP. 5-HTP bypasses a step in the conversion process of serotonin production. It is generally recommended to try 5-HTP prior to L-tryptophan due to speculative increased efficacy as a result of the more efficient conversion to serotonin.
Note: You’ll want to take these on an empty stomach due to the fact that they compete with other amino acids. Many people recommend taking them first thing in the morning with a Vitamin B-Complex or specific B-vitamins.
Assuming you’re taking either 5-HTP or Tryptophan, you’re probably going to want some B-vitamins. Specifically, you’ll want to make sure that you’re getting Vitamin B3 (which aids in the conversion of tryptophan) and Vitamin B6 (which helps convert 5-HTP into serotonin). These are more for absorption of other supplements, but may provide unique standalone benefits as well.
It should be noted that some people react to B Vitamins with a significant increase in overall energy. While the energy boost may be beneficial for combating withdrawal fatigue, it may increase anxiety and/or agitation. Proceed with caution if you notice that your anxiety ramps up when taking B Vitamins and discontinue if you believe it is worsening your withdrawal symptoms. Should you notice detrimental effects of a B-complex, consider individual B-Vitamins like B3, B6, and B12.
8. L-Tyrosine or L-Phenylalanine (DLPA)
If you were on a non-serotonergic antidepressant, you need not use supplements that increase serotonin. Many atypical antidepressants affect neurotransmitters such as norepinephrine and dopamine (to a lesser extent). Supplementing 5-HTP or L-Tryptophan is unlikely to help curb the neurotransmitter deficits that you’re dealing with.
A couple of options that you have if you’re trying to increase norepinephrine or dopamine levels are both L-Tyrosine and/or L-Phenylalanine. These are very potent amino acids and shouldn’t be taken in large quantities if you are particularly sensitive to stimulatory neurotransmitters. Taking too much may make you feel stuck in high-gear, like you’re uncomfortably agitated and/or hype.
If you supplement L-Tyrosine, your brain will be increasing levels of dopamine and norepinephrine. While this may be what some people need during withdrawal, it is important to proceed with caution, especially if you have a history of anxiety. It should be mentioned that if you were taking an SNRI, you may want to take L-Tyrosine along with 5-HTP or a serotonergic agent.
10. Himalayan Salt or Sea Salt
If you have a low sodium-potassium ratio, you’ll want to increase your salt intake. Generally with prolonged exposure to a fight-or-flight response, your adrenals become taxed. If you feel excessively fatigued and trapped in a state of prolonged fight-or-flight, you may want to consider adding some Himalayan Salt or some fresh Sea Salt to your diet.
In animal studies, an abnormally low sodium intake is associated with increased anxiety. Some even go as far as to speculate that lack of salt in the diet can be a direct cause of mood problems and adrenal insufficiency. I’d recommend avoiding standard table salt due to the fact that it’s processed with chemicals; stick to fresh sea salt or Himalayan salt.
Other supplements to consider…
There are a few other supplements that you may want to consider if you haven’t found relief from the ones listed above. These include: GABA, Rhodiola Rosea, SAM-e, and St. John’s Wort.
- GABA: It remains unclear as to whether GABA supplements actually work or if they’re merely a placebo. Many people speculate that they are incapable of crossing the blood-brain barrier, hence eliciting no effect. Others believe that certain GABA supplements work for anxiety and they notice a clear calming effect. You could experiment with GABA and determine for yourself if you get any benefit. If it works, it should calm you down, reduce anxiety, curb insomnia, and decrease agitation.
- Rhodiola Rosea: Some people have had success supplementing Rhodiola Rosea after discontinuing their antidepressant. There is some evidence that this herbal supplement can help combat fatigue, increase energy, reduce depression, and even help with anxiety. This is certainly something to consider if none of the other supplements have helped.
- SAM-e: S-Adenosyl methionine is commonly used by people to help take the “edge off” during antidepressant withdrawal. Many people consider it to function as a standalone antidepressant. If you aren’t having success with any of the options listed above, you may want to go through a trial of this stuff. Personally I used this during withdrawal from an antidepressant and found that it exacerbated my withdrawal symptoms. Although I had a bad experience, it doesn’t mean that yours won’t be better.
- St. John’s Wort: This is a legitimate plant-based antidepressant that is known to help normalize serotonin levels during withdrawal. If you don’t find the 5-HTP or the L-Tryptophan helpful, this could be a third option to consider. It has been tested in clinical trials and has proven itself as one of the only herbal treatments for mild cases of depression.
- Source: http://www.ncbi.nlm.nih.gov/pubmed/17990195
- Source: http://www.ncbi.nlm.nih.gov/pubmed/22589230
- Source: http://www.ncbi.nlm.nih.gov/pubmed/25719303
Don’t go overboard with supplementation
The bottom line is that you shouldn’t take more supplements than you really need. Additionally, both the dosage and duration of supplementation should be kept to a minimum. The more supplements you blindly throw at the withdrawal symptoms, the more likely you’re going to experience supplement-induced side effects and interactions. This will make it even more difficult to determine whether you’re experiencing protracted antidepressant withdrawal or side effects of your supplements.
I’d do some experimentation and find what works best for you. If you don’t react well to one supplement, simply stop taking it and try something else. Realize that activated charcoal isn’t something you need to take daily, and that melatonin can be used on an “as-needed” basis. If you’re trying to increase neurotransmitters that were depleted with your antidepressant, then specifically target those – don’t throw other supplements (that increase other neurotransmitters) into the equation.
How long should you supplement?
There are certain supplements that should be taken “as-needed” and clearly don’t need to be taken daily for benefit. For example, if you are sleeping good, but randomly experience a bout of insomnia, you can take some melatonin. Understand that humans didn’t evolve shoveling down supplements on a daily basis.
Therefore you should attempt to gradually reduce your amount of supplementation over-time. If you are taking 5-HTP or L-tryptophan daily, you may want to keep at it for a few months. Once you’ve taken them for a few months, you should then attempt to reduce the doses and taper yourself off of them. While these help increase serotonin levels, you don’t need to rely on them for the long-term.
Think of the supplements as a way for your body to repair itself and minimize withdrawal symptoms. Just like opioid-replacement options are used to help people discontinue painkillers, think of these serotonin boosters in a similar sense. They will help make the transitory process a little bit easier from being medicated to being medication-free. Eventually, you’ll want to be both drug and supplement free (if possible).
Should you take every supplement listed above?
You certainly don’t need to take the entire stack of supplements above to get benefit. Be sure to focus on the most troubling withdrawal symptoms and using a supplement that directly targets those symptoms. If you’re experiencing insomnia, taking omega-3 fatty acids probably aren’t going to help much. For insomnia, you’d be much better off supplementing melatonin.
On the other hand, if you’re experiencing foggy thinking and brain zaps, but have no problem falling asleep at night, you may want to avoid the melatonin, and take the omega-3 fatty acids. Obviously in the event that you have an array of severe symptoms, take as many supplements as necessary to get you back on track. Always make sure that the combinations of supplements you’re taking aren’t going to interact.
Keep in mind that taking activated charcoal with any of the supplements listed above will minimize their effectiveness. Activated charcoal is meant to clean up toxins within the body, but when you take it with other supplements, it binds to them and may minimize their effectiveness and/or clear them from the body.
What about multivitamins?
There is significant controversy regarding the usage of multivitamins. These are composite vitamins that contain a “little bit” of each of the essentials. The problem with multivitamins is that you’re getting a diluted source of each vitamin, and you’re also getting vitamins that you probably don’t need. Multivitamins don’t generally provide a sufficient source of the specific vitamins that your body needs, and you’re getting stuff that you don’t need.
Most large-scale studies show that mortality actually increases with consistent supplementation of multivitamins. While some people claim that multivitamins offer balance, you should hesitate to take them and instead opt to take the vitamins that specifically target deficiencies. A case could be made for a very high-quality multivitamin, but do your research before you supplement.
What supplements helped you during antidepressant withdrawal?
If you’ve taken supplements to help you cope with antidepressant withdrawal, be sure to mention them in the comments section below. Feel free to discuss what your most troubling withdrawal symptoms were, what supplements helped the most, and/or what supplements didn’t provide any benefit. If there’s a supplement that’s not listed here that you think should be included, don’t hesitate to mention it below.