Antidepressant withdrawal is a complex and important aspect of mental health that deserves our attention and understanding. Withdrawing from psychiatric medications can be a debilitating experience for many people. With a stressed and dysregulated nervous system, it's no surprise that people will turn to natural remedies to alleviate their discomfort. While some people might benefit from a supplement, others might not be able to tolerate it.
As I continue to learn more from my patients about medication tapering and managing their withdrawal symptoms, I've realized the critical role that healthy lifestyle practices, good nutrition, and supplements may play in preparing the body for this transition. After delving into the world of nutritional psychiatry, I've learned that it's a good idea to address underlying issues such as vitamin/mineral deficiencies, inflammation, gut health, and heavy metal toxicity at the very least before the tapering process begins.
The body is already struggling with these internal stressors so it makes sense to start here.
Additionally, withdrawing from psychiatric medications in a weakened and stressed state is a recipe for disaster.
In this article, we’ll review three supplements – Magnesium Glycinate, N-acetyl-cysteine (NAC), and Omega-3 Fatty Acids. These are supplements that many of my clients have found helpful for reducing their withdrawal symptoms.
But first, we need to understand what happens when we taper our antidepressant medications and the challenges we may encounter.
The Antidepressant Withdrawal Process and Its Challenges
Traditional psychiatric references use the term "discontinuation syndrome" to refer to the withdrawal symptoms when individuals quickly stop or taper antidepressants such as Paroxetine/Paxil, Sertraline/ Zoloft, Venlafaxine/Effexor, etc.; too quickly (2, 3). However, some Health Care Professionals prefer the term "withdrawal" over “discontinuation syndrome” as it depicts a clearer picture of what people are experiencing during this difficult time.
Current standards propose a four-week taper time. However, I've found that short tapers can be devastating, with symptoms lasting weeks or months. In my experience, patients who abruptly discontinue or rapidly reduce antidepressants frequently report a wide range of unpleasant side effects. These may include:
- Exhaustion
- Headache
- Achiness
- Sweating
- Poor sleep (including vivid dreams)
- Nausea/vomiting
- Dizziness and lightheadedness
- Burning and electric-like sensations
- Anxiety, irritability, agitation, and aggression
According to one antidepressant withdrawal study, "physiological dependence" is the cause of withdrawal symptoms when an antidepressant is reduced, discontinued, or switched to another medicine.
Furthermore, a 2021 research article explains that a "physiological dependence" is formed, which is why withdrawal symptoms may occur when the antidepressant is reduced, stopped, or cross-tapered to another medication.
Some clinicians use the acronym "FINISH" to describe these discontinuation symptoms:
- Flu-like symptoms (lethargy, fatigue, headache, achiness, sweating),
- Insomnia (with vivid dreams or nightmares),
- Nausea (sometimes vomiting),
- Imbalance (dizziness, vertigo, lightheadedness),
- Sensory disturbances ("burning," "tingling," "electric-like" or "shock-like" sensations)
- Hyperarousal (anxiety, irritability, agitation, aggression, mania, jerkiness)
While current guidelines suggest a brief taper period of up to four weeks with "linear reductions," I have observed that short tapers can be disastrous, with symptoms lasting for weeks or months.
These withdrawal symptoms may be the result of "reversal effects on neurotransmitters.” Moreover, if withdrawal symptoms are not recognized, some individuals may be misdiagnosed with a new mood disorder.
Due to the potentially challenging nature of the withdrawal process, individuals often seek natural solutions to help alleviate symptoms and calm the nervous system. Many people have found that incorporating supplements into their routine can be beneficial. Three common supplements are N-acetyl-cysteine, Magnesium, and Omega-3 fatty acids.
3 Supplements Commonly Used for Antidepressant Withdrawal Symptoms
1. N-acetyl-cysteine (NAC)
N-acetyl-cysteine, better known as NAC, is formed from the amino acid cysteine, and it is a prerequisite for glutathione, the master antioxidant (4, 5). NAC is well-known for its potent anti-inflammatory qualities, which are essential for mental wellness.
According to a 2010 review, NAC efficiently passes the blood-brain barrier and even reduces inflammation in the brain in rodents. Furthermore, NAC can influence serotonin, that “feel-good” chemical in our brains that promotes positive moods.
NAC has been quite beneficial in lowering withdrawal symptoms in some of my clients, with little to no side effects. This is encouraging, but further research is needed to determine how NAC may reduce antidepressant withdrawal symptoms.
2. Magnesium
Magnesium is recognized as the “relaxation mineral.” It is found in every cell of the body and is vital for regulating various bodily systems from muscle relaxation, heart health, and energy production to regulating neurotransmitters or brain chemicals.
Although this mineral is abundant in nature, many people are deficient. Magnesium is depleted in our soil and may leave our body during times of stress or from some medications such as diuretics, antibiotics, birth control, and proton pump inhibitors such as omeprazole.
Although about 1% of magnesium is present in blood, the majority of magnesium is located in cells. Blood tests are often within the normal range because the body attempts to maintain homeostasis or balance. As a result, blood tests are unable to represent magnesium levels accurately. To fully understand our magnesium reserves, a functional test like Hair Tissue Mineral Analysis (HTMA) is useful.
Magnesium is found in various food sources, such as leafy green vegetables, nuts, poultry, beef, and whole grains, but in limited amounts. Although this mineral is abundant in nature, many people are deficient. Magnesium is depleted in our soil and may leave our body during times of stress or from some medications such as diuretics, antibiotics, birth control, and proton pump inhibitors such as omeprazole.
The Recommended Daily Allowances, or RDA, for magnesium for adult males aged 19-51+ is 400-420mg a day and for women 310-320mg/day. Requirements for pregnant women are about 350-360mg/day, and for lactating women, 310-320mg/day.
Some of the hallmark physical signs I see in clinical practice of low magnesium are complaints of eye twitching, muscle spasms, anxiety, constipation, and poor sleep. Many of my patients have reported magnesium's positive effects, including reduced or eliminated muscle spasms and eyelid twitching, as well as a more restful, and deep sleep.
Magnesium is available in different formulations. Magnesium glycinate and magnesium L-threonate are two of my favorite supplements because they are easily absorbed by the body. I don’t typically recommend magnesium oxide as it has a laxative effect and is poorly absorbed.
3. Omega-3 Fatty Acids:
Omega-3 Fatty acids are the backbone of brain function. Research suggests that more than 60% of the "brain's dry weight" is fat, with a large amount of omega-3 fatty acids (5). These healthy fats play a critical role in how the cells within our brains communicate with each other.
It is also a significant part of healthy cell membrane structure, and its maintenance, and repair. All of the cell structure is derived from fat.
Omega-3 fatty acids have been extensively studied, with numerous reported benefits in mental health and wellness, especially for their anti-inflammatory properties.
The problem is that most Americans don’t eat nearly enough foods rich in Omega-3s like seafood, flax, chia seeds, or walnuts. Instead, they tend to favor other fats called Omega-6 fats. Vegetable oils like corn, safflower, and soybean oils and a variety of packaged food items tend to be rich in Omega-6 fats.
This preference for omega-6 fats causes an imbalance in the ratio between omega-6 to omega-3. High levels of omega-6 can interfere with omega-3 anti-inflammatory function and exacerbate inflammation throughout the body. Controlling inflammation is a key component to reducing oxidative stress in the brain and managing our moods.
Research has shown that supplements with combined EPA and DHA (two types of Omega-3 fatty acids), with higher levels of EPA, are beneficial for mental wellness.
I've observed supplementation of high-dose omega-3 fatty acids has helped many clients reduce their withdrawal symptoms and it has even helped lower brain fog.
Omega-3 supplements are commonly made using fish oil, however, for vegetarians/vegans, algae-derived options are also available.
When choosing a fish oil supplement, select a supplement from a reputable supplier that uses 3rd part testing to assure quality and that the contents are pure and free of toxins. A common seal is “USP” which can be found on the side of the label. This seal is an indication the supplement has undergone outside testing for safety and efficacy. When you open the bottle, if it smells rancid or oxidized, return it to the store.
If you are curious about your omega-3 consumption, download my FREE Omega-3 Evaluation.
Final Thoughts
In summary, magnesium, NAC, and omega-3 fatty acids are three supplements that offer multiple benefits for our health and well-being.
- NAC has shown promise in supporting mental health, reducing symptoms of conditions such as depression and anxiety, and reducing inflammation.
- Magnesium plays a crucial role in various bodily functions. It has been linked to improved sleep, reduced stress, and enhanced mood.
- Omega-3 fatty acids, particularly EPA and DHA, are essential for optimal brain function, and their supplementation has been associated with improved mental health and reduced inflammation.
While these supplements have the potential to improve our health and emotional well-being, it is critical that you consult with your healthcare provider before starting any new supplement regimen.
Your personal healthcare provider can assess your needs, consider potential interactions with medications, and guide you toward the appropriate dosage. So, before embarking on any supplement journey, be sure to check with your healthcare provider first.
When choosing any supplement it's important to note that the Food Drug Administration (FDA) does not regulate supplements in the same way as medications. Therefore, it's crucial to choose high-quality supplements from reputable sources to ensure their efficacy and safety.
Reading customer reviews and checking for third-party testing can provide additional peace of mind. The consumer lab website, consumerlab.com, is one of my favorite reputable sites for supplement information and updates.
Finally, if you're experiencing withdrawal symptoms from antidepressants, please follow up with your mental health prescriber. Take the proactive step towards finding the right solution for you and regain control of your well-being.
Disclaimer: This information is being provided to you for educational and informational purposes only. It is being provided to you to educate you about wellness and as a self-help tool for your own use. It is not medical or psychological advice. Please do not stop psychiatric medications or any current medications abruptly as this may cause serious physical and emotional reactions. If your goal is to wean off psychiatric medications, please see your healthcare provider for further guidance.
