Have you been on the medicine for at least a year and done well during that time?
The likelihood of a depression relapse (or recurrence) decreases after 9 to 12 months following a depression response.
Are you still having some residual symptoms of depression?
The more ongoing symptoms you have, the greater the chance of another depressive episode.
Have you recently tried unsuccessfully to come off the medicine?
If you gradually reduced your medicine and still had depression symptoms return within the last three to six months, you may need to wait a little longer before trying again. If you stopped the medicine abruptly, your depression symptoms may have recurred because of the sudden dose decrease, or they may have been discontinuation symptoms. In that case, you may be able to try again, but go more slowly.
Have you had multiple episodes of depressions in the past, or do you have a strong family history of mood problems? These could indicate a strong biological predisposition to depression and a possible need for ongoing medication maintenance therapy.
Is your physical health good, and are you taking care of yourself?
Medical problems, chronic pain, poor sleep habits, little physical activity, and poor dietary habits can all work against doing well off antidepressants.
Are you using excessive amounts of alcohol or illicit drugs?
Substance abuse will work against you when trying to come off medication.
How is your current stress level?
Timing can be everything when it comes to stopping your medication. Problems in areas such as work, school, home, health, relationships, and finances can affect your ability to stay well. If the conditions are not ideal, you should consider waiting until those issues resolve.
There is a detailed self-test in my book called START (Successfully Tapering Antidepressants Rating Test) that can help you determine if now is the right time to quit antidepressants. Use the results of START and the answers to the above seven questions to discuss tapering-off options with your doctor.
Michael Banov MD is a Harvard-trained, triple board-certified adult, adolescent, and addiction psychiatrist and medical director of Northwest Behavioral Medicine and Research Center in Atlanta, Georgia. More detailed information on how to determine the right time to quit antidepressants -- as well as how to do it safely -- is in Dr. Banov's new book, Taking Antidepressants: Your Comprehensive Guide to Starting, Staying On, and Safely Quitting (Sunrise River Press, 2010). Find out more at www.takingantidepressants.com
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