Common SSRIs Compared

SSRI	Typical Dose	Main Uses	Notes
Sertraline	50–200 mg	Depression, anxiety, PTSD, OCD	Most versatile, widely used
Fluoxetine	20–60 mg	Depression, bulimia, OCD	Long half-life: easiest to stop
Citalopram	20–40 mg	Depression	Simple, few drug interactions
Escitalopram	10–20 mg	Depression, anxiety	Slight improvement on citalopram
Paroxetine	20–60 mg	Depression, anxiety, PTSD	Short half-life: harder to stop

First 2 WeeksSSRIs can temporarily increase anxiety and agitation in the first 1–2 weeks. Do not stop. This usually settles. Contact your doctor or mental health team if you feel significantly worse or have thoughts of self-harm.

Timeline: What to Expect

Timeframe	What Happens
Days 1–3	Possible nausea, headache, restlessness
Week 1–2	Side effects may peak: anxiety, insomnia common
Week 2–4	Side effects usually settle; sleep often improves first
Week 4–6	Mood starts to lift: motivation returns
Week 6–8	Full antidepressant effect usually achieved
6–12 months	Recommended minimum treatment duration after recovery

Common Side Effects

Nausea (usually settles after 1–2 weeks: take with food)
Insomnia or excessive drowsiness (depends on person)
Sexual side effects (reduced libido, delayed orgasm): affects 30–40%
Headache
Dry mouth
Sweating

Sexual Side EffectsSexual dysfunction is common with SSRIs, reported in roughly 25% to 70% of people depending on how it is asked about, and is frequently under-discussed. It doesn't always resolve. Options include waiting, dose reduction, switching to bupropion or mirtazapine (lower risk), or adding another medication. Always discuss with your prescriber.

Stopping: What the Evidence Actually Shows

Discontinuation symptoms are the part of antidepressant treatment most argued over, and both extreme accounts are unhelpful. A systematic review pooling 79 studies and 21,002 patients gives the most useful set of numbers currently available.²

Around 31% of people reported at least one symptom after stopping an antidepressant. But 17% reported symptoms after stopping placebo — a dummy tablet with nothing to withdraw from. Once that is accounted for, the incidence attributable to the drug itself came out at roughly 15%: about one person in six or seven. Severe symptoms were much less common, at about 2.8% after an antidepressant against 0.6% after placebo.²

Both things are true at onceDiscontinuation symptoms are real, and they are not what happens to most people who stop. The high placebo figure also means that experiencing symptoms does not prove the drug caused them — the underlying condition returning is a genuine alternative explanation, and telling those apart changes what should happen next.

Which drug matters. The same review found discontinuation symptoms reported more often with desvenlafaxine, venlafaxine, imipramine and escitalopram, and rated as more severe with imipramine, paroxetine and venlafaxine or desvenlafaxine.² Drugs that leave the body quickly tend to be harder to stop than those that clear slowly, which is why the taper that suits one antidepressant may be far too quick for another.

Dependence Is Not the Right Word

Discontinuation symptoms are often described, including by people experiencing them, as withdrawal from an addictive drug. The comparison is understandable and it is not accurate. Antidepressants do not produce craving, do not drive dose escalation to chase an effect, and are not sought compulsively. What happens is that the brain adjusts to the drug’s presence and needs time to readjust to its absence — the same thing that happens with several medicines nobody calls addictive.

The distinction matters because the wrong word leads to the wrong action. People who believe they are addicted sometimes stop abruptly to get it over with, which is precisely what produces the worst symptoms. A planned reduction over weeks to months, slower at the lower doses where each reduction is proportionally larger, is what the evidence supports.

Do not stop on your ownNever discontinue an antidepressant without discussing it with the prescriber, and never stop abruptly because side effects are troubling — switching or adjusting is usually possible. If mood worsens markedly, or thoughts of self-harm appear at any point during a reduction, seek help the same day.

How to Stop an SSRI Safely

Never stop abruptly: this causes discontinuation syndrome (dizziness, electric shock sensations, flu-like symptoms)
Taper dose over 4–8 weeks minimum (longer if on medication >1 year)
Fluoxetine can often be stopped more quickly due to its long half-life
If symptoms return during taper, slow down and discuss with your doctor

How long should I take an antidepressant?

NICE and most guidelines recommend at least 6 months after feeling well. For recurrent depression (3+ episodes), long-term or indefinite treatment is often recommended.

Will antidepressants change my personality?

SSRIs treat depression: they help you feel like yourself again. Most people report that they feel 'normal', not sedated or blunted. If you feel emotionally numb, discuss dose adjustment.

Can I drink alcohol on SSRIs?

Alcohol is a depressant and worsens depression. It can also increase sedation and impair your response to treatment. While not absolutely forbidden, minimising alcohol is strongly advised.

Do SSRIs cause weight gain?

Some SSRIs cause modest weight gain (1–3 kg) with long-term use, but this varies. Paroxetine has the highest risk; fluoxetine may initially cause weight loss.

References

The clinical information on this page is drawn from peer-reviewed sources indexed by the US National Library of Medicine. Links go to the source so you can read it yourself.

Selective Serotonin Reuptake Inhibitors. In: StatPearls. Treasure Island (FL): StatPearls Publishing. NCBI Bookshelf NBK554406
Sertraline. In: StatPearls. Treasure Island (FL): StatPearls Publishing. NCBI Bookshelf NBK547689
Henssler J, Schmidt Y, Schmidt U, Schwarzer G, Bschor T, Baethge C. Incidence of antidepressant discontinuation symptoms: a systematic review and meta-analysis. Lancet Psychiatry. 2024;11(7):526–35. PMID 38851198 · doi:10.1016/S2215-0366(24)00133-0

SSRIs: Complete Antidepressant Guide