The WHY question

'Why’ is a really important question but asking it can seem confrontational and people may be unlikely to open up. They might instead tell you what they think you want to hear. So try asking ‘why’ without using the actual word. For example:

• What is leading you to make this change?
• How important is this change to you?
• What is not working at the moment?
• What would be some benefits?
• What things are you worried about?

This is different to asking more leading and confrontational questions such as:

• Why do you need to stop your antidepressant?
• Why don’t you want to carry on taking something that has been helpful?
• Why aren’t you taking your medication?
• Why haven’t you been taking it as prescribed?
• Why don’t you try and take it for a while longer?

Antidepressant withdrawal symptoms

Our understanding about antidepressant discontinuation symptoms is growing all the time and management recommendations have changed. Half of patients will experience withdrawal symptoms on reducing or stopping medication. These can be severe in around half of cases and can last months or sometimes years. 

For others, withdrawal symptoms (previously referred to as discontinuation symptoms) are short and self-limiting. Patients on long-term antidepressants (> six months) are more likely to experience withdrawal effects. 

Patients should be warned not to stop taking antidepressants abruptly as this can give rise to severe and long-standing withdrawal symptoms, increasing relapse risk. Tapering the dose over a few months seems to reduce the risk of withdrawal symptoms. It takes between 3-24 months for a patient to successfully come off an antidepressant.