Antidepressant Discontinuation Syndrome: Just the Beginning

I’m terrified.

After my suicide attempt and subsequent psychiatric hospitalization in 2014, all my medication was changed. I was started on a different antidepressant (Pristiq, 100 mg.) and a different antipsychotic (Abilify, 15 mg). In 2018, following my stroke I became severely depressed and returned to therapy. My therapist, Dr. Lev, added a second antidepressant (Remeron, 45 mg.) to my cocktail. I’ve been stable on these medications ever since.

I started a new job this year. That means new insurance. When I ran out of the Pristiq, Dr. Lev had to send in a refill to the pharmacy which triggered a prior authorization request from my new insurance company. Unfortunately, by the time she got notified that prior authorization was necessary, I only had one tablet left, which I took this morning.

In an article published by the AMA, Jack Resneck, a dermatologist and immediate past president of the AMA, writes about prior authorizations, “Many years ago, health insurance plans came up with this process, and at the time it was just for brand-new, expensive medications that had just come to the market or new treatments that they wanted to limit use of.”

I can manage one or two days without the Pristiq, but more than that I start to worry. I’m anxious that I may start to go through withdrawal or what is more formally called antidepressant discontinuation syndrome which can happen if you stop taking your…