How do you taper off an antidepressant safely?

With a plan, not a cliff edge. The NHS describes the standard approach: your doctor gradually reduces your dose over several weeks or months - always following their schedule, never your own improvisation. Why so slow: your brain adapted to the drug over months, and it needs weeks to re-adapt downward; cutting too fast triggers discontinuation symptoms - dizziness, nausea, flu-like feelings, insomnia, vivid dreams, irritability, and the famous electric-shock sensations people call brain zaps. They are uncomfortable, not dangerous, and they are the signal to slow the taper, not to panic - a small step back up, then smaller or slower steps down, usually fixes it. The two drugs that demand the most patience: venlafaxine and paroxetine, which clear the body fast and punish abrupt cuts hardest; fluoxetine, by contrast, lingers for weeks and is the most forgiving. Two things to separate in your head: discontinuation symptoms (start within days of a cut, fade within a couple of weeks) versus relapse (the original depression or anxiety returning, typically weeks later and building) - your prescriber helps you tell them apart, because they have opposite meanings. Timing tip: pick a stable life stretch for the taper, not exam season or a house move. Pymander is a free AI doctor, 24/7 by text, that can help you prepare for the appointment.