Duration of SSRI Withdrawal Flu-Like Symptoms
Flu-like symptoms from SSRI withdrawal typically last 2-3 weeks, with symptoms peaking around day 5 after discontinuation. 1
Timeline of Symptom Onset and Resolution
- Onset: Withdrawal symptoms generally begin within 24-48 hours after stopping the SSRI 1, 2
- Peak intensity: Symptoms reach their maximum severity around day 5 1
- Typical duration: Most symptoms resolve within 2-3 weeks 1
- Extended cases: In some patients, particularly with paroxetine exposure, symptoms can persist up to 4 weeks 3
The evidence consistently shows this 2-3 week timeframe across multiple sources, though the American Academy of Child and Adolescent Psychiatry notes that symptoms usually resolve within 1-2 weeks in most cases 3.
Specific Flu-Like Manifestations
The flu-like symptoms you can expect include:
- Fatigue, lethargy, and myalgia 4
- Chills 4
- Nausea and vomiting 4, 1
- Headache 1
- Dizziness and light-headedness 4, 1
Factors That Influence Duration
Medication half-life is the most critical determinant of withdrawal symptom duration and severity:
- Short half-life SSRIs (paroxetine, fluvoxamine, sertraline) carry higher risk and potentially longer symptom duration 5, 1
- Long half-life SSRIs (fluoxetine) have lower risk due to self-tapering effect 5, 4
Additional factors affecting duration include:
- Daily dose at time of discontinuation (higher doses = longer symptoms) 1
- Duration of SSRI treatment (longer treatment = more prolonged withdrawal) 1
- Abruptness of discontinuation versus gradual taper 4, 2
Management to Shorten Duration
If symptoms are severe or intolerable, reinstituting the original SSRI and implementing a gradual taper is the most effective approach 5, 4, 1:
- The American Academy of Child and Adolescent Psychiatry recommends a tapering period of 3-4 weeks for fluoxetine, with longer tapers needed for shorter half-life agents 5
- For mild symptoms, reassurance that they are transient and self-limiting is often sufficient 4
- For severe symptoms, restart the medication and taper more slowly 4, 1
Critical Pitfalls to Avoid
Do not mistake withdrawal symptoms for relapse of depression or a new medical illness 4:
- Misdiagnosis can lead to unnecessary testing and inappropriate treatment 4
- The temporal relationship (symptoms starting 24-48 hours after discontinuation) is the key diagnostic feature 1, 2
- Withdrawal symptoms are distinctly different from recurrence of underlying depression 6, 7
Do not assume all patients follow the 2-3 week timeline: