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Feeling Stuck on Antidepressants in Midlife? How to Taper Off Safely with Mark Horowitz, PhD

Mar 23, 2026
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INSIGHT

Antidepressants Have Wide Long Term Side Effects

  • Long-term adverse effects include sexual dysfunction, weight gain, cognitive impairment, sleep disruption, gut problems and possibly increased stroke/fracture risk in older adults.
  • Horowitz notes many effects are subtle, build over months, and patients often only recognize them after stopping the drug.
INSIGHT

Dependence Is Not The Same As Addiction

  • Antidepressants are not addictive in the craving/compulsive sense but they cause physical dependence that produces withdrawal when stopped.
  • Horowitz compares dependence to caffeine withdrawal: common and non-addictive yet physiologically real.
INSIGHT

Withdrawal Often Looks Like Relapse

  • Withdrawal often mimics relapse but can be a distinct new syndrome including anxiety, panic, suicidality, brain zaps, dizziness and gut symptoms.
  • Horowitz stresses many clinicians misinterpret withdrawal as relapse and re-prescribe instead of slowing taper.
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