This topic is not medical advice; it is simply sharing the collective experience of those harmed by antidepressants or having difficulty coming off to give you talking points you can share with a medical practitioner who is knowledgeable about AD drug harm and tapering.

 

Reinstating an Antidepressant 

 

When a user of an antidepressant tapers too quickly to zero or abruptly stops their drug, they can experience a whole range of debilitating symptoms which don’t pass in a few days and can instead last for weeks, months or even years.

 

This happens due to physical dependence the brain has developed to the drug, ie. the brain has adapted to the presence of the drug. It is thought the symptoms are caused by the brain and body struggling to function "normally" once the drug has been removed and that the brain is trying and struggling to "rebalance" back to normal functioning, or homeostasis. Whilst the brain is making these readaptations back to homeostasis the symptoms will persist.

 

Can reinstating help with this?

 

There is no known cure for antidepressant withdrawal apart from time. The only thing that can help reduce or cushion the symptoms is reinstatement.

 

Reinstating, when it works, works well and just a small amount of the drug can offer the brain enough of what it is looking for to relieve some of the symptoms a sufferer is dealing with. 

Readily available doses of most antidepressants are much higher than are often tolerated and so the key to a successful reinstatement is to try a lower dose and only then increase it gradually from there if required, in case a higher one is too much.

 

High dose reinstatements have a history of adding fuel to the fire and making symptoms worse not better, so taking a smaller dose helps mitigate that risk.

If you had an adverse reaction whilst taking your antidepressant or felt that you were not tolerating it well, but are now experiencing WD symptoms having tried to stop it, then a lower dose may help, ADRs tend to be dose sensitive and may not be a problem for you at a lower dose and clearly you are sensitive to it and should start small and with caution.

 

Reinstatement is best done immediately after stopping or as soon as possible. A common excepted time frame is within three months of cessation of the drug; however, this is not a rule. There have been successful reinstatements outside of the time frame but the longer it is left the riskier the process becomes.

 

Reinstatement doesn’t always work and has in the past made peoples symptoms worsen. It is up to you to decide if the risk is worth taking based on your current symptoms and personal circumstances.

 

Settling on a lower dose for RI means you have less drug in your system and less to taper after stabilisation. 

 

Having already destabilised yourself by stopping the drug, likely too quickly, your system is now more sensitive and large doses and or increases may cause you to react badly to the drug and get even worse, not better (sometimes referred to as kindling).

 

Another reason less drug may be needed is your receptors may have already up-regulated whilst you were off the drug, you might not need as much now as a result.

 

What dose should I try?

 

Reinstatement is not an exact science. There are a number of things to think about when deciding on a reinstation dose. Often the major factor here is assessing the severity of the symptoms, how long you were taking the drug and how long ago was it since your final dose.

 

If you have been on a drug for a long time and have only just stopped it, something around half your original dose is likely all you need to reduce your WD symptoms. 

Some have found even half the dose is too much. We would recommend caution and consider no more than 10% of the original dose as a starting point, you can always increase this if you find it helps having held at this dose for a couple of weeks.

 

If you have been off some time and or have had an ADR, then a more cautious approach should be taken. Often a dose of under 1mg (2.5-5% of the original) allows you to check to see how you react to the drug. Even this small amount may be enough to elevate some of the symptoms. After a 7-14 day hold, you could look to increase slightly from here if needs be. 

 

If you have hyper alerting symptoms such as anxiety panic or sleeplessness, you may find you are too sensitive for reinstatement but if you still feel you want to try then again a very low dose similar to above would be the safest approach.

 

Remember, as above, you can always start small and gradually increase it after a while if you tolerate it but it hasn't given you enough symptom relief, whereas trying too much too quickly risks causing further harm that is difficult to reverse.

 

How long does it take to work?

 

The first thing to look out for after having reinstated is a severe worsening of your condition, if this happens it best to reduce or stop taking the drug immediately.

 

Sometimes reinstatement can offer almost immediate relief of WD symptoms. This isn’t always the case, however. 

It can take a number of days for the quantity of medication in your body/bloodstream to stabilise after introducing a dose depending on your physiology and the drug in question, so it is best to hold after that initial dose for 7-14 days whilst you wait to see its effect on you as it builds up in your system. Once you feel you have seen the full effect of the reinstatement you could consider some small gradual increases to see if this further helps things, always holding at each change for 7-14 days.

 

Often people feel better initially after reinstating and then improve further over the coming weeks and months, that initial improvement is often a good sign.

 

You may still experience windows and waves during this stabilisation period; they tend to lessen over time.

 

If you increase a few times and find your symptoms worsen then you have potentially reached the limit of the effectiveness of the reinstatement and it would be best to return to the previous dose and hold there and wait to settle.

 

It’s good to be cautious with further up doses, more is not always better. Symptoms can take a few weeks to show so you don’t want to feel ok and then suddenly find you get worse as time passes. Holding after the initial stabilisation allows you to check to see what symptoms might show over time.

 

When should you start to taper after a reinstatement?

 

A common question is when are you stable enough, following a reinstatement, to begin a taper? You are not necessarily looking to be completely symptom free but to see a significant reduction in severity of symptoms. Keep a daily diary and rate your symptoms from 1-10, 1 being mild and 10 severe. The goal is to be able to consistently have 1-3 as your score before commencing a taper.

 

Generally, it is best to think in terms of months rather than weeks after reinstatement to become stable.

 

Sometimes a very long hold is needed to get to a place where you can tolerate further dose reductions.

 

Tapering with severe WD symptoms in most cases is not a good idea and is thought to worsen nervous system irritation and make protracted withdrawal more likely so should be avoided. If you have already destabilised yourself and undergone several rounds of dose changes, continuing to go up and down can just lead to continuing to worsen as you are likely highly sensitised by this point. This is why typically if a reinstatement has begun to work, it is thought to be best, to hold for a while to give your body some stability as beginning a taper can just further destabilise you again.

 

What rate should I reduce my dose when I’m ready to taper?

 

The normal guide is no more than 10% of the last dose of the previous month or following a hyperbolic taper schedule. Listen to your body and look for WD symptoms after each drop. If you experienced a cold turkey prior to reinstatement, then your system is likely very sensitive and very small drops might be all you can take. You might consider a small trial of perhaps 2.5% to see how you feel. Alternatively you could taper using the Brass Monkey Slide or a Micro taper, both are often more gentle on an irritated nervous system.

 

Brass Monkey Slide

Micro-taper instead of 10% or 5% decreases

 

Don’t rush the process, if you get WD symptoms hold at the new dose for 7-14 days and see if they settle, if they don’t you could consider increasing back to your previous dose and holding there.

 

Reinstating a different drug

 

It is always best to reinstate the original drug you were taking. Trying to take a different drug to treat withdrawal symptoms from a CT or too fast a taper is likely to make you much worst.

 

'Sister' Drugs

 

'Sister' drugs are two antidepressants based on the same 'base' drug.

For example; if you were taking Escitalopram which is considered to be hard to taper, you may wish to reinstate Citalopram, which may be easier for you to taper. Another example of sister drugs are Venlafaxine and Devenlaflaxine (But from the SNRI Class).

 

'Cousin' Drugs

 

'Cousin' Drugs are drugs in the same class as each other. For example; All drugs in the SSRI class are 'cousins' of each other. All drugs in the SNRI class are 'cousins' of each other.

If the drug you were originally taking is no longer available, then you may wish to consider trying an alternative ‘cousin’ in the hopes your brain accepts this and relieves your symptoms.

 

Reinstatement is, in itself, a risky process and trying a different drug further increases this risk, so is not advised unless absolutely necessary. Your nervous system is likely highly sensitised at this point, and whilst some have seen success swapping drug, MANY have been harmed or had significant difficulties and may have been better off RI the original drug, or considering staying off the drug completely, and waiting to recover.

 

This topic was inspired by Altostrata from Surviving Antidepressants fantastic threads which are well worth a read for further information.

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

How long does it take to stabilize after reinstating or updosing?

Hypersensitivity and kindling

 

Our topic on tapering can be found here;

Tapering Information

 

On 3/6/2026 at 5:07 AM, Chippy said:

Reinstatement is best done immediately after stopping or as soon as possible. A common excepted time frame is within three months of cessation of the drug; however, this is not a rule. There have been successful reinstatements outside of the time frame but the longer it is left the riskier the process becomes.

Excellent post! Thank you so much for the thoughtful description. I am finding myself at a bit of a crossroads on whether or not I should reinstate Prozac at perhaps 5mg or so taper. It's tough, on one hand I would like to wait it out to the 6 week mark and see if I improve. On the other hand, I don't want to worsen and then be unsuccessful in reinstatement. 

9 hours ago, HopeHeals said:

Excellent post! Thank you so much for the thoughtful description. I am finding myself at a bit of a crossroads on whether or not I should reinstate Prozac at perhaps 5mg or so taper. It's tough, on one hand I would like to wait it out to the 6 week mark and see if I improve. On the other hand, I don't want to worsen and then be unsuccessful in reinstatement. 

I’ve just responded to your thread with some thoughts. Glad you found the post helpful.