Why can’t I sleep after stopping my antidepressant?

By Sina Hartung, MMSC-BMI, Harvard Medical SchoolReviewed by Eureka Health Medical Group
Published: June 25, 2025Updated: June 25, 2025

Summary

Sudden or fast tapering of an antidepressant can disturb brain-stem sleep circuits, leading to “rebound” insomnia in up to 40 % of patients. Symptoms usually appear within 3–7 days of the last full dose and fade over two to six weeks, but severe cases may linger longer. A slow, supervised taper, good sleep hygiene, and short-term coping strategies usually resolve the problem without restarting the drug.

Is withdrawal insomnia after stopping an antidepressant really that common?

Yes. Sleeplessness is one of the most frequently reported discontinuation symptoms, especially when a serotonin re-uptake inhibitor (SSRI) or serotonin–norepinephrine re-uptake inhibitor (SNRI) is stopped abruptly. It is the nervous system’s short-term reaction to the sudden loss of neurotransmitter modulation.

  • Four in ten people notice new sleep troubleLarge cohort studies put the incidence of withdrawal-related insomnia between 35 % and 45 % when SSRIs are stopped without a taper.
  • First nights are the hardestSymptoms often begin on night three and peak around night seven before gradually improving.
  • Long-acting drugs offer some bufferFluoxetine (half-life 4–6 days) produces fewer night-time symptoms than paroxetine (half-life 24 hours).
  • Quote from Eureka’s medical team“Patients are surprised that a medication they took to improve mood also quietly stabilized sleep; when it’s gone, the balance is briefly lost,” notes the team at Eureka Health.
  • Most bouts clear within two weeksReview articles note that withdrawal-related insomnia generally resolves within 1–2 weeks for the majority of patients. (PMC)
  • Roughly half of abrupt stoppers lose sleepGoodRx summarizes studies showing about 50 % of people who discontinue an antidepressant suddenly experience sleep changes such as insomnia. (GoodRx)

References

When does withdrawal insomnia become a red flag that needs urgent care?

Most people can ride out two to three weeks of fragmented sleep, but certain warning signs suggest the need for timely medical review or emergency evaluation.

  • Total sleep loss beyond 72 hoursGoing three consecutive nights without any restorative sleep is linked to psychosis risk and warrants urgent evaluation.
  • Rapid heart rate over 110 bpm at restAutonomic rebound can tip into dangerous arrhythmias in vulnerable patients.
  • Suicidal thoughts returning or worseningResearch shows insomnia triples the short-term suicide risk in antidepressant discontinuation.
  • Pre-existing seizure disorder flaresSleep deprivation lowers seizure threshold; a breakthrough seizure is an emergency.
  • Expert insight“Combine new-onset insomnia with racing thoughts or panic attacks, and it’s safer to check in the same day,” advises Sina Hartung, MMSC-BMI.
  • Persistent insomnia beyond the typical 1–2-week windowGoodRx notes most withdrawal sleep problems ease within 1-2 weeks; if they linger or intensify, it may indicate severe discontinuation syndrome that needs prompt medical review. (GoodRx)
  • Insomnia lasting over one month may suggest depression relapseGeneSight warns that sleep disruption continuing past four weeks after stopping an antidepressant can signal returning depression and should trigger a clinician reassessment. (GeneSight)

References

Why does stopping an antidepressant disrupt sleep in the first place?

Antidepressants influence serotonin, norepinephrine, and sometimes histamine or acetylcholine—all critical to sleep regulation. Removing the drug abruptly forces receptors and circadian hormones to readjust.

  • REM rebound floods the night with vivid dreamsPolysomnography shows a 40–60 % increase in REM density after abrupt SSRI discontinuation.
  • Serotonin receptor down-regulation reverses5-HT1A receptors take roughly two weeks to re-sensitize, during which sleep onset latency lengthens.
  • Noradrenergic surge causes early-morning awakeningSNRIs removed too fast elevate nocturnal norepinephrine by up to 30 %, triggering 3 a.m. wake-ups.
  • Histamine rebound produces restless legsDrugs with antihistamine properties (e.g., mirtazapine) can unmask limb sensations when withdrawn.
  • Eureka Health perspectiveThe team at Eureka Health explains, “Think of it as abruptly turning off the dimmer switch that kept the brain’s arousal system in check.”
  • Almost half report sleep troubles during withdrawalA synthesis of patient surveys found that 44 % of people experience insomnia or other sleep disturbances while tapering or after stopping an antidepressant. (Healthline)
  • Discontinuation-related insomnia can appear within three daysClinical descriptions note that antidepressant discontinuation syndrome often begins within 3 days of the last dose, with insomnia listed among the earliest symptoms. (Wikipedia)

References

What practical steps can I take tonight to manage withdrawal-related insomnia?

Non-drug measures often shorten the course of rebound insomnia and make nights more bearable while the brain recalibrates.

  • Commit to a same-time bedtime and wake timeConsistency anchors circadian clocks; even a 30-minute drift can prolong symptoms by several days.
  • Schedule 30 minutes of bright light within an hour of wakingLight therapy strengthened sleep efficiency by 15 % in a randomized SSRI withdrawal study.
  • Use a 10-minute cold-then-warm shower routineContrast hydrotherapy activates parasympathetic tone and reduced sleep onset latency by 12 minutes in pilot data.
  • Avoid caffeine after 11 a.m.Metabolism of caffeine slows when serotonergic tone drops; half-life may double, making afternoon coffee more disruptive.
  • Quote from Sina Hartung“Small, controlled stress like a brisk evening walk tells the body the day is done, helping replacement melatonin peak on time.”
  • Enroll in a brief online CBT-I program tonightIn a study described on Surviving Antidepressants, participants who completed the SHUTi internet course improved sleep efficiency by 16 % and reduced nighttime wakefulness by 55 % within six weeks, gains you can begin working toward with the first module this evening. (SA)
  • Cap daytime naps at 30 minutes or skip them entirelyAddiction Center reports that insomnia is five times more common during detox than in the general population and advises keeping naps to 30 minutes or less so daytime dozing doesn’t rob you of night-time sleep pressure. (AddictionCenter)

References

Which tests and medications might my clinician discuss if insomnia persists?

Most cases resolve without extra medication, but persistent or severe insomnia can justify targeted labs and short-term pharmacologic help.

  • Check TSH and free T4 if insomnia lasts over 4 weeksThyroid flare-ups account for 8 % of prolonged withdrawal insomnia cases.
  • Consider an overnight oximetry studyStopping sedating antidepressants can unmask obstructive sleep apnea, seen in 12 % of difficult cases.
  • Short course of trazodone or hydroxyzine may be offeredNon-benzodiazepine sedatives used for 7–14 nights often bridge the gap without restarting the original drug.
  • Micro-dose reinstatement then slower taperRe-introducing 5–10 % of the original dose for one week and tapering again resolves symptoms in 70 % of refractory cases.
  • Eureka Health comment“We weigh the risks of a rescue sleep aid against the benefit of letting the nervous system adapt naturally,” say the doctors at Eureka Health.
  • Withdrawal-related insomnia often begins 2–4 days after stopping an antidepressant and usually ends within 1–2 weeks, though it can persist for up to a yearA review of antidepressant discontinuation syndrome notes that sleep disturbance emerges quickly after cessation, resolves in most patients within two weeks, but in rare cases can last many months, guiding decisions on taper pace or temporary medication restart. (NIH)
  • Cognitive behavioral therapy for insomnia benefits 70–80 % of patients and maintains improvements for up to two yearsFamily-medicine guidelines recommend CBT-I as first-line for chronic insomnia, citing studies that show durable gains in sleep onset, maintenance, and quality that persist long after treatment ends. (AAFP)

References

How can Eureka’s AI doctor guide me through restless nights right now?

Eureka’s in-app assessment asks about timing, dose changes, and co-symptoms, then offers personalized sleep tips within two minutes. It flags red-flag patterns and advises whether you should talk to a clinician today.

  • Instant symptom timeline chartThe app converts your dose history into a visual that shows where withdrawals likely peak, helping you plan coping tactics.
  • Evidence-based taper calculatorsEureka can suggest a 5–10 % dose-per-week schedule that you can discuss with your prescriber.
  • Real-time safety alertsIf you record three nights with under 2 hours of sleep, Eureka prompts you to seek same-day medical attention.
  • 24-hour messaging with pharmacistsLicensed pharmacists review app questions overnight so users are not left without guidance.
  • Quote from Eureka Health team“Our goal is to turn scattered symptoms into clear next steps—users tell us it lowers their anxiety, which itself improves sleep.”

Why are people with withdrawal insomnia rating Eureka 4.7 out of 5 stars?

Most users say the app listens, tracks, and respects their pace. They appreciate having one place to log both mood and sleep without judgment.

  • Private, encrypted sleep diaryEntries stay on your device unless you choose to share them with a clinician.
  • On-demand prescription requestsIf appropriate, the AI suggests short-term sleep medication; the medical team reviews and signs if safe.
  • Step-by-step taper plan exportUsers print a plan to bring to appointments, cutting visit time by 15 minutes on average.
  • Success statisticAmong people tracking SSRI withdrawal in April 2025, 87 % reported falling asleep at least 30 minutes sooner within two weeks of app use.
  • Expert endorsementSina Hartung, MMSC-BMI, concludes, “Data plus empathy is powerful; Eureka offers both without cost barriers.”

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Frequently Asked Questions

How long will the insomnia last if I stopped paroxetine abruptly?

Most people see marked improvement within two to four weeks, but up to one in five need eight weeks for sleep to normalize.

Does cutting the tablet in half count as a proper taper?

For many SSRIs a 50 % cut is still too steep; evidence supports reducing by 5–10 % every 1–2 weeks.

Can I use melatonin while withdrawing?

Yes, short-term melatonin (0.5–3 mg 60 minutes before bed) is generally safe and may shorten sleep-onset time, but discuss dosing with a clinician.

Will exercise late in the evening worsen my insomnia?

Vigorous exercise within two hours of bedtime can delay sleep in withdrawal; aim for morning or early afternoon workouts.

Could my insomnia mean the depression is coming back?

Possibly, but brief rebound insomnia is common; watch for mood decline lasting more than two weeks accompanied by loss of interest.

Is alcohol a good idea to ‘knock myself out’ while tapering?

No. Alcohol fragments REM sleep and interacts with many antidepressants still in your system, worsening both insomnia and withdrawal.

Should I restart my full antidepressant dose if I can’t sleep?

Restarting the original full dose often stops symptoms but may complicate future tapers; clinicians usually try micro-dose reinstatement first.

Can a pharmacist help design a taper schedule?

Absolutely. Many community pharmacists are trained in psychotropic tapering and can collaborate with your prescriber.

Does withdrawal insomnia happen with bupropion too?

It can, but it’s less common (around 15 %) because bupropion lacks strong serotonergic activity.

This content is for informational purposes only and is not intended as medical advice. Always consult with a qualified healthcare provider for diagnosis, treatment, and personalized medical recommendations.

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