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Rebound Effect: And you thought it was bad the first time around

How to Prevent Depression

“Okay, Bill, I quit the med. I guess I’m not surprised by a return of symptoms, but I didn’t expect this! What’s going on here?”

 Sounds like someone may be experiencing a rebound effect.

Within the realm of meds someone with a mood or anxiety disorder may be taking – Xanax, Prozac, Lunesta, etc. – it can happen upon cessation.

chipur readers have described what may be rebound effect, whether they knew it or not. So I promised an article on it several days ago – buckle-up, here we go…

Rebound Effect

Simply, a rebound effect is a return of symptoms (often worse than before meds therapy) when a med used to manage them has been suddenly discontinued.

Though not as intense, it’s not unlike the “crash” experienced when an amphetamine user quits the substance. However, the effects may be more drawn-out.

Though no one knows for sure why it occurs, it may be a manifestation of homeostasis (self-regulation and balance), the body doing all it can to restore order. So what’s it doing? It’s pulling itself in the opposite direction of the drug.

Using a non-psychotropic as an example – sudden cessation of the corticosteroid clobetasol, used in the treatment of psoriasis, can generate a much more severe case of psoriasis.

Some Meds & Effects

Here are just some of the drug types that are apt to cause a rebound effect upon cessation. I’ve included assorted helpful and interesting info…

  • Antidepressants: (Prozac, Viibryd, Effexor, etc.): Extended use of any med that increases the amount of serotonin, or other neurotransmitters in the brain, can cause some receptors to “turn off” temporarily or become desensitized. So when the amount of said neurotransmitter available in the synapse returns to an otherwise normal state, there are fewer receptors to attach to – causing feelings of depression until the brain re-adjusts. Rebound effects may include depression, anxiety, and panic.
  • Benzodiazepines (Xanax, Klonopin, Halcion, etc.)/Hypnotics (Lunesta, Ambien, etc.): Some 70% of those using a benzo will experience a rebound effect upon cessation. Severe anxiety will likely present, and insomnia if the med was being used to induce sleep. Rebound withdrawal can present if the med was being used to ward off withdrawal or rebound withdrawal effects.
  • Amphetamines: (Concerta, Ritalin, Dexedrine, etc.): Rebound effects can include psychosis, depression, and a return of ADHD symptoms (in a temporarily exaggerated form).
  • Decongestant nasal sprays: A rebound effect may be constant nasal congestion, known as rhinitis medicamentosa.
  • GERD (gastroesophageal reflux disease) meds (Nexium, Prevacid, Prilosec, Protonix, etc.): A study has shown that perfectly healthy people suffer significant heartburn symptoms they’d never had before when they stopped taking one of these drugs after two months of use.

Can Rebound Effect Be Treated?

Rebound effect can be treated, perhaps avoided altogether. The first step is always chatting with your doc before taking a med – and for sure before stopping it. And don’t assume she/he will anticipate or recognize rebound effect(s). You have to do your research and be assertive.

Medications with a known rebound effect can be withdrawn gradually or in conjunction with another medication that doesn’t traditionally cause rebound effect.

For example, let’s reference corbetasol again. Withdrawal should be gradual, perhaps diluting the medication with lotion until very little actual medication is being applied.

Now, the only way to relieve rebound symptoms caused by some meds is to gut them out for a few days. Fact is, if the original cause of the symptoms is no longer present, the rebound effects will go away on their own.

Let’s Wrap It Up

Anyone managing a mood or anxiety disorder juggles plenty of balls. Taking on more in the form of rebound effect really isn’t an option.

Unfortunately, it happens.

And if it’s happening to you, or has happened, now you know what it is – and what to do about it.

And isn’t that just chipur! Knowledge, action, relief, and freedom…

Interested in checking-out chipur’s Feel Better Articles? Click away here. How ’bout the articles on meds, supplements, and devices? Right here.

  • JustCurious

    Regarding the Clobetasol, you mentioned in the beginning of the article,  you have spelled it differently in further reference in the article (corbetasol).  Are we talking two different drugs, or the same one.  I do use Clobetasol, so thank you for the information on rebounding.

  • Warning: Benzo rebound can be dangerous, causing seizures and death. Even if it doesn’t kill you, you might wish it would. It’s that bad.

    I’ve never been as close to suicide as when I was quitting benzos after only 9 months of daily use. It feels like early stage dementia combined with the worst depression, anxiety and insomnia imaginable. A year-long panic attack. Total inability to experience pleasure from the things you once loved. In one study, 11% of males and 23% of females with a sedative abuse problem committed suicide. That was almost me.

    After 2+ years clean, I’m about 90% healed. Not sure if I’ll ever be 100% normal again.

    • Thank you for your visit and contribution, HLM. First and foremost, kudos to you for 2+ years of “cleanliness.” That’s a huge accomplishment. And here’s hoping you regain that final 10%.

      Benzos are serious, serious biz. And I wonder how many prescribers include details such as yours in their informed consent sharing (if they use informed consent at all). Embarking upon the benzo path calls for plenty of due diligence and thought. What you’ve presented bangs the point home.

      Please visit and comment again…
      Bill

  • Forbidden Fruit

    Sweet mother of Pearl, there is NOTHING like the depression and anxiety of a benzo rebound! After a single dose I can expect 1-2 days of sheer misery–moodiness, panic & rage aimed at my innocent girlfriend. My thoughts are warped and negative, and everything seems hopeless. It’s like having your brain stuck in a vice.

    I’d rather just suffer through anxiety than take a benzo and pay for it later.

    • “Sweet mother of Pearl,” I love it, FF. Reads like a well-considered good decision to me. Glad you detailed some of what goes on. Good for those who happen-by.

      Appreciate your visit and participation…
      Bill