What Happens If I Miss a Day of My Antidepressants?

Here’s what missing a dose could feel like, what to do next, and some tips to help you remember to take your medication.

Many people with depression take antidepressants.

In fact, data from the CDC has shown that antidepressants are one of the main forms of treatment for depression in the United States. The CDC also reports that antidepressants are one of the most common prescription medications used by Americans.

Most antidepressants are taken daily. And while it’s best to remember to take your medication when you’re supposed to, sometimes things happen and you might miss a day of your antidepressants.

It’s important to remember not to panic — you’ll be OK! Just resume taking your regular doses as soon as possible.

If you do miss a dose of your antidepressants, here’s a rundown on what skipping a day may look like, what to do, and some tips to help you remember to take your medication.

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How do antidepressants work?

It’s thought that depression is caused in part by an imbalance of certain neurotransmitters. Neurotransmitters are chemical messengers that carry signals between cells, influencing everything from muscle movement to organ function to mood.

When our neurotransmitters are out of balance, the brain can’t correctly pass signals to nerves throughout the body. Antidepressants work by increasing the levels of neurotransmitters in the brain.

For example, take the neurotransmitter serotonin, which is linked to mood and emotion. SSRI antidepressants (selective serotonin reuptake inhibitors), like Prozac and Zoloft, work by blocking serotonin from being reabsorbed after the neurotransmitter has passed along its message.

This leaves more serotonin available in your brain, which boosts your serotonin levels. Higher serotonin levels can in turn help relieve depression symptoms.

What are the potential side effects if you miss a day of antidepressants?

Antidepressants are usually prescribed to be taken daily. If you miss a dose, the levels of medication in your body fluctuate. Fluctuating levels of medication in turn cause neurotransmitter levels in your brain to change. For some people, this can result in uncomfortable physical and emotional symptoms.

Other people may not experience any symptoms.

While side effects and their severity can vary from person to person and from medication to medication, common symptoms of missing a day of antidepressants include:

• irritability
• agitation
• anxiety
• mood swings
• fatigue
• nausea
• dizziness
• lightheadedness

You may experience more severe side effects after forgetting your antidepressants if:

• You take a higher dosage of antidepressants.
• Your antidepressants have a short half-life.
• Your body metabolizes your antidepressants more quickly.

On the flip side, you may experience milder side effects if

• You take a lower dosage of antidepressants.
• Your antidepressants have a long half-life.
• Your body metabolizes your antidepressants more slowly.

If you miss more than one dose or consistently miss doses over a short period of time, you may begin to feel the effects of a sudden withdrawal from your medication. Some people feel these effects after only one missed dose. This is what’s known as discontinuation syndrome.

What is discontinuation syndrome?

If you stop taking antidepressants too suddenly, you may experience antidepressant discontinuation syndrome (ADS). When you abruptly stop antidepressant use rather than slowly tapering it off, the sudden chemical shifts in your brain can trigger a physiological and neuropsychiatric response.

ADS symptoms are sometimes referred to as “withdrawal” symptoms. However, this terminology doesn’t mean you’re addicted to antidepressants, as antidepressants aren’t considered addictive.

About 20% of people who stop taking their antidepressants too suddenly experience ADS. A 2014 review found the likelihood and severity of ADS symptoms to be associated with the duration of antidepressant use and the dosage.

ADS symptoms can include:

• flu-like symptoms including fatigue, headache, nausea, and sweating
• dizziness
• lightheadedness
• insomnia, or vivid dreams and nightmares
• tinnitus
• sensory disturbances like burning, tingling, or electric shock-like sensations
• anxiety
• irritability
• agitation
• mania

ADS symptoms can occur within 2–4 days of stopping antidepressants and can last anywhere from a week to a couple of months. If you start taking your antidepressants again, symptoms will usually go away within a few days.

Are some antidepressants worse to miss than others?

The side effects of missing a day of antidepressants vary depending on dosage, where you are in your treatment regimen, your body, and the type of medication.

The Royal College of Psychiatrists breaks down the risk of withdrawal symptoms after a missed dose of certain antidepressants (or after discontinuing treatment) as follows:

• Highest risk: duloxetine (Cymbalta, Irenka), venlafaxine (Effexor XR), paroxetine (Paxil, Paxil CR, Pexeva)
• Moderate risk: sertraline (Zoloft), citalopram (Celexa), escitalopram (Lexapro)
• Low risk: fluoxetine (Prozac), bupropion (Wellbutrin XL, Wellbutrin SR, Aplenzin)

Take Zoloft (sertraline) and Prozac (fluoxetine), for example. Zoloft has a relatively short half-life of 26 hours, whereas Prozac has a long half-life of 4–6 days. The half-life of an antidepressant refers to the amount of time it takes for 50% of the medication to leave your body.

Put more plainly:

• 26 hours after a dose of Zoloft, 50% of the medication is left in your body.
• 4–6 days after a dose of Prozac, 50% of the medication is left in your body.

This means that Prozac remains in your body for a longer amount of time between doses than Zoloft does. In other words, it’s likely that you won’t experience severe symptoms after just one missed dose of Prozac. You might not experience any symptoms at all.

With Zoloft, on the other hand, you may begin to experience the effects of missing a dose more quickly. For Zoloft to work most effectively, a certain amount of it needs to be in your body at all times. This means that it can be more impacted by irregularity.

This doesn’t make Zoloft more dangerous than Prozac; it just means that you may be a bit more uncomfortable if you forget to take it.

What should I do if I miss a day of antidepressants?

So you missed a day of antidepressants. Maybe you were in a huge rush in the morning and only remembered your antidepressants after you left. Maybe you went away for the weekend and forgot your prescription at home.

Whatever the reason, it happens and it’s OK! Don’t beat yourself up about it and remember that you’ll get through the next couple hours or the day if need be.

Here’s what you should do:

• If you remember within a couple of hours of the missed dose and you have your antidepressants with you, you can take your dose.
• If you remember just a few hours before your next scheduled dose, skip the forgotten dose and just take your next dose as scheduled.
• Never take two doses at a time to try to “catch up,” as this can increase your risk for dangerous side effects.

If you’ve missed a couple of days, it may take some time for the medication to work its way back into your system. Trust that your antidepressants will get back to doing their job, and if anything feels off, bring it up with your doctor.

Tips for remembering your medication

Remembering to take your antidepressants can be hard.

Here are some strategies that you can try incorporating into your daily routine to help you remember.

• Alarms and reminders: Set daily alarms or reminders on your phone, smartwatch, tablet, computer, or any other electronic device that you use regularly. When they pop up, take your medication immediately.
• Stickie notes: Stick notes in places you know you’ll see during your morning routine, like your bedside table, bathroom mirror, fridge, or front door. For travel, tape notes to your usual weekend bags and suitcases to remind yourself to pack enough medication for your trip.
• Activity association: Take your antidepressants as you complete a particular activity, like getting up, eating breakfast, or brushing your teeth. This can help your brain associate that activity with your medication so that the activity itself reminds you to take it.

Things to keep in mind

It’s important to remember that feeling better with antidepressants doesn’t necessarily mean that you no longer have depression. It might just mean that your medication is working. If you stop taking your medication, particularly if you do so abruptly or without making a plan with your doctor, the positive effects you’re feeling may well go away.

It’s also important to remember that there’s nothing wrong with taking antidepressants. Depression is a health condition, and like other health conditions, pharmaceutical treatment options are available and effective.

If antidepressants help you function on a daily basis and live your life more fully, more power to you! Keep doing what works for you.

If you’re considering stopping antidepressants, it’s best to consult with your healthcare professional first. They can help you come up with a plan to gradually taper off your medication rather than stopping cold turkey.

The takeaway

Missing a day of antidepressants can be jarring, but you’re going to be OK.

Most of the time, you’ll probably skip the missed dose entirely and take your next daily dose as scheduled.

You may feel some symptoms, but they’ll go away once your antidepressants work their way back into your system and help your mind and body reset.