10 Medications That Are Dangerous to Stop Abruptly

Written by Austin Ulrich, PharmD, BCACP | Reviewed by Amy B. Gragnolati, PharmD, BCPS Updated on April 21, 2022print_outlinedemail_outlined

Key takeaways:

• Stopping some medications abruptly — like beta blockers, benzodiazepines, and antidepressants — can lead to withdrawal symptoms.
• Withdrawal from certain medications can cause serious side effects. The risk is typically greater if you’ve been on the medication for a long time or your dose is high.
• Always talk to your healthcare provider (HCP) before stopping any medication.

Iryna Imago/iStock via Getty Images

“Can I just stop my medication?” This is one question healthcare providers (HCPs) hear often. And it has a complicated answer. 

Some medications can be dangerous to stop abruptly. Not only could your medical condition get worse, but you could also have dangerous side effects. And with some medications like antidepressants, stopping cold turkey is riskier the longer you’ve been taking them. 

Some medications need to be gradually lowered (tapered). Your HCP can help you make a taper plan. In other words, they’ll help you slowly lower your dose over a period of time.

Below, we’ll talk about 10 medications that may lead to serious problems if stopped abruptly. 

1. Clonidine (Catapres, Catapres-TTS)

If you take a blood pressure medication, you might wonder if you’ll ever be able to stop it. If your HCP gives you the green light to stop taking it, how do you do it?

It depends. Clonidine (Catapres, Catapres-TTS) is a medication that treats high blood pressure — though it’s not a first-choice option. It’s also used off-label for other conditions, like nicotine dependence, opioid withdrawal, or tic disorder. 

Stopping clonidine abruptly can cause a surge of stress hormones, particularly norepinephrine (noradrenaline). This can cause a situation of very high blood pressure known as the “rebound hypertension” effect. Before stopping clonidine, talk to your HCP about how to safely lower your dose.

2. Propranolol (Inderal) and other blood pressure medications 

Propranolol (Inderal) treats many heart conditions. These include high blood pressure, chest pain, and atrial fibrillation. It can also protect the heart after a heart attack. Other FDA-approved uses for propranolol that aren’t related to the heart, include tremors, a specific tumor of the adrenal gland (pheochromocytoma), and migraine prevention. It’s also sometimes used off-label for performance anxiety. 

Propranolol is part of a group of medications called beta-blockers. Stopping beta-blockers may cause withdrawal symptoms, including:

• Higher blood pressure
• Chest pain
• Anxiety
• Fast heartbeat
• Heart attack

Keep in mind that stopping any blood pressure medication cold turkey may be dangerous because it can cause your blood pressure to rise quickly. These include:

• Calcium channel blockers, like amlodipine (Norvasc) 
• Angiotensin-receptor blockers (ARBs), like losartan (Cozaar)
• Diuretics, like spironolactone (Aldactone)

Talk to your HCP before stopping any blood pressure medications. They can help you determine if it’s safe to stop the medication. And they can give you a plan for how to lower your dose slowly.

3. Venlafaxine (Effexor, Effexor XR)

Venlafaxine (Effexor XR, Effexor) is part of a group of medications called serotonin-norepinephrine reuptake inhibitors (SNRIs). It can treat depression, anxiety, and panic disorder. 

Venlafaxine has a shorter half life than many antidepressants, meaning it leaves your body quickly. Because of this, stopping venlafaxine abruptly can shock your body and lead to withdrawal symptoms, such as: 

• Irritability
• Nausea
• Vomiting
• Dizziness
• Nightmares
• Headache
• Tingling sensation on skin (paresthesia)

Talk to your HCP before stopping venlafaxine. They’ll likely recommend that the dose be lowered slowly. In studies of venlafaxine, doses were lowered by 75 mg every week until the medication was stopped. Sometimes, the dose may need to be lowered over several months to avoid withdrawal symptoms.

4. Paroxetine (Paxil)

Paroxetine (Paxil) is part of a group of medications called selective serotonin reuptake inhibitors (SSRIs). It’s used to treat the following conditions:

• Depression
• Anxiety
• Obsessive-compulsive disorder (OCD)
• Panic disorder
• Post-traumatic stress disorder (PTSD)
• Premenstrual dysphoric disorder (PMDD)
• Social anxiety disorder (SAD)

Like venlafaxine, it has a short half life. It’s one of the SSRIs that’s most likely to cause withdrawal symptoms. So it needs to be tapered gradually prior to stopping. If you stop taking it suddenly, symptoms may include:

• Nausea
• Headaches
• Dizziness and vertigo
• Flu-like symptoms
• Anxiety
• Confusion
• Irritability
• Sleep disturbances (like dreaming excessively or insomnia) 

If you’re taking paroxetine and thinking about stopping it, talk to your HCP about how to safely taper your medication.

5. Benzodiazepines

Benzodiazepines — like alprazolam (Xanax), lorazepam (Ativan), and diazepam (Valium) — are used for anxiety symptoms and panic attacks. They’re also used off-label for a variety of medical conditions including insomnia and alcohol use disorder. 

Benzodiazepines shouldn’t be stopped abruptly. Withdrawal symptoms — including seizures — may occur if you suddenly stop taking these medications. Seizures can happen soon after stopping the benzodiazepine, but they can also occur days later.

Other benzodiazepine withdrawal symptoms include:

• Headache
• Heart palpitations
• Sweating
• Nausea
• Diarrhea
• Trouble sleeping and nightmares
• Irritability or agitation
• Memory and concentration problems
• Anxiety or panic attacks
• Tremors
• Muscle aches, pain, and stiffness
• Confusion
• Delirium
• Delusions
• Hallucinations

Withdrawal is more likely to happen if you’ve been taking a high dose. They can also happen if you have been taking the medication for a long time. Lowering your dose slowly with the approval of your HCP can help you avoid serious withdrawal symptoms.

6. Topiramate (Topamax)

Topiramate (Topamax, Qudexy XR, Trokendi XR) is FDA-approved to treat epilepsy and help prevent migraines. It’s one of the two medications in Qsymia (phentermine and topiramate) used to help with weight loss. And it’s also used off-label to treat alcohol use disorder.

Topamax withdrawal can occur when it’s stopped abruptly instead of tapered. The greatest risk is that your seizures worsen. Instead of stopping Topamax at once, your HCP can help you taper your dosage gradually.

7. Gabapentin (Neurontin)

Gabapentin (Neurontin) is FDA-approved to treat seizures and nerve pain. It’s also used off-label to treat withdrawal symptoms in alcohol use disorder. 

But, you shouldn’t stop taking gabapentin suddenly. Withdrawal symptoms can start as soon as 12 hours after stopping it. 

Gabapentin withdrawal symptoms occur more commonly in people taking this medication at a high dose or in those who take it for a long time. They include:

• Trouble sleeping
• Agitation
• Anxiety and restlessness
• Tiredness
• Sensitivity to light
• Headache
• Sweating
• Dizziness
• Nausea
• Irritability
• Irregular heartbeat
• Pain

In people using gabapentin for seizures, stopping it can cause seizures to return or worsen. Talk to your HCP before stopping gabapentin. They can help you come up with a plan to lower your dose slowly.

8. Prednisone (Sterapred, Deltasone) and other corticosteroids

Prednisone is a corticosteroid medication that can treat many medical conditions, including:

• Allergies
• Skin conditions 
• Rheumatoid arthritis
• Some cancers
• Kidney conditions

If you’ve been taking prednisone for more than a week, you may experience withdrawal side effects if you stop it abruptly. This is because stopping corticosteroids abruptly can cause your adrenal glands to stop working. Your adrenal glands produce many of the hormones that help your body function normally. Stopping prednisone can lead to symptoms like:

• Weakness
• Nausea
• Vomiting
• Diarrhea
• Abdominal pain

Work with your HCP to wean off the medication, rather than stopping the medication abruptly.

9. Opioid pain medications

Opioids are prescription medications, like codeine, morphine ER (MS Contin), and oxycodone (Roxicodone). If you’ve been taking opioids for a long time, stopping them suddenly can cause symptoms like: 

• Sweating
• Diarrhea
• Generalized pain
• Restlessness
• Anxiety 

If you need opioids for pain control, taking the lowest dose

10. Baclofen (Lioresal)

Baclofen (Oxobax, Gablofen) is in a group of medications called “muscle relaxants.” It treats muscle spasms in people with spinal cord injury and multiple sclerosis (MS).

Withdrawal from baclofen can occur from injectable or oral dosage forms. Withdrawal symptoms include: 

• Fever
• Weakness
• Nausea
• Worsening muscle spasms

Withdrawal from injectable forms tends to be more severe. It can cause hallucinations, delirium, and seizures. If left untreated, it can even cause death.

If you’re taking oral baclofen or receive injectable baclofen, don’t stop your medication abruptly. Talk to your HCP about how to wean slowly if it’s no longer needed.

The bottom line

Some medications shouldn’t be stopped suddenly because they can cause dangerous withdrawal symptoms. These symptoms are often more severe if you’ve been taking the medication at a higher dose for a long time. Blood pressure medications, antidepressants, and opioid medications are just some examples of medications that need to be carefully tapered rather than stopped abruptly.

Always talk to your HCP before stopping any medications. They can help you come up with a plan to lower your medication dose slowly. This will help you avoid any negative effects of withdrawal from a medication.