Coming off medication: breathing through the side effects

What happens when you’re coming off medication?

Your body adjusts to a medicine you take every day. When the dose drops, it needs time to readjust, and for a while some things can swing the other way. Doctors call these discontinuation or rebound symptoms. Most settle within days or weeks.

Change or stop a medicine only with your prescriber’s plan, which usually means a slow taper, and call them if a symptom is severe or getting worse.

Breathing won’t speed any of this up, but it can make the days easier: a slower rhythm for a body on edge, and one simple thing for an anxious mind to follow.

Which breath helps with which symptom?

Symptom	Common after stopping	Breath to try
Dizziness, “brain zaps”, anxiety, irritability, low mood	Antidepressants	Small, slow 4-6 breathing, no holds
A racing or pounding heart	Beta-blockers	Coherent breathing, sitting down
Sleepless nights	Sleeping tablets	4-7-8 or 4-6, lights off
Heartburn and acid	Acid-reflux tablets (PPIs)	Slow belly breathing after meals
A blocked nose	Decongestant nasal sprays	Small breaths through the clearer side

Dizzy, anxious or low after antidepressants? Breathe small and slow.

The NHS lists the common withdrawal symptoms, among them dizziness or unsteadiness, a feeling like an electric shock in your head, feeling restless, irritable, anxious or low, and sleep problems. They usually start within a few days and last a few weeks, though for some people they last longer (NHS, antidepressants).

They’re common but not universal. In a review of 79 studies with about 21,000 people, about 1 in 3 had at least one symptom after stopping an antidepressant, but so did about 1 in 6 who stopped a placebo. Severe symptoms affected about 3 in 100 people stopping an antidepressant (Henssler et al. 2024).

Use the breath at the top of this page, gently:

1. Sit down first, with your back supported.
2. Breathe in through your nose for 4 seconds, smaller than you think.
3. Breathe out slowly for 6 seconds. No holds, nothing forceful.
4. If you feel dizzy, keep your eyes open on something still and make the breaths smaller.

If you have thoughts of suicide, speak to your doctor straight away, or get emergency help if you don’t feel safe.

Breathing won’t stop “brain zaps”, the brief electric-shock feelings. They’re poorly understood: in an analysis of hundreds of online posts, people often linked them to moving their eyes from side to side, and for most they faded with time (Papp and Onton 2018). What the breath can help with is the anxiety around them: breathing-focused practices reduced anxiety in a review of 40 trials (Leyro et al. 2021).

Heart racing after stopping beta-blockers? Sit down and slow down.

Beta-blockers slow the heart, and stopping them suddenly can bring a rebound. In a small study of 5 people with high blood pressure who stopped a beta-blocker all at once, 4 developed a fast heartbeat, sweating, tremor or a general unwell feeling within 2 to 6 days (Kristensen et al. 1979). Stopping suddenly has also been linked to serious heart problems (Miller et al. 1975, Psaty et al. 1990), which is why doctors reduce beta-blockers gradually rather than stopping them at once.

If your heart feels fast or pounding during a taper, tell your prescriber, and meanwhile sit down and try coherent breathing, 5 in and 5 out.

Your heart speeds up slightly as you breathe in and slows as you breathe out, and slow breathing makes those swings bigger, a sign of your body shifting towards rest (Laborde et al. 2022). Chest pain, or a racing heart with breathlessness or faintness, needs medical help straight away, not a breathing exercise. More in how to lower your heart rate.

Awake again after stopping sleeping tablets? Use the night breaths.

Sleep often gets worse for a while after stopping, called rebound insomnia. In a sleep-lab study, the first night after stopping was disturbed, and tapering roughly halved the lost sleep compared with stopping at once (Roehrs et al. 1992). In a trial of 1,507 people stopping a 4-week course, worse sleep or next-day wellbeing after stopping was at least as common in those whose tablet had been a placebo, and for some it lasted through the 2 weeks of follow-up (Hajak et al. 1998). Stopping a pill can unsettle sleep by itself, so one bad night isn’t the verdict.

Recent recommendations from German and Austrian sleep societies advise a gradual taper after more than about 2 weeks of use, with behavioural therapy for insomnia alongside (Hajak et al. 2026).

1. Lights off, phone face down.
2. Breathe in quietly through your nose for 4 seconds.
3. Hold for 7 seconds, softly. Shorten it if it feels long.
4. Breathe out through your mouth for 8 seconds. Do 4 rounds, then carry on with 4-6 breathing.

In a review of 9 studies, slow breathing before bed improved how well people said they slept, though sleep measured by devices didn’t clearly change (Eide et al. 2026). If counting keeps you awake, Breathform keeps time with a soft tone on a dark screen. More in breathing exercises for sleep.

Heartburn back after acid-reflux tablets? Belly breathing after meals.

The tablets that cut stomach acid, called PPIs, can leave a rebound when you stop. In a trial of 120 healthy volunteers with no reflux to begin with, 44% had heartburn, acid or indigestion in the month after stopping 8 weeks of a PPI, against 15% of those on a placebo (Reimer et al. 2009). Once symptoms have settled, a guideline suggests many people can, with their doctor or pharmacist, step down to a lower dose, stop, or take them only when needed (Farrell et al. 2017).

Slow belly breathing trains the diaphragm, the muscle that wraps around the bottom of your food pipe. In a small trial of 19 people with reflux, 4 weeks of belly-breathing training cut the time the food pipe spent acidic from about 9% to under 5%, and those who kept it up used much less acid-reducing medicine 9 months later (Eherer et al. 2012).

Sit upright after a meal, breathe in for 6 seconds into your belly and out for 6, for 5 to 10 minutes. The full routine is in breathing exercises for GERD.

Nose blocked after a decongestant spray? Keep it gentle.

Using a decongestant nasal spray for too long can make your nose more blocked, called rebound congestion, and it can take a while to settle once you stop. Most of what’s known comes from case reports rather than trials. Stopping the spray is the first step, and a steroid nasal spray may help it settle faster (Ramey et al. 2006): your pharmacist can advise.

While it settles, keep your breathing small and slow. Breathe in through whichever side is clearer, or through your mouth if you need to, and let the out-breath be a little longer than the in-breath. In healthy people, humming raises nitric oxide in the nose about 15-fold (Weitzberg & Lundberg 2002), though whether that helps a blocked nose has barely been studied.

Does breathing help with withdrawal symptoms?

No trial has tested breathing exercises for coming off medication. The evidence is for the symptoms themselves.

For anxiety, a review of 40 trials found breathing-focused practices reduced it, a moderate-to-large effect overall, though most trials were at high risk of bias (Leyro et al. 2021). For sleep, slow breathing before bed improved how people rated their sleep (Eide et al. 2026). For reflux, belly-breathing training reduced acid in one small trial (Eherer et al. 2012).

So: a gentle, low-risk way to make the days easier alongside your prescriber’s plan. It can ease the discomfort; it doesn’t shorten withdrawal.

How well each breath is studied

• 4-6 breathingWell studied
• Coherent breathingWell studied
• 4-7-8 breathingEarly research or tradition
• Slow breathing (6-6)Some evidence

Every study on this page (17)

• NHS, antidepressants: The NHS lists withdrawal symptoms of coming off antidepressants, including dizziness or unsteadiness, unusual feelings like an electric shock in the head, feeling restless, irritable, anxious or tearful, feeling low, sleep problems and a racing or pounding heart; they usually begin within a few days and last a few weeks, but can last months or longer for some; anyone with suicidal thoughts should speak to their doctor straight away, or call 999 or go to A&E if they cannot keep themselves safe; doctors agree a plan to reduce the dose gradually and may slow it or go back to a higher dose.
• Henssler et al., 2024: Meta-analysis of 79 studies (21,002 patients): incidence of at least one discontinuation symptom was 31% after stopping antidepressants and 17% after stopping placebo; severe symptoms 2.8% vs 0.6%; accounting for non-specific effects, about 15% (one in six to seven) have antidepressant discontinuation symptoms.
• Papp and Onton, 2018: Qualitative analysis of 595 online posts: brain zaps are a poorly understood symptom of antidepressant discontinuation, frequently associated with lateral eye movements, typically transitory but occasionally lasting months or years; gradual tapering only partly mitigated them.
• Leyro et al., 2021: Across 40 trials with 3,047 people, breathing-based therapies eased anxiety more than comparison groups, but most trials had design flaws.
• Kristensen et al., 1979: In hypertension, the beta-blocker withdrawal syndrome comprises tachycardia, sweating, tremor and malaise; 4 of 5 patients developed one or more of these within 2–6 days of abruptly stopping propranolol.
• Miller et al., 1975: In 20 patients with angina, untoward ischaemic events developed in 10 within two weeks of abruptly stopping long-term propranolol; the authors concluded it should be reduced gradually.
• Psaty et al., 1990: In a population-based case-control study of people treated for high blood pressure, those who had recently stopped beta-blockers had a transient fourfold increase in the relative risk of coronary heart disease (RR 4.5).
• Laborde et al., 2022: Across 223 studies, slow breathing raised heart-rhythm signs of calm, during practice and after, though that alone doesn't prove a health benefit.
• Roehrs et al., 1992: In 21 adults, sleep was disturbed on the first night after discontinuing a 6-night course of a hypnotic; rebound insomnia was greater after abrupt than tapered discontinuation (tapering halved the loss of sleep time), and pill discontinuation itself, including placebo, disturbed sleep.
• Hajak et al., 1998: In 1,507 insomnia outpatients stopping 28 days of a hypnotic or placebo, rebound (sleep or daytime well-being worse than before treatment) was seen in every group, and the overall rebound rate was higher after placebo than after each active drug; rebound persisted at varying levels across the 2-week follow-up for some patients.
• Hajak et al., 2026: Consensus recommendations of the German and Austrian sleep societies: after more than 2 weeks of use, hypnotic medicines that can cause withdrawal should be tapered gradually (weekly reductions of 10–25%), with behavioural therapy recommended alongside.
• Eide et al., 2026: Across nine studies, slow breathing before bed improved how well people felt they slept, but sleep-lab and tracker results were inconclusive.
• Reimer et al., 2009: In a randomised placebo-controlled trial of 120 healthy volunteers, 44% of those given 8 weeks of a proton-pump inhibitor reported at least one relevant acid-related symptom (heartburn, acid regurgitation or dyspepsia) in weeks 9–12 after stopping, compared with 15% on placebo.
• Farrell et al., 2017: Evidence-based guideline: in adults who have completed at least 4 weeks of PPI treatment for heartburn or mild to moderate reflux and whose symptoms have resolved, deprescribe by reducing the dose, stopping or using on-demand dosing (not for Barrett’s oesophagus, severe oesophagitis or a history of bleeding ulcers).
• Eherer et al., 2012: In a randomised controlled study of 19 people with non-erosive GERD or healed oesophagitis, 4 weeks of abdominal breathing training cut the time with oesophageal pH below 4 from 9.1% to 4.7% and improved quality of life; at 9 months, those who kept training used less PPI (98 to 25 mg a week).
• Ramey et al., 2006: Review: rhinitis medicamentosa (rebound congestion) is induced by overuse of nasal decongestants; very few prospective studies exist and most knowledge comes from case reports; stopping the decongestant is first-line treatment, and intranasal steroids may be used to speed recovery.
• Weitzberg & Lundberg, 2002: Humming raised nitric oxide in the nose 15-fold compared with breathing out quietly, in 10 healthy people; health effects weren't tested.

Questions people ask

How long do discontinuation symptoms last?

It depends on the medicine. After antidepressants, the NHS says symptoms usually start within a few days and last a few weeks, though for some people they last months. Rebound sleeplessness after sleeping tablets often lasts a few nights, longer for some. If symptoms are hard going, your prescriber may slow the taper or go back a step before trying again.

What do brain zaps feel like?

Brief jolts or buzzing in the head, often described as a small electric shock, sometimes with dizziness. People often notice them when they move their eyes from side to side. They’re a recognised effect of coming off antidepressants, they’re poorly understood, and for most people they fade with time. Breathing won’t stop them, but it can help with the unease they bring.

Is rebound insomnia normal after stopping sleeping tablets?

Yes. Sleep often gets worse for a while after stopping, especially if you stop all at once, and tapering softens it. In one large trial it was at least as common in people whose tablet had been a placebo, so stopping a pill can unsettle sleep by itself. A bad first few nights doesn’t mean you can’t sleep without them.

Why does heartburn come back after stopping acid tablets?

Because your stomach can make extra acid for a while after the tablets stop, a rebound. In one trial, nearly half of healthy volunteers who had taken an acid-reducing tablet for 8 weeks got heartburn or indigestion in the month after stopping. Stepping down gradually with your prescriber, and slow belly breathing after meals, can help you through it.