10 Medications That Are Dangerous to Stop Abruptly

There are many reasons you may want to stop taking a medication. Maybe you’re getting unwanted side effects. Or, perhaps, it’s not working as well as you hoped. Cost or refills could be a factor, too. No matter the reason, you may understandably feel tempted to stop your medication without talking to your healthcare professional (HCP) first – but not so fast.

Some medications can be dangerous to stop abruptly. Not only could your medical condition get worse, but you could also experience problematic side effects or withdrawal symptoms. And with some medications, such as antidepressants, stopping cold turkey is riskier the longer you’ve been taking them. The dose of some medications need to be gradually lowered (tapered). Your HCP can help you with a taper plan to 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. 

Keep in mind: This list isn’t all inclusive. Other medications, such as insulin, blood thinners, and thyroid medications, can also be dangerous to stop abruptly. 

1. Clonidine (Catapres, Nexiclon XR)

Clonidine (Catapres, Nexiclon XR) is a medication that’s used for high blood pressure, attention-deficit hyperactivity disorder (ADHD) in children, and Tourette syndrome. It’s also sometimes taken off-label for other conditions, such as smoking cessation and opioid or alcohol withdrawal.

Stopping clonidine abruptly can cause a surge of stress hormones, particularly norepinephrine (noradrenaline). This can cause “rebound hypertension”, where your blood pressure suddenly increases to dangerous levels. 

Before stopping clonidine, talk to your HCP about alternative medicines. And if it’s safe to do so, they can come up with a plan to safely lower your clonidine dose gradually.

Good to know: Clonidine comes in many forms, including tablets, skin patches, and an injection. Rebound hypertension can happen no matter what form of clonidine you’re taking or the reason you’re taking it.

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2. Propranolol (Inderal) and other blood pressure medications

Propranolol (Inderal) treats many heart conditions. These include high blood pressure, chest pain, and irregular heart rhythms. It can also protect the heart after a heart attack. Other FDA-approved uses for propranolol include treatment of 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 a beta blocker suddenly may lead to withdrawal, causing signs and symptoms such as:

• High blood pressure

• Chest pain

• Anxiety

• Fast heartbeat

• Heart attack

Also keep in mind that suddenly stopping any blood pressure medication can be dangerous. Talk to your HCP before stopping any of these blood pressure medications:

• Calcium channel blockers, such as amlodipine (Norvasc) 

• Angiotensin-receptor blockers (ARBs), such as losartan (Cozaar)

• Diuretics, such as spironolactone (Aldactone)

3. Venlafaxine (Effexor XR)

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

Stopping venlafaxine too quickly can lead to withdrawal symptoms. Symptoms usually start 24 to 48 hours after stopping the medication and may include:

• Irritability

• Nausea

• Vomiting

• Dizziness

• Nightmares

• Headache

• Tingling sensation on skin (paresthesia)

Talk to your HCP before stopping venlafaxine. They’ll likely recommend that you lower your dose 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 conditions such as depression, anxiety, and certain menopause symptoms.

Paroxetine is the SSRI that’s most likely to cause withdrawal symptoms. It generally needs to be tapered gradually prior to stopping it. 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 it down.

5. Benzodiazepines

Benzodiazepines — such as alprazolam (Xanax), lorazepam (Ativan), and diazepam (Valium) — are used for anxiety symptoms and panic attacks. They’re also prescribed off-label for a variety of other 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 may include:

• Headache

• Heart palpitations

• Sweating

• Nausea

• Trouble sleeping and nightmares

• Irritability or agitation

• Anxiety or panic attacks

• Delirium

Withdrawal is more likely to happen if you’ve been taking a high dose. They can also happen if you have been taking medication for a long time. Withdrawal symptoms usually appear within 2 to 5 days after stopping a benzodiazepine. Lowering your dose slowly with the help of your HCP can help you avoid serious withdrawal symptoms.

6. Topiramate (Topamax)

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

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

7. Gabapentin (Neurontin)

Gabapentin (Neurontin) is 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:

• Agitation

• Anxiety and restlessness

• Tiredness

• Sensitivity to light

• Dizziness

• Irregular heartbeat

If you’re taking gabapentin for seizures, stopping it can cause seizures to return or worsen. This is why it’s important to talk to your HCP about a plan before stopping gabapentin. 

8. Prednisone and other corticosteroids

Prednisone is a corticosteroid medication that can treat many medical conditions, such as allergies, inflammatory bowel disease (IBD), and other inflammation-related health conditions.

If you’ve been taking prednisone or other oral steroids for more than 1 week, you may experience withdrawal side effects if you stop it abruptly. It can also happen with higher potency corticosteroids, regardless of how long you’ve been taking it. This is because stopping corticosteroids abruptly can cause your adrenal glands to stop working correctly, and they won’t be able to produce enough of the hormones that help your body function normally. Stopping prednisone can lead to symptoms such as:

• Weakness

• Nausea

• Vomiting

• Diarrhea

• Abdominal pain

Depending on what you’re taking corticosteroids for, they’re usually prescribed in tapered doses. If not, make sure to talk to your HCP about how to wean off the medication slowly.

9. Opioid pain medications

Opioids, such as codeine, morphine (MS Contin), and oxycodone (OxyContin), are prescription pain medications. If you’ve been taking an opioid for a long time, stopping it suddenly can cause withdrawal symptoms. You may start to notice these symptoms between 1 to 3 days after your last dose and may experience symptoms such as:

• Sweating

• Diarrhea

• Pain

• Restlessness

• Anxiety 

If you need opioids for pain control, taking the lowest dose for the shortest amount of time possible can help you avoid opioid withdrawal symptoms. Taking less medication means it is easier to stop later on. But if you’re taking an opioid medication long-term, it’s best to wean off the medication instead of stopping abruptly. 

10. Baclofen (Lioresal)

Baclofen (Lioresal, Fleqsuvy) is in a group of medications called muscle relaxers. 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 the 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.

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Written by:

Vanessa Carranza, PharmD

Vanessa Carranza, PharmD, is a pharmacist who has dedicated her career to the advancement of medical education for healthcare providers, patients, and caregivers, most notably in the oncology space.

Reviewed by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

Reviewed by:

Christina Palmer, MD

Christina Palmer, MD, is a board-certified family physician with a special interest in chronic care management, women’s health, mental health, and preventive care. She has over 10 years of experience in primary care research, innovation, and practice.

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