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Medication guides, in plain language
What a medication is, who it suits, what starting or stopping it is actually like, and what the evidence says — written by a prescriber who would rather you knew before you decided. None of these pages contains a dose or a schedule; those are decided with you at an evaluation.

Starting an antidepressant
The first week, the side effects that pass and the ones that need a message, and how long it really takes to work.
Starting Lexapro: the first week, and how long it takes to work
What the first week on Lexapro (escitalopram) is like, which side effects are normal and which are not, how long it takes to work, and what to do…
Learn more →Starting Zoloft: the first week, and how long it takes to work
What the first week on Zoloft (sertraline) is like, which side effects are normal and which are not, how long it takes to work, and what to do while…
Learn more →
Coming off an antidepressant
One page per medication people search for by name: why stopping it suddenly is felt, why the last steps are the hardest, which forms allow small steps, and how a supervised taper works. Start with the supervised tapering service if you want the general picture first.
How to taper off Lexapro
Escitalopram — Escitalopram leaves the body over roughly a day, which places it in the middle of the antidepressants: more forgiving than venlafaxine…
Learn more →How to taper off Zoloft
Sertraline — Sertraline leaves the body over roughly a day.
Learn more →How to taper off Wellbutrin
Bupropion — Bupropion and its active breakdown products leave the body over roughly a day, which places it in the middle of the antidepressants.
Learn more →How to taper off Effexor
Venlafaxine — Venlafaxine and its active metabolite leave the body faster than almost any other antidepressant — hours rather than days — which is…
Learn more →How to taper off Cymbalta
Duloxetine — Duloxetine leaves the body over roughly half a day, which is faster than sertraline or escitalopram and places it, with venlafaxine and…
Learn more →How to taper off Paxil
Paroxetine — Paroxetine leaves the body over roughly a day at steady doses, but it also slows its own metabolism — so as the dose falls, the drug…
Learn more →How to taper off Pristiq
Desvenlafaxine — Desvenlafaxine leaves the body over roughly half a day, which places it with venlafaxine and paroxetine among the antidepressants…
Learn more →How to taper off Prozac
Fluoxetine — Fluoxetine and its active metabolite stay in the body for weeks rather than a day — by far the longest of the common antidepressants.
Learn more →How to taper off trazodone
Trazodone — Trazodone leaves the body over a matter of hours, which is why it works as a bedtime medication and why its absence is noticed the same…
Learn more →How to taper off Celexa
Citalopram — Citalopram leaves the body over a little more than a day, which places it in the middle of the SSRIs alongside escitalopram and…
Learn more →
Anxiety and sleep, without a benzodiazepine
NCNE does not prescribe benzodiazepines. These are the options it does use, as needed and not habit-forming, and what each can and cannot do.
Propranolol for anxiety
Propranolol is a beta blocker used off-label for the physical side of anxiety — racing heart, shaking, sweating — before a presentation or a flight.
Learn more →Hydroxyzine for anxiety
Hydroxyzine is an antihistamine that is FDA-approved for anxiety and is not habit-forming.
Learn more →Trazodone for sleep
Trazodone is the most prescribed sleep medication in the US and it is not approved for insomnia.
Learn more →Prazosin for nightmares
Prazosin is a blood-pressure medication used off-label for trauma-related nightmares.
Learn more →
Adult ADHD
The non-stimulant options, and what to do when ADHD and anxiety arrive together. See also adult ADHD at NCNE.
Testing
Pharmacogenomic testing: what it costs, what it covers, and what the report does and does not tell you. See also the GeneSight testing service.
If you are in immediate danger, call 911. For urgent emotional support at any hour, call or text 988(Suicide & Crisis Lifeline). Telehealth visits and this website are not an emergency service.
Have a question one of these pages did not answer? Book a telehealth evaluation with Laura Gabriel, PMHNP-BC, or send a message and we will respond within two business days.