My Husband Stopped His Antidepressant and Now Believes I Want to Kill Him

Reader’s Question

My husband stopped taking Effexor for depression about 2 months ago. He becomes agitated very easily and now thinks I want to kill him. I do not physically abuse my husband. It scares me that he thinks this. Am I safe?

Our Consulting Clinical Psychologist’s Reply

There are several issues in this brief question. First, Effexor is an SNRI (Serotonin and Norepinephrine Reuptake Inhibitor) antidepressant. Sudden or “cold turkey” withdrawal can produce some very uncomfortable withdrawal symptoms that range from common conditions such as dizziness, upset stomach, etc. to very odd reports of “brain shivers” or electrical-like sensations. The severity of these symtpoms is often related to the dosage and the individual metabolism. Most importantly, feeling your spouse wants to kill you is not a withdrawal symptom. There are several possible reasons for this behavior:

1. Sudden withdrawal from antidepressants often causes the depression/anxiety disorder to return…sometimes very strongly. His agitation tells me that his situation and symptoms are probably related to changes in his neurochemistry similar to the changes that produced the depression. In short, you may be seeing a very strong return, if not exaggeration of the original depressive disorder.
2. There is a difference between wanting to kill someone and trying to kill someone. If he feels you might want to kill him, this is not uncommon in severe depression. The overwhelming guilt of a severe depression makes us feel that people around us don’t love us, want us out of their lives, and wish us dead and gone.
3. If he feels you are trying to kill him — that’s another story. The feeling that people are trying to kill us, when it’s untrue, is a form of paranoia. If he has paranoia, he’ll also believe others are treating him unfairly and in severe episodes, that there is a conspiracy to kill him involving members of the community. Paranoia is often accompanied by bizarre behavior such as installing cameras, fixing his own food (to prevent poisoning), etc.
4. In his withdrawal misery, he may be misinterpreting the withdrawal symptoms (such as brain shivers or electrical sensations) as evidence that something seriously is going wrong and you are the closest person to him.

Bottom line: He needs to return to a psychiatrist as soon as possible. His symptoms are neurotransmitter events and not just daily mood swings. His depression may be back in strength. Worse, the experience may have prompted a change in other neurotransmitters such as Dopamine which can produce paranoid thoughts. Get him to a mental health specialist.

Are you safe? Look at his behaviors. Is he taking any action on his thoughts — buying a gun, fixing his own food, getting a protection order, calling the police, etc.? You’re probably safe if he feels you might want him dead. If he feels you are trying to kill him and is acting in a bizarre and/or self-protecting manner — then your risk for danger increases. Any aggressiveness toward you should be viewed as a danger sign. Again, the best bet for you and your husband is to return him to treatment ASAP.