People who take antidepressants for more than two years face a significantly higher risk of withdrawal symptoms when stopping the medication compared to short-term users, according to new research led by University College London (UCL).
The study also found that long-term users experience more severe and longer-lasting withdrawal effects and have greater difficulty discontinuing the drugs.
The research, published in Psychiatry Research, analyzed survey responses from 310 individuals in England who had attempted to stop antidepressants prescribed through NHS primary care.
While 62% of participants found antidepressants helpful, 79% reported at least one withdrawal symptom, and 45% experienced moderate to severe symptoms. Among those on antidepressants for two years or more, 79% were unable to stop the medication when they tried.
Withdrawal symptoms include both emotional effects, such as anxiety and mood changes, and non-emotional symptoms like dizziness, headache, vertigo, and nausea.
The study distinguished these to account for overlap with depression relapse, finding that 76% experienced at least one non-emotional withdrawal symptom, with 43% reporting four or more.
Duration of antidepressant use was the strongest predictor of withdrawal severity and difficulty stopping, independent of the severity of the underlying mental health condition. The odds of experiencing withdrawal symptoms were ten times greater for those on the medication longer than two years compared to those on it less than six months.
Among long-term users, 64% reported moderate or severe withdrawal effects, with 30% experiencing symptoms lasting more than three months, and 12% enduring symptoms for over a year. In contrast, most short-term users’ symptoms resolved within four weeks.
Dr. Mark Horowitz, lead author and visiting clinical researcher at UCL, emphasized the importance of limiting antidepressant use to the necessary duration to reduce withdrawal challenges. He noted, “While coming off antidepressants can be easier for people who have only taken them for a short period of time, these drugs are commonly used for a long time”.
The study’s limitations include a low survey response rate (18%), which may have skewed results toward those experiencing withdrawal. The researchers also found inconclusive evidence regarding tapering methods due to insufficient data but highlighted the need for further research on effective tapering strategies to mitigate withdrawal symptoms.
Senior author Professor Joanna Moncrieff of UCL advised that individuals wishing to stop antidepressants should do so under the guidance of an informed healthcare professional to manage withdrawal safely.
Practical advice for patients and clinicians:
- Use antidepressants only as long as clinically necessary.
- Plan discontinuation with professional support, ideally using gradual tapering.
- Monitor for withdrawal symptoms, especially in long-term users.
- Seek medical advice promptly if severe or prolonged symptoms occur.
This study underscores the importance of awareness around antidepressant withdrawal and the need for tailored strategies to help patients safely discontinue these medications.
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