How should one discontinue an antidepressant therapy?
Antidepressants are used both short-term and long-term for treatment. For those who wish to discontinue the medication, the question arises: How should I best stop taking it? Can I do it suddenly or do I have to wean myself off gradually? Experts can allay certain concerns.
A recent study published in "Lancet Psychiatry" by Charité-Universitätsmedizin Berlin and University Hospital Cologne provides reassuring news for women and men considering ending their antidepressant treatment. For instance: The experience of so-called withdrawal symptoms is often influenced by negative expectation biases - and not necessarily by the medication itself. In other words: Those who anticipate symptoms may indeed experience them.
The researchers' meta-analysis included approximately 21,000 cases and concluded that genuine medication-induced withdrawal symptoms occur in approximately 16-17% of cases. However, most of these symptoms are mild, while in 3% of cases they are severe. "Our analysis shows that, on average, every third person experiences symptoms after discontinuing antidepressants," says Jonathan Henssler, head of the Evidence-Based Mental Health research group at Charité. "However, only half of the symptomatology can be attributed to the medication."
Not necessarily a gradual tapering off
"The majority of those affected can discontinue antidepressants without experiencing significant symptoms," explains Henssler. "In most cases, therefore, no lengthy or gradual tapering off of the medication is necessary."
Those considering ending their antidepressant therapy should not do so alone. Professor Christopher Baethge of University Hospital Cologne advises: "It is important that all people who wish to discontinue antidepressant treatment are medically closely monitored and individually supported in case of withdrawal symptoms."
"Our results do not mean that some symptoms that people experience when discontinuing antidepressants are not 'real' or that all withdrawal symptoms are due to patients' expectations," says Baethge. "A shared decision-making process between patients and their doctors, prior to starting treatment, is the basis for good care."
The findings from the study suggest that the expectation of withdrawal symptoms might contribute to their occurrence, not solely the medication itself. Despite the presence of mild symptoms in some cases, a gradual tapering off of antidepressants is often not necessary, according to Jonathan Henssler. It's imperative for individuals contemplating discontinuation to seek medical supervision and support during the process, as emphasized by Professor Christopher Baethge.
