Research reveals nearly one in six individuals stopping antidepressant use could experience withdrawal symptoms.
Recent research has shifted the focus on the potential risks associated with stopping antidepressants. A new meta-analysis of 79 studies, with a total of 21,009 participants aged 45 on average, has provided more accurate insights.
Approximately 15% of people who stopped taking antidepressants dealt with withdrawal symptoms such as dizziness, headaches, nausea, insomnia, and irritability, as reported in the study published in The Lancet Psychiatry. Additionally, one in 35 individuals experienced severe withdrawal symptoms. This is the first stage of a larger project focused on understanding antidepressant withdrawal.
Dr. Jonathan Henssler, the lead author of the study, emphasized the importance of recognizing the potential risks before making decisions to stop taking antidepressants. Despite acknowledging the beneficial properties of antidepressants in improving mental health, it's crucial to realize that "they don't work for everyone, and some patients may experience unpleasant side effects."
The occurrence of withdrawal symptoms had been noticed since the 1950s, but medical professionals had largely ignored these reports until the late 1990s. There has been considerable debate on the issue since then, often with claims of withdrawal rates as high as 50% and half being severe. Many of these claims originated from unconventional reviews, which relied on data from online surveys-an unreliable source according to Dr. Sameer Jauhar, a senior clinical lecturer in affective disorders and psychosis at King's College London.
To better understand the risk, the authors of the study reviewed data from both randomized controlled trials and observational studies. In total, they analyzed 44 randomized controlled trials and 35 observational studies published between 1961 and 2019. Most of these studies focused on mood and anxiety disorders. The researchers also identified medications with frequent discontinuation symptoms: desvenlafaxine, venlafaxine, imipramine, and escitalopram. On the other hand, fluoxetine and sertraline had the lowest rates of discontinuation symptoms.
Interestingly, pharmaceutical companies financed 45 of the studies, and this support didn't significantly affect the overall results, according to the review.
Dr. Jauhar commended the authors for focusing on this topic, fearing that previous misinformation could have discouraged individuals from considering treatment options in the past. He encouraged professionals to use science and evidence when making decisions.
Notably, some of the data in the meta-analysis came from studies focused on the efficacy of antidepressants, rather than the withdrawal symptoms. This resulted in a disparity in the duration of antidepressant usage-12 weeks in 36 out of the 79 included studies-making it unlikely that severe withdrawal symptoms would occur.
Antidepressants don't trigger addiction. Withdrawal symptoms could be the result of the sudden reduction in neurotransmitters in the brain. The study didn't reveal a difference between tapered and abrupt discontinuation, but it should be noted that this finding doesn't provide definitive evidence. Some other studies suggest tapering can minimize the likelihood and severity of symptoms.
In summary, the study offers more accurate information about the risks of stopping antidepressants, but it's still essential for physicians to discuss the potential implications with their patients.
However, it's important to remember that the included studies were not always focused on withdrawal symptoms. Furthermore, the duration of antidepressant usage varied significantly, with some studies only lasting 12 weeks, while others spanned up to a year. Henssler and his team highlighted the need for further research based on these findings.
"'Slow and cautious' is how the doctor should guide patients off their medications to minimize the effects of any potential withdrawal symptoms, according to Dr. Oliver Howes, the chair of the psychopharmacology committee at the Royal College of Psychiatrists in the UK, in a recent statement. He wasn't part of the study.
It's crucial to consider someone's history of mental health and carefully plan the whole process so they don't slip back into their illness, said Dr. Paul Keedwell, a consultant psychiatrist from the same institution who wasn't involved in the study.
The study didn't mention how long these symptoms might last, but earlier research suggests that in most instances, they vanish within two weeks. The process gets more tricky for people who've been consuming their meds for more than a year. In these scenarios, the withdrawal symptoms can carry on for several months, though rarely lasting a year.
However, Dr. Keedwell reminded us, "It's essential to recall that withdrawal symptoms aren't harmful. Although they might reappear at some point in the future, this shouldn't be a reason to refuse antidepressant therapy in the first place. The advantages and risks of treatment merit a conversation with your physician."
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Individuals seeking to improve their wellness might consider the potential risks of stopping antidepressants, as the study found that 15% of people experienced withdrawal symptoms upon discontinuation.
To preserve mental health during the process of stopping antidepressants, doctors recommend a gradual and cautious approach to minimize withdrawal symptoms, allowing patients to adjust to the changes gradually.
