Health
Studies highlight the difficulty of stopping antidepressants
A study of British patients with a long history of depression reveals how difficult it is to stop dosing, even for those who feel good enough to try.
More than half of the participants who gradually discontinued antidepressants relapsed within a year. In contrast, those who continued on regular medication during the study had a low recurrence rate of nearly 40 percent.
Both groups were taking common antidepressants daily and felt healthy enough to recover from a recent depressive attack and consider quitting the drug.
Studies also show that recurrence is common, and an editorial published in the New England Journal of Medicine in Wednesday’s study may recommend lifelong medication for patients with some previous seizures. It suggests that there isn’t.
Counseling and behavioral therapies are other options for patients who want to stop antidepressants, and studies have shown that those treatments in combination with medications work for many.
In a government-sponsored study, few UK patients received any psychological treatment. The UK’s national health care system provides it, but it is difficult to access due to the long waiting times for treatment, said Gemma Lewis, the lead author of the study and a researcher at the University of London. According to Lewis, the patients in this study were being treated for depression by a general primary care physician in the United Kingdom.
Depression is a mood disorder that includes persistent and debilitating sadness, hopelessness, and loss of interest in normal activities. According to the World Health Organization, it affects about 5 percent of adults worldwide. Reported rates are slightly lower in the UK and higher in the United States, but Lewis said that different ways of assessing depression make country-to-country comparisons difficult.
The study enrolled 478 patients in four cities in the United Kingdom, most of them middle-aged Caucasian women. All were taking a common class of antidepressants called selective serotonin reuptake inhibitors. This includes drugs known under the brand names Prozac and Zoloft. Half were randomly assigned to gradually discontinue the drug, and the others did not change the drug. It is unclear if similar results will be achieved with other patients taking other antidepressants.
Although 56% of patients who discontinued medication relapsed during the study, Lewis emphasized that a significant proportion did not recur, including most patients taking antidepressants.
“Many people want to continue using antidepressants, and this treatise shows that it’s a good decision for many,” says Lewis.
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