Antidepressant withdrawal symptoms affect one in six people

38 minutes ago

Philippa Roxby,BBC News Health Reporter

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Previous studies have shown that one in six people experience symptoms when they stop taking antidepressants, which is less common than previously thought.

The researchers said their findings would help inform doctors and patients “without causing undue alarm.”

The Lancet Psychiatry review looked at data from 79 trials involving more than 20,000 patients.

Some subjects were treated with antidepressants, while others were treated with fake pills or placebos, which allowed the researchers to gauge the true impact of stopping the medication.

When people stop taking antidepressants, they can experience unpleasant symptoms like dizziness, headaches, nausea and insomnia, which researchers say can cause considerable distress.

Previous estimates suggested that antidepressant discontinuation symptoms (ADS) affect 56% of patients, with almost half of cases classified as severe.

However, this review by the Universities of Berlin and Cologne estimates that:

• One in six to seven people may experience symptoms when they stop taking an antidepressant.
• 1 in 35 people will develop severe symptoms
• Some antidepressants are more likely to cause symptoms than others.

Official Health Guidance Stopping antidepressants suddenly or missing doses can cause withdrawal symptoms, so tapering the dose gradually is recommended.

The guidelines add that most people are successful in stopping taking antidepressants.

Other studies suggest that ADS lasts for 1 to 2 weeks.

Study author Professor Christopher Bethge, from the department of psychiatry and psychotherapy at the University of Cologne, said the findings were “very convincing”.

But the survey's low estimates of ADS “do not mean it's all in their heads.”

“Worsening anxiety”

They found that 17% of people experienced symptoms after stopping the placebo or fake pill.

“One possible explanation is increased awareness of worsening anxiety and depression after stopping supposedly effective medications,” Prof Bethge said.

Many of the 40 symptoms associated with stopping antidepressants can also be caused by other illnesses.

“This study shows the importance of comparing antidepressants with a placebo when studying antidepressant cessation,” said Prof Glyn Lewis, from University College London.

The most commonly used antidepressants in the UK – citalopram, sertraline and fluoxetine – were associated with the lowest risk of ADS.

However, venlafaxine, which is also used in the UK, was the second highest.

'High risk'

Dr Paul Keedwell, a RCP and consultant psychiatrist, said anyone thinking of stopping medication should always seek medical advice.

“Firstly, depending on your history of mental illness, you may be at higher risk for recurrent depression,” he said.

“Depressive relapse can be confused with withdrawal symptoms.

“Second, unpleasant withdrawal symptoms can be largely prevented with proper medical supervision.

“It is important to state that withdrawal symptoms are not dangerous and the risk of experiencing withdrawal symptoms in the future is not a reason to refuse treatment with antidepressants.

“Be sure to discuss the pros and cons of each treatment with your doctor.”

More than eight million people in England are taking antidepressants for conditions such as depression, anxiety and obsessive-compulsive disorder – one million more than five years ago.

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