Antidepressant withdrawal affects one in six people

Image source, Getty Images

  • Author, Philippa Roxby
  • Role, Health journalist, BBC News

One in six people experience symptoms when they stop taking antidepressants – fewer than previously thought, a review of previous studies suggests.

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

The journal Lancet Psychiatry examined data from 79 trials involving more than 20,000 patients.

Some had been treated with antidepressants and others with a dummy drug or placebo, which helped researchers assess the true effect of stopping the drugs.

Some people experience unpleasant symptoms such as dizziness, headaches, nausea and insomnia when they stop taking antidepressants, which researchers say can cause considerable distress.

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

But this journal, from the universities of Berlin and Cologne, estimates:

  • One in six or seven patients can expect symptoms when stopping antidepressants
  • One in 35 people will have serious symptoms
  • Symptoms are more common with some antidepressants than others

Official health guidelines are to reduce the antidepressant dose in stages over time, rather than stopping abruptly or missing doses, which could lead to withdrawal symptoms.

Most people stop antidepressants successfully, the guide adds.

Other research suggests that ADS lasts one to two weeks.

Study author Professor Christopher Baethge, from the Department of Psychiatry and Psychotherapy at the University of Cologne, said the results were “quite robust”.

But the study’s lower estimate of ADS “doesn’t mean it’s all in their heads.”

“Worsening anxiety”

It found that 17% of people experienced symptoms after stopping a placebo or dummy drug.

“One possible explanation is a greater awareness of worsening anxiety and depression after stopping a seemingly helpful medication,” Professor Baethge said.

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

“This shows the importance of comparing antidepressants with placebo when studying treatment cessation,” said Professor Glyn Lewis, of University College London.

The most commonly used antidepressants in the UK – citalopram, sertraline and fluoxetine – had the lowest risk of Alzheimer’s syndrome.

But venlafaxine, which is also used in the UK, comes in second.

‘High risk’

Dr Paul Keedwell, consultant psychiatrist and fellow of the Royal College of Psychiatrists, said people considering stopping treatment should always seek medical advice.

“First, depending on your mental health history, the risk of your depression relapsing may be high,” he said.

“Sometimes a relapse of depression can be confused with withdrawal symptoms.

“Secondly, unpleasant withdrawal symptoms can be largely avoided with proper medical supervision.

“It is important to say that withdrawal symptoms are not dangerous and the risk of experiencing them at a later date should not be a reason to refuse antidepressant treatment.

“The pros and cons of treatment should always be discussed with your doctor.”

In England, more than eight million people take antidepressants to treat depression, anxiety, obsessive-compulsive disorder and other conditions – a million more than five years ago.

News Source :
Gn Health

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