Antidepressants are prescribed to treat depression and anxiety. These medications are often taken for a long time. Usually guidelines recommend doing this for 6-12 months after improvement or for two years. However, many people take them longer, the review authors point out. Between 30% and 50% of long-term antidepressant prescriptions occur without evidence. Scientists remind that their unnecessary appointment can be accompanied by side effects. In addition, no evidence-based approaches have yet been developed to safely discontinue antidepressants after long-term use.
The new review covered data from 33 randomized trials, which involved almost 5,000 people. About a third of the participants stopped taking antidepressants abruptly, the rest gradually reduced the dose.
The dose reduction usually did not take more than four weeks. At the same time, the authors of the review point out, the British College of Psychiatrists recommends decreasing the dose of antidepressants before stopping treatment for several months or even years in order to increase safety.
The review authors write that the available research does not allow concluding how to safely terminate long-term antidepressant use. This is due to the fact that the quality of the evidence presented to date is rather low.
“As a general practitioner, the first thing I see is how many people struggle to stop taking antidepressants. More than 1000 studies have looked at how to start taking antidepressants, and only 33 studies worldwide have looked at how to stop taking it. This is definitely an area of expertise that needs immediate attention, ”said Ellen Van Leeuwen (Ellen Van Leuven) from the University of Ghent, lead author of the review.
“We would also like to draw attention to the fact that antidepressant withdrawal symptoms can often be mistaken for a relapse of the disease. Withdrawal is not indicative of a relapse; it may indicate that a slower drug withdrawal is required before stopping the drug altogether, ”said Dr. Tony Kendrick (Tony Kendrick) from the University of Southampton, co-author of the review.