A recent study has found that one in six people who stop taking antidepressants will experience withdrawal symptoms, also known as discontinuation symptoms.
These can include dizziness, headache, nausea, insomnia, and irritability.
The findings come from a comprehensive review and meta-analysis published in The Lancet Psychiatry.
The study, conducted by researchers from Virginia Commonwealth University, the University of Texas at Austin, and the University of Virginia, analyzed data from 79 different studies involving over 21,000 patients.
They discovered that around 15% of people stopping antidepressants experienced at least one discontinuation symptom.
Additionally, about 3% of patients experienced severe symptoms, which sometimes led them to drop out of the study or restart their medication.
Dr. Jonathan Henssler from Charité-Universitätsmedizin Berlin explains that while antidepressants can be effective for many people, they don’t work for everyone and can cause unpleasant side effects.
“It’s crucial for doctors and patients to understand what might happen when stopping antidepressants,” he says. “Our study confirms that some patients will experience discontinuation symptoms, and for a few, these symptoms can be quite severe.”
Antidepressants are commonly used to treat depressive disorders, either alone or with other treatments like psychotherapy.
However, deciding to stop using them, especially after recovery, needs to be carefully managed to avoid withdrawal symptoms. Dr. Henssler emphasizes the importance of doctors monitoring and supporting patients during this process.
Previous studies suggested that over half of patients experience withdrawal symptoms, with many being severe.
However, these estimates often came from observational studies that can’t reliably determine cause and effect. In contrast, this new study used randomized controlled trials (RCTs) to provide more accurate results.
In these trials, half of the participants received a placebo (dummy pill) and the other half the medication, helping to distinguish between actual withdrawal symptoms and those influenced by patient expectations (known as the “nocebo effect”).
The study found that a third (31%) of people who stopped taking antidepressants experienced at least one symptom.
Severe symptoms were less common, occurring in about 3% of patients. Certain antidepressants, like imipramine (Tofranil), paroxetine (Seroxat), and desvenlafaxine (Pristiq), were linked to a higher risk of severe symptoms compared to others.
Interestingly, 17% of patients in RCTs experienced discontinuation-like symptoms even when stopping a placebo, suggesting that approximately half of all reported symptoms might be due to negative expectations or general non-specific symptoms.
The study did not find a significant difference between tapering off antidepressants gradually and stopping them suddenly.
However, the researchers caution that more research is needed to draw firm conclusions about the best way to discontinue antidepressants. Previous studies indicate that tapering might help reduce the severity and incidence of withdrawal symptoms.
The findings aim to provide reassurance that the rates of discontinuation symptoms are not as high as previously thought.
Christopher Baethge from the University of Cologne notes, “It’s important for patients to have accurate, evidence-based information under the care of a clinician. While discontinuation symptoms can be common, they should be taken seriously, and patients should be supported through the process.”
The study highlights the importance of understanding and managing the risk of discontinuation symptoms when stopping antidepressants.
Accurate information and proper medical support are crucial for patients to navigate this process safely. Future research should continue to explore the best methods for discontinuing antidepressants and further investigate the impact of these symptoms.
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