People who take antidepressants for more than two years may be much more likely to have withdrawal symptoms when they try to stop, according to a new study from University College London (UCL).
The research suggests that the longer a person stays on these medicines, the greater the chance that stopping them will be difficult and that the symptoms may last for a long time.
Antidepressants are widely used to treat depression, anxiety, and several other mental health conditions.
For many people they are helpful and can greatly improve daily life. Some people only need them for a few months, while others continue taking them for years because of ongoing symptoms or concerns that their illness could return.
When people stop antidepressants, they may experience withdrawal symptoms because the brain needs time to adjust to working without the medicine. These symptoms can include anxiety, mood changes, tiredness, dizziness, headaches, nausea, and other physical problems. Some of these symptoms can look very similar to depression or anxiety returning, making it hard for patients and doctors to tell the difference.
The new study, published in Psychiatry Research, looked at 310 people in England who had received National Health Service therapy and had tried to stop taking prescribed antidepressants.
Although 62% said the medicines had helped them, nearly 80% reported at least one withdrawal symptom, and about 45% described their symptoms as moderate or severe.
The researchers found that people who had taken antidepressants for more than two years were far more likely to have withdrawal problems than those who had used them for less than six months. They were about 10 times more likely to report withdrawal symptoms. Almost four out of five long-term users said they could not stop taking the medicine when they tried.
Long-term users also had much more serious symptoms. Nearly two-thirds experienced moderate or severe withdrawal, while one-quarter described their symptoms as severe. In comparison, most people who had used antidepressants for less than six months had no symptoms or only mild ones.
The study also showed that withdrawal often lasted much longer for people who had taken antidepressants for years.
About 30% of long-term users said their symptoms continued for more than three months, and 12% reported symptoms lasting longer than a year. Among short-term users, most people recovered within four weeks.
Lead researcher Dr. Mark Horowitz said the length of time people stayed on antidepressants was the strongest factor linked to withdrawal. The researchers found this was true even after considering how severe a person’s depression or anxiety had been before treatment.
The researchers noted some limits to the study. Only a small share of invited people completed the survey, so those with stronger withdrawal experiences may have been more likely to respond.
The study also could not clearly measure whether slowly reducing the medicine lowered the risk because too few long-term users had tapered their dose gradually.
Senior author Professor Joanna Moncrieff said people should not stop antidepressants on their own. Instead, they should work with a healthcare professional who understands withdrawal and can help reduce the medicine safely if stopping is the right choice.
The researchers said the findings suggest antidepressants should be used for no longer than necessary while still providing the care that each patient needs.
The study was published in Psychiatry Research.
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