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Psychology Today: Antidepressant Withdrawal Said to Affect “Millions”

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Antidepressant Withdrawal Said to Affect “Millions”

Christopher Lane Ph.D.

Posted Oct 06, 2018 



“It is not uncommon for the withdrawal effects to last for several weeks or months,” determine James Davies and John Read, both at London-based universities, in the latest issue of Journal of Addictive Behaviors. In that respect, their findings—extrapolated from 23 peer-reviewed studies—contradict guidelines on antidepressants issued by the American Psychiatric Association and the UK's National Institute for Health and Care Excellence, with both claiming that discontinuation issues are usually “mild” and “self-limiting” (resolved in 1-2 weeks).


The metastudy, “A systematic review into the incidence, severity and duration of antidepressant withdrawal effects,” points to a problem far-more widespread and persistent than regulators have acknowledged. Current guidelines “underestimate the severity and duration of antidepressant withdrawal, with significant clinical implications.” At such, the guidelines themselves cannot accurately be seen as evidence-based. They are instead misleading, at odds with the findings, and “in urgent need of correction.”


The metastudy found that “withdrawal incidence rates from 14 studies ranged from 27 percent” to as high as “86 percent, with a weighted average of 56 percent.”


Strikingly, that range more or less exactly replicates the findings of Jerrold Rosenbaum and Maurizio Fava, researchers at Massachusetts General Hospital, who in 1997 determined that among patients discontinuing antidepressants, 22 to 78 percent suffered withdrawal symptoms, depending on the drug in question.


Overall, Davies and Read’s metastudy points to far-greater prevalence rates and far-more serious and longer-lasting discontinuation symptoms than current guidelines advise, with the withdrawal syndrome often lasting for weeks, even entire months. In the process, the authors upend long-standing assumptions that the drugs are largely well-tolerated, with antidepressant withdrawal generally rare, mild, and “self-limiting” (resolved in 1-2 weeks). On the contrary, tolerance for the drugs is shown to be much lower than assumed, with discontinuation problems more frequent and more chronic than two sets of national guidelines suggest.


Given the scale and gravity of these results, patients concerned about the drugs’ adverse effects are strongly advised NOT to terminate treatment abruptly, but instead to taper carefully and gradually by microdoses over a course of several months, always in consultation with their doctor, to ensure their own safety. Peer-reviewed, specialist information on discontinuation issues is available on the website Surviving Antidepressants, with a forum devoted to “Tapering.” Much of the bibliography on withdrawal is also detailed here, in this 2011 post on “Side Effects.



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