Davies, 2018 A systematic review into the incidence, severity and duration of antidepressant withdrawal effects: Are guidelines evidence-based?

[Altostrata]

Addict Behav. 2018 Sep 4. pii: S0306-4603(18)30834-7. doi: 10.1016/j.addbeh.2018.08.027. [Epub ahead of print]

A systematic review into the incidence, severity and duration of antidepressant withdrawal effects: Are guidelines evidence-based?

Davies J1, Read J2.

 

Abstract at https://www.ncbi.nlm.nih.gov/pubmed/30292574 Full text PDF

 

INTRODUCTION:

The U.K.'s current National Institute for Health and Care Excellence and the American Psychiatric Association's depression guidelines state that withdrawal reactions from antidepressants are 'self-limiting' (i.e. typically resolving between 1 and 2weeks). This systematic review assesses that claim.

 

METHODS:

A systematic literature review was undertaken to ascertain the incidence, severity and duration of antidepressant withdrawal reactions. We identified 24 relevant studies, with diverse methodologies and sample sizes.

 

RESULTS:

Withdrawal incidence rates from 14 studies ranged from 27% to 86% with a weighted average of 56%. Four large studies of severity produced a weighted average of 46% of those experiencing antidepressant withdrawal effects endorsing the most extreme severity rating on offer. Seven of the ten very diverse studies providing data on duration contradict the UK and USA withdrawal Guidelines in that they found that a significant proportion of people who experience withdrawal do so for more than two weeks, and that it is not uncommon for people to experience withdrawal for several months. The findings of the only four studies calculating mean duration were, for quite heterogeneous populations, 5days, 10days, 43days and 79weeks.

 

CONCLUSIONS:

We recommend that U.K. and U.S.A. guidelines on antidepressant withdrawal be urgently updated as they are clearly at variance with the evidence on the incidence, severity and duration of antidepressant withdrawal, and are probably leading to the widespread misdiagnosing of withdrawal, the consequent lengthening of antidepressant use, much unnecessary antidepressant prescribing and higher rates of antidepressant prescriptions overall. We also recommend that prescribers fully inform patients about the possibility of withdrawal effects.

 

 

Discussions on this site:

 

Psychiatric drug withdrawal study gets news coverage in the UK

 

Template Letter Of Evidence To Doctors/Psychiatrists - feel free to use!

Luke Montagu: Millions are taking antidepressants 'they don't really need', fueling growing epidemic of addiction to prescription medicines

 

The Sedated Society, book by Dr. James Davies

 

 

 

[India]

It can also be read here 

 

https://prescribeddrug.org/wp-content/uploads/2018/10/Davies-Read.pdf

 

https://prescribeddrug.org/wp-content/uploads/2019/02/Davies-and-Read-final.pdf

 

I didn't have much luck with the NIMH link

 

Edited December 1, 2020 by ChessieCat
added new link

[Bunyapine]

I have to thank @Altostrata for putting this on the SA site. I have a copy to take to the doctor and will also show to  the people who always use the phrase ‘Dr Google’ frequently with derision! When I first started experiencing withdrawal symptoms and could get  no explanation, it was very upsetting. Thank goodness I found this site! I feel what we are suffering is hard enough and not being taken seriously or just treated as ‘anxious’ person makes it so much harder to bear! 

[Altostrata]

Researcher Mark Horowitz recently gave a presentation at Royal College of Psychiatrists defending Davies & Read's paper and drawing out some interesting specifics:

Whether studies are RCTs, observational or survey data all fit along a curve that increases for increasing duration of use. Hugely misleading to patients and doctors to focus on studies for patients only on 12 weeks of antidepressants pic.twitter.com/RrwyOqHGE0

— Mark Horowitz (@markhoro) October 10, 2019

 

Same relationship exists for severity: longer that patients use antidepressants, the more severe withdrawal is reported to be: in patients with over 3 years of use, more than half report moderately severe or severe symptoms. pic.twitter.com/euAIh951Jw

— Mark Horowitz (@markhoro) October 10, 2019