This site is intended for health professionals only

Antidepressants have more severe withdrawal symptoms than guidelines suggest, says research

Millions of antidepressant users could experience “severe withdrawals” if they cut down or come off their medication, according to a new review.

The UK’s All Party Parliamentary Group (APPG) for Prescribed Drug Dependence reviewed the withdrawal affects of antidepressants across 23 existing studies and found that withdrawals are much more widespread, severe and long lasting than current guidelines suggest.

The study, published today (2 October) in the Journal of Addictive Behaviours found that over half of patients (56%) who stop or reduce their antidepressants experience withdrawal symptoms, with 46% of those reporting their symptoms as severe.

One of the studies suggested that 40% of patients experience symptoms for at least six weeks, while another found that 25% experience them for at least three months.

Based on the data, the authors estimate that around four million people in England may experience symptoms and 1.8 million could experience severe symptoms.

Misdiagnoses of relapse

One of the review’s authors, Dr James Davies, said: “This new review of the research reveals what many patients have known for years – that withdrawal from antidepressants often causes severe, debilitating symptoms which can last for weeks, months or longer.

‘”Existing NICE guidelines fail to acknowledge how common withdrawal is and wrongly suggest that it usually resolves within one week. This leads many doctors to misdiagnose withdrawal symptoms, often as relapse, resulting in much unnecessary and harmful long-term prescribing.”

The findings of the research have been passed on to Public Health England, which is conducting a review into prescription pill dependency.

Sir Oliver Letwin MP, and chair of the APPG for Prescribed Drug Dependence, said: “This systematic review provides important new data on antidepressant withdrawal which will be considered by Public Health England as part of their current review into prescribed drug dependence.

“The data suggests that existing medical guidelines in this area should urgently updated to reflect the fact that antidepressant withdrawal is much more common, severe and long lasting than previously stated. Furthermore, we hope that other medical boxes will take note of this new research, and update their own guidance accordingly.”

“Broadly relfective”

However, Professor David Taylor of the Royal Pharmaceutical Society (RPS) said: “The author’s findings are broadly reflective of the clinical reality, although it should be noted that many of the studies reviews allowed abrupt or rapid discontinuation of antidepressant treatment, which probably worsens withdrawal symptoms and duration.

“It is clearly important that patients are informed of the risk of discontinuation reactions and their likely duration, and advised to withdraw treatment as slowly as necessary,”he added.

Benefits of antidepressants

Professor Wendy Burn, president of the Royal College of Psychiatrists, emphasised the benefits of antidepressant medication.

“Antidepressants are an effective, evidence-based treatment for moderate to severe depression, and are a life-saver for many people,”she said.

“But not enough research has been done into what happens when you stop taking them. It’s good to see more of a focus on this. We are pleased that Public Health England are prioritising dependence on, and withdrawal from, prescribed medicines as an area of review and welcome NHS England’s referral to the National Institute for Clinical Excellence (NICE) asking that they do the same.

“Mental health currently receives less than 6% of UK health research funding. The more we learn about the treatment of patients with mental illness, the better the outcome for our patients. That’s our priority,”she said.

Latest Issue

Be in the know
Subscribe to Hospital Pharmacy Europe newsletter and magazine