Antidepressants Must Be Discontinued Slowly with Therapy, Study Finds

The largest study published to date in The Lancet Psychiatry reveals that the only effective way to discontinue antidepressants is through a gradual tapering process combined with psychological support.

This study analyzed 76 controlled trials involving 17,000 participants, indicating that a slow withdrawal over more than four weeks, coupled with therapy, can prevent relapse to a similar extent as remaining on the medication.

Lead author Giovanni Ostuzzi from the University of Verona noted that 30% of individuals prescribed antidepressants do not have depression, while 40% take them for five years or more, and 22% continue indefinitely.

The study found that abrupt withdrawal or rapid tapering within four weeks are the least effective strategies. The researchers estimate that a careful withdrawal process can prevent one relapse in every five individuals compared to quicker methods.

Jonathan Henssler from Charite Hospital in Berlin emphasized the significance of psychological support, which has proven to be more effective across various pharmacological strategies. Despite the benefits outlined, the study acknowledges a limitation due to insufficient data on withdrawal symptoms, which remain a barrier for many patients.

The authors recommend that clinical guidelines promote regular treatment reviews and strongly discourage rapid discontinuation of antidepressants. Psychiatrists like Gerard Anmella from the Hospital Clinic of Barcelona highlight the challenges in providing adequate psychological support within public healthcare systems, suggesting a need for protocol-based interventions to reduce relapse rates.