Quitting antidepressants is not as risky as previously feared: only one in six patients suffers withdrawal symptoms, a major study suggests.
The researchers say their findings should reassure people who could benefit from the drugs but are worried about doing so in case of side effects when they stop taking them.
The analysis, which is the largest of its kind, found that 15 percent of users experience one or more complaints caused directly by stopping taking the pills.
But only 2 to 3 percent suffer severe symptoms, according to results published in The Lancet Psychiatry.
Previous research has suggested that 56 percent of patients may experience withdrawal symptoms, although experts have said this figure is not solid.
Quitting antidepressants is not as risky as previously feared: only one in six patients suffers withdrawal symptoms, major study suggests (file image)
Fifteen percent of users experience one or more complaints directly caused by stopping taking antidepressants, but only 2 to 3 percent suffer severe symptoms, according to results published in The Lancet Psychiatry (file photo).
The most frequently reported conditions were dizziness, headache, nausea, insomnia, and irritability.
Discontinuation symptoms usually occur within a few days and the new study found they lasted from 1.5 to 196 days.
Researchers in Germany analyzed a variety of antidepressants for the work, which included data from 21,000 patients involved in 79 investigations.
Nearly three-quarters (72 percent) of those included were women and the average age was 45 years.
Of a list of 11 different antidepressants, citalopram, sertraline and fluoxetine, which are the most widely used in the UK, were the least likely to suffer withdrawal symptoms.
According to researchers, fluoxetine, for example, takes longer to leave the body and may cause fewer withdrawal effects.
But venlafaxine, which is also used in the UK, came in second among people experiencing symptoms.
The NHS and the Royal College of Psychiatrists advise doctors to work with patients to develop a plan where the dose of antidepressants is slowly reduced in a bid to reduce the risk.
Dr Jonathan Henssler of Charite – Universitatsmedizin Berlin, author of the study, said: “There is strong evidence that antidepressants can be effective for many people experiencing a depressive disorder, either alone or in conjunction with other treatments such as psychotherapy.” .
‘However, they do not work for everyone and some patients may experience unpleasant side effects.
‘In patients who have recovered with the help of antidepressants, the decision of doctors and patients may be to stop taking them in time.
“Therefore, it is important for both doctors and patients to have an accurate, evidence-based picture of what might happen when patients stop taking antidepressants.
Of a list of 11 different antidepressants, citalopram, sertraline and fluoxetine, which are the most widely used in the UK, were the least likely to suffer withdrawal symptoms.
‘It is important to note that antidepressant discontinuation symptoms are not due to antidepressants being addictive.
‘There is a crucial need for all patients who stop taking antidepressants to receive advice, follow-up and support from healthcare professionals.
“However, our findings, which consolidate data from a large number of studies, should also ensure that rates of discontinuation symptoms are not as high as some previous studies and reviews have suggested.”
The research found that stopping imipramine, paroxetine and venlafaxine was associated with a higher risk of severe symptoms compared to other antidepressants.
Dr Sameer Jauhar, a consultant psychiatrist at King’s College London, said previous estimates of withdrawal symptoms have been high.
He added: “This new, comprehensive review and meta-analysis indicates that rates are much lower and also occur in people coming off placebo, as opposed to antidepressants.”
‘If placebo is taken into account, rates of withdrawal symptoms are around 14 percent, and 2 percent in the case of severe withdrawal.
‘It must be recognized that this only applies to those who participate in the trials, although it is the best evidence we have.
“Clinically, doctors will still need to have conversations about how to stop medications and do so safely, although it will be gratifying to know that withdrawal rates are not as high as reported.”
