One in six people go into withdrawal after stopping antidepressants

One in six people have symptoms when they stop taking antidepressants – fewer than previously thought, medical research suggests.

The researchers say their findings will help inform doctors and patients “without causing undue alarm”.

The analysis in Lancet Psychiatry analyzed data from 79 studies involving more than 20,000 patients, writes

Some had been treated with antidepressants and others with a dummy drug or placebo, which helped the researchers assess the real effect of drug withdrawal.

Some people experience unpleasant symptoms such as dizziness, headaches, nausea and insomnia when they stop taking antidepressants, which researchers say can cause considerable distress.

Previous estimates suggested that antidepressant withdrawal symptoms (ADS) affected 56% of patients, with nearly half of cases classified as severe.

But this analysis, by the Universities of Berlin and Cologne, estimates:

One in six or seven patients can expect symptoms when stopping antidepressants.

One in 35 will have severe symptoms

Symptoms are more common with some antidepressants than others

The official health recommendation is to reduce the dose of antidepressant drugs in stages over time, rather than stopping them suddenly or skipping doses, which could lead to withdrawal symptoms.

Most people successfully get off antidepressants, the guide adds.

Other research suggests that SDA lasts one to two weeks.

Study author Professor Christopher Baethge, from the University of Cologne's department of psychiatry and psychotherapy, said the results were “quite solid”.

But ADS's lower estimate “doesn't mean it's all in their heads.”

Worsening of anxiety

It found that 17% of people experienced symptoms after stopping a placebo or dummy drug.

A possible explanation is a greater awareness of worsening anxiety and depression after discontinuing an apparently helpful drug.” said Professor Baethge.

Many of the 40 symptoms related to stopping antidepressants can also be caused by other conditions.

“This shows the importance of comparing antidepressants with placebo when studying discontinuation,” said Professor Glyn Lewis, from University College London.

The most commonly used antidepressants in the UK – citalopram, sertraline and fluoxetine – had the lowest risk of ADS.

But venlafaxine, which is also used in the UK, had the second highest.

High risk

Dr Paul Keedwell, consultant psychiatrist and fellow of the Royal College of Psychiatry, said people planning to come off medication should always seek medical advice.

“First, depending on your mental health history, there could be a high risk of relapse of depression,” he said.

“Sometimes a relapse of depression can be confused with withdrawal symptoms. Second, unpleasant withdrawal symptoms can be largely prevented with proper medical supervision. It is important to say that withdrawal symptoms are not dangerous and the risk of experiencing them at a later date should not be a reason to refuse antidepressant treatment. The pros and cons of treatment should always be discussed with your doctor.”

More than eight million people in England are taking antidepressants for depression, anxiety, obsessive-compulsive disorder and other conditions – a million more than five years ago.