Antidepressants withdrawal ‘affects millions’

Millions of antidepressant users face side-effects when they try to come off the drugs, a new review has found.

More than half (56%) of patients who stop taking antidepressants or try to reduce their usage will experience withdrawal symptoms, according to the research.

Of these, 46% will report experiencing severe side-effects.

The review of evidence was carried out on behalf of the All Party Parliamentary Group for Prescribed Drug Dependence.

It calls for fresh guidance for patients choosing to come off antidepressants.

Current clinical guidelines from the National Institute for Health and Care Excellence (Nice) state antidepressant withdrawal symptoms “are usually mild” and last about one week.

The research, by Dr James Davies, of the University of Roehampton, and Professor John Read, from the University of East London, has been published in the Journal of Addictive Behaviours.

The authors estimate around four million patients in England may experience symptoms when withdrawing from antidepressants, and that they may be severe for 1.8 million of these people.

Dr 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 authors reviewed 14 studies, most of which found many patients experience withdrawal for weeks, months or longer.

In one study, 40% of people had withdrawal symptoms for at least six weeks, while in another, 25% of patients had symptoms for a minimum of three months.

Symptoms of antidepressant withdrawal can include anxiety, flu-like symptoms and insomnia.

Sir Oliver Letwin, chairman of the All Party Parliamentary Group 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 be 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 bodies will take note of this new research, and update their own guidance accordingly.”

Professor Wendy Burn, president of the Royal College of Psychiatrists, said: “Antidepressants are an effective, evidence-based treatment for moderate to severe depression, and are a life-saver for many people.

“But not enough research has been done into what happens when you stop taking them.

“As this review shows, for many people the withdrawal effects can be severe, particularly when antidepressants are stopped abruptly.

“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 Nice asking that they do the same.”

Paul Chrisp, director of the centre for guidelines at Nice, said: “In July 2018, the committee met and concluded that the current evidence base needs updating to include research from July 2016 onwards. Nice agrees.

“It is important that the final recommendations are based on the most up-to-date evidence possible. In addition to updating the existing evidence reviews, we will include new work on patient choice and a focus on shared decision-making.

“We hope the final guideline will allow people with depression to be offered the best treatments and reach joint decisions about their care that reflect their preferences and values.”