Most people have no severe withdrawal from antidepressants, large review finds

Most people do not experience severe withdrawal when discontinuing antidepressants, and clinical guidelines should be updated to reflect this, say the UK authors of the largest review of the evidence to date.1

The past decade has seen heated debate about the effects of stopping antidepressants. Both the National Institute for Health and Care Excellence (NICE) and the Royal College of Psychiatrists now warn that severe symptoms can result from withdrawal of antidepressants and that such treatment should be tapered.

The new systematic review and meta-analysis, published in JAMA Psychiatry,1 included only randomised controlled trials—50 in total, involving 17 828 participants. The analysis also included unpublished data from 11 such trials.

The average age of the participants was 44, and 70% were female. Most studies included people with major depressive disorder or generalised anxiety disorder, and the maximum follow-up was a year.

Two meta-analyses were carried out: one looked at the trials that used a standardised measure known as the Discontinuation Emergent Signs and Symptoms (DESS) scale, and the other reviewed the trials that used various other scales.

Patients who discontinued antidepressants experienced an average of one more symptom on the 43 symptom DESS scale than those …