Stopping antidepressants doesn’t lead to as many withdrawal symptoms as previously thought, according to a new study.
In a large trial examining the crucial weeks after people end treatment, scientists found that the symptoms reported after one week weren’t even enough to register as clinically significant. The study, published in JAMA Psychiatry on last week, ruled out mood change as a symptom and said dizziness was the effect most commonly reported.
The findings appear to contradict earlier studies, including one that found that as many as half of patients coming off antidepressants experienced symptoms including dizziness, nausea or headaches. Prior research tended to attract patients who already suffered from withdrawal, said Gemma Lewis, associate professor of psychiatric epidemiology at University College London and one of the study’s authors.
“It is my opinion that those surveys have overestimated the findings,” Lewis said in an interview.
The average patient in the study experienced only one discontinuation symptom a week after stopping treatment. People needed to have at least four symptoms to experience withdrawal, according to the study criteria. The research didn’t consider how severe the symptoms were.
Besides dizziness, some patients experienced nausea, vertigo and nervousness, symptoms that make “biological sense,” said Sameer Jauhar, clinical reader in affective disorders and psychosis at Imperial College London and the paper’s lead author.
The scientists distinguished between relapse and withdrawal. “If someone comes off an antidepressant and they get an episode of depression coming back again, that needs treatment,” Jauhar said.
The researchers reviewed about 50 studies on the topic, including some unpublished data, including more than 17,000 participants. Jauhar said he hopes the data will reassure patients as well as inform clinical decisions after studies reporting higher levels of symptoms led the Royal College of Psychiatry to update its guidelines on the topic.
“This new study is extremely welcome in terms of helping to destigmatize antidepressants,” said Katharina Domschke, chair of the department of psychiatry and psychotherapy at the University of Freiburg, Germany. The term “withdrawal symptoms” should be reserved for substance dependence, she wrote.
Burrin writes for Bloomberg.