New review concludes antidepressant withdrawal far more serious than previously thought

Monday, October 1, 2018

The incidence, severity and duration of antidepressant withdrawal are all more severe than suggested in existing guidelines

Dr James Davies, of the University of Roehampton's Psychology Department, led the systematic review, which drew upon numerous existing studies to show that antidepressant withdrawal is a far more severe problem than current clinical guidelines claim.

Antidepressant withdrawal is a known phenomenon, with existing guidelines of both the UK's National Institute for Clinical Excellence (NICE) and the US' American Psychiatric Association (APA) claiming that withdrawal symptoms last no longer than 1-2 weeks. They are additionally described as ‘mild and self-limiting’ by NICE, which acknowledges that symptoms ‘can be severe if the drug is stopped abruptly’.

However, Dr Davies' review of the literature shows that symptoms are routinely severe, regardless of whether the medication is stopped abruptly or gradually. An average of 56% of patients who stop or reduce their antidepressants experience withdrawal symptoms, with 46% of these reporting their symptoms as severe. In four large studies reviewed by Dr Davies and his team, almost 50% of those who have experienced withdrawal effects chose the most extreme option offered to them when given a scale of the severity of those effects. Symptoms include anxiety, insomnia, dizziness and flu-like symptoms, with some studies suggesting they may also include mania, emotional blunting and long-term, possibly permanent, sexual dysfunction. Around a quarter of patients experience such symptoms for at least three months after ceasing medication.

Based on this data and the number of people taking antidepressants in the UK, the authors of the study believe that around 4 million people in England may experience withdrawal symptoms, with nearly half of those experiencing severe symptoms.

The authors of the study strongly recommend that existing NICE and APA guidelines are updated to reflect the reality revealed by this study, with patients informed of withdrawal effects when being prescribed antidepressants.

Dr James 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 full review, originally published in published in the Journal of Addictive Behaviors, can be found here.

The University of Roehampton offers a wide range of courses in Psychology at undergraduate and postgraduate level, alongside postdoctoral research opportunities.