A review by the Cochrane Fellowship found that the existing research on different antidepressant withdrawal regimens does not provide a good indication of how to do this correctly.
Antidepressants are prescribed to treat depression and anxiety. These medicines are often taken long-term. Generally, guidelines recommend doing this 6-12 months after improvement, or within two years. However, many people take them longer, the review authors point out. Between 30% and 50% of long-term antidepressant prescriptions occur without evidence-based indications. Scientists remind that their unnecessary appointment may be accompanied by side effects. In addition, evidence-based approaches to the safe withdrawal of antidepressants after long-term use have not yet been developed.
The new review included data from 33 randomized trials involving nearly 5,000 people. Participants in about a third of them stopped taking antidepressants abruptly, the rest reduced the dose gradually.
Dose reductions usually did not take more than four weeks. At the same time, the authors of the review point out that the British College of Psychiatrists, in order to increase safety, recommends reducing the dose of antidepressants before stopping them for several months and even years.
The review authors write that the available research does not allow for conclusions about how to safely end long-term antidepressants. This is because the quality of the evidence presented to date is rather low.
“As a general practitioner, the first thing I see is how many people struggle to stop taking antidepressants. Over 1,000 studies have looked at how to start antidepressants, and only 33 studies worldwide have looked at how to stop. This is definitely an area of expertise that needs immediate attention,” said Ellen Van Leeuwen (Ellen Van Leeuwen) from the University of Ghent, lead author of the review.
“ We would also like to draw attention to the fact that antidepressant withdrawal symptoms can often be mistaken for a relapse. Withdrawal is not indicative of a relapse, it may indicate that a slower withdrawal of the drug is required before completely stopping the drug,” said Dr. Tony Kendrick (Tony Kendrick) from the University of Southampton, co-author of the review. span>