Around one in six people who stop taking antidepressants experience withdrawal symptoms, but this is fewer than had previously been thought, research has suggested.
An analysis of randomised controlled trials – covering 79 trials involving more than 20,000 patients – published in the journal The Lancet Psychiatry, found 15% of patients will experience one or more withdrawal symptoms directly caused by stopping taking their medication. Around 2% to 3% will suffer severe symptoms, it added.
This figure is lower than previous estimates, which had suggested more than half (56%) of all patients are affected if they come off their medication.
According to the NHS, it is estimated some 86 million antidepressants were prescribed in 2022-23 to 8.6 million patients in England.
Positively, the most commonly used antidepressants in the UK – citalopram, sertraline and fluoxetine – were found to have the lowest rates of withdrawal symptoms. However, venlafaxine, which is also used in the UK, was second highest for people experiencing withdrawal symptoms.
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In its conclusions, the research team, led by Professor Christopher Baethge, from the Department of Psychiatry and Psychotherapy at the University of Cologne in Germany, emphasised that the study was “meant to inform clinicians and patients about the probable extent of antidepressant discontinuation symptoms without causing undue alarm”.
The results confirmed “that for a proportion of patients discontinuation symptoms will be severe, and will potentially lead to disengaging from practitioners or to reinstating antidepressant use”.
Therefore, it was important that “all patients discontinuing antidepressants need to be counselled and monitored, and patients who report antidepressant discontinuation symptoms must be helped, in particular those who develop severe antidepressant discontinuation symptoms,” the research concluded.
In a linked editorial, professor Glyn Lewis, professor of epidemiological psychiatry at the University College London Division of Psychiatry and associate professor Dr Gemma Lewis, conceded the presence of discontinuation symptoms when patients stop taking antidepressants had “sparked heated discussion”.
Nevertheless, despite some limitations, the current study “was a substantial improvement on anything that has been published before”, they added.
Separately, a successful NHS trial has led to an electric headset for treating depression being recommended for wider use.
The headset, developed by Flow Neuroscience, was given to patients with depression by their GP to wear for 30 minutes daily for six weeks.
The device delivers a weak direct electrical current to the front of the brain to stimulate the areas responsible for emotional expression.
The research found more than half (58%) of people saw improvements within six weeks, and one in three even went into remission.
One of the trial leads, Northampton GP Dr Azhar Zafar, told Sky News that patients reported having to use fewer medications as a result.
“It’s a new option because for years and years, we will have only the option of medication or a cognitive behavioural therapy. This method of treatment is an additional treatment,” he said.
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