Doctors need more evidence to help patients stop taking antidepressants safely and effectively, a collaborative study has found.
Mieke van Driel, an emeritus professor of general practice at the University of Queensland, says long-term antidepressant use was on the rise because people took antidepressants for much longer than guidelines recommended.
“The difficulty of distinguishing between withdrawal symptoms and relapse presents a real challenge when patients stop taking antidepressants,” van Driel says.
“This often results in inappropriate continuation of antidepressant medication when it is no longer useful. Many of the symptoms of withdrawal overlap with a possible relapse of the original mental health condition. It might make it look like more people are having a return of their anxiety or depression than is really the case.”
People can experience a range of symptoms when weaning off their medication, including sleep troubles, lowered mood, anxiety, and appetite changes.
Van Driel says it was difficult for clinicians and patients to distinguish between relapse and withdrawal due to limited high-quality research and treatment protocols for stopping long-term antidepressant medication.
“Future studies need to distinguish carefully between withdrawal symptoms and relapse, and try using taper schemes of varying degrees that lower doses over longer periods of time, months to years rather than weeks to months,” she says.
“These kinds of studies would give us a clearer idea if we can safely and successfully help people come off antidepressant medication.
“Ultimately, we really need more studies about discontinuing antidepressants—especially in primary care given that’s where most prescribing takes place—before we can make more definitive conclusions,” van Driel says.
“We know future studies will be critical in addressing the urgent need for more and better evidence, given the concerning trend of long-term use of antidepressants here in Australia and around the world.”
One in seven Australians are taking medication every day to treat their anxiety and depression. In 2019, there were 27 million prescriptions provided for antidepressants across Australia, with around 86% of those written by GPs. Australia has the second-highest consumption of antidepressants of all Organisation for Economic Co-operation and Development countries.
This research appears in the Cochrane Library.
Source: University of Queensland