Stopping Antidepressants Could Be Safer With a Slow Therapist Led Taper
Breaking up with antidepressants is widely acknowledged as a tough journey. Many people report horrendous side effects, including stomach problems, irritability and insomnia. With about seven million Britons estimated to be taking mood-balancing drugs, knowing how to stop has long eluded experts. A new study in The Lancet Psychiatry now points to a clearer path: gradually reducing the dosage with the support of a trained mental health professional.
In This Article:
Gradual Taper With Professional Support Cuts Relapse By About One In Five
Analysing medical records from more than 17,000 individuals, researchers found that the most effective method is gradually lowering the dosage alongside seeing a therapist. This could help prevent relapse in one in five patients, dramatically reducing the number who cannot come off antidepressants. Patients were followed for around a year; those who abruptly stopped taking their medication were at a 40 per cent risk of relapse. Those who gradually came off antidepressants, while seeing a psychiatrist, reduced their risk of relapse by nearly 50 per cent. The study found this was almost as effective as continued drug usage without psychological support.
Experts Warn That Changing Antidepressants Triggers Anxiety And More Research Supports Slow Taper With Psychotherapy
Experts warn that guidelines for stopping antidepressants are unclear, and many people experience anxiety when a medication is changed or reduced. 'As soon as an antidepressant is changed or reduced, it is a source of anxiety for the person.' 'Our findings suggest that while antidepressants are effective in preventing depressive relapses, they do not need to be a long term treatment for everyone,' study co-author, Dr Debora Zaccoletti, said. 'However, there are no real guidelines: When medication is stopped, there is no follow up.' Analysing the data, 'Continuing with or without psychological support, slow tapering with the psychological support and continuing at the antidepressant at reduced doses had similar benefits in preventing relapse within the first year after stopping.' 'Abrupt stopping or fast tapering carried the highest risk of relapse.' 'Our new review clarifies the scientific evidence about the most effective way to come off antidepressants for individuals successfully treated for depression and could change how coming off antidepressants is managed globally,' Prof Ostuzzi added. 'These findings highlight the need for clinical guidelines to be updated to promote regular treatment reviews and individualised deprescribing with gradual tapering and structured psychological support for patients with depression who are feeling better and wish to come off their medication.' 'The powerful drugs — taken by millions — have long been known to potentially trigger symptoms including dizziness, headaches, insomnia and nausea when coming off them.' 'The NHS has warned that side effects such as a loss of libido and achieving orgasm, lower sperm count and erectile dysfunction can persist after taking them — and patients have described feeling carved out, relationships wrecked, from their use.'
NHS Data And The Way Forward For Prescribing Guidelines
Latest NHS data shows a record 8.8 million people in England are now on mood-boosting drugs. Common SSRIs prescribed in the UK include citalopram, fluoxetine and sertraline, sometimes known by brand names Cipramil, Prozac and Lustral. But their use has been linked to long-term and even permanent sexual dysfunction by researchers. The NHS has warned that side effects such as a loss of libido and achieving orgasm, lower sperm count and erectile dysfunction can persist after taking them — and patients have described feeling carved out, relationships wrecked, from their use. Most medics, and the NHS, consider the use of SSRI for depression, particularly persistent or severe cases, as worthwhile given the debilitating nature of the condition. Dr Jonathan Henssler, MD, said: 'The best patient outcomes were achieved with strategies that maintained antidepressant therapy.' Dr Alberto Ortiz Lobo, a leading psychiatrist at La Paz University, welcomed the findings. He said: 'This is a crucial study given the alarming increase in antidepressant prescriptions and the need to consider strategies for reducing their use.' He added that gradually reducing the dose helps support changes in the brain. Continuing, he said: 'Psychological support provides confidence and security in this process, in which the person regains their agency and autonomy, reappropriates their emotions and stops delegating their well-being to a medication.'
