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Kicking antidepressants is not as risky as once feared - as new study finds only one in six patients suffered withdrawal symptoms

3 months ago 17

Coming off antidepressants is not as risky as previously feared with only one in six patients suffering withdrawal symptoms, a major study suggests.

Researchers say their findings should reassure people who could benefit from the drugs but have been worried about doing so in case of side-effects when they stop taking them.

The analysis, which is the largest of its type, found 15 per cent of users experience one or more complaints directly caused by stopping the pills.

But just 2 per cent to 3 per cent suffer severe symptoms, according to the results published in The Lancet Psychiatry.

Previous research has suggested 56 per cent of patients may experience withdrawal symptoms, although experts have said this figure is not robust. 

Coming off antidepressants is not as risky as previously feared with only one in six patients suffering withdrawal symptoms, a major study suggests (file pic)

Fifteen per cent of users experience one or more complaints directly caused by stopping antidepressants, but just 2 per cent to 3 per cent suffer severe symptoms, according to the results published in The Lancet Psychiatry (file pic)

The most frequently reported conditions were dizziness, headache, nausea, insomnia and irritability.

Discontinuation symptoms typically occur within a few days, and the new study found they lasted from 1.5 to 196 days.

Researchers in Germany looked at a range of antidepressants for the work, which included data for 21,000 patients involved in 79 pieces of research.

Almost three-quarters - 72 per cent - of those included were women and the average age was 45.

From a list of 11 separate antidepressants, citalopram, sertraline and fluoxetine - which are the most commonly used in the UK - had the lowest chances of suffering withdrawal symptoms.

According to researchers, fluoxetine, for example, takes longer to leave the body and may account for fewer withdrawal effects. 

But venlafaxine, which is also used in the UK, was second highest for people experiencing symptoms.

The NHS and Royal College of Psychiatrists advise doctors work to with patients to develop a plan in which their dose of antidepressants is slowly tapered down in a bid to reduce the risk.

Dr Jonathan Henssler, from Charite - Universitatsmedizin Berlin, an author on the study, said: 'There is strong evidence that antidepressants can be effective for many people who are experiencing a depressive disorder, either alone, or alongside other treatments such as psychotherapy.

'However, they do not work for everyone, and some patients may experience unpleasant side effects.

'In patients who have recovered with the help of antidepressants, the decision from doctors and patients may be to stop taking them in time.

'Therefore, it's important both doctors and patients have an accurate, evidence-based picture of what might happen when patients stop taking antidepressants.

From a list of 11 separate antidepressants, citalopram, sertraline and fluoxetine - which are the most commonly used in the UK - had the lowest chances of suffering withdrawal symptoms

'It's important to note that antidepression discontinuation symptoms are not due to antidepressants being addictive.

'There is a crucial need for all patients stopping antidepressants to be counselled, monitored and supported by healthcare professionals.

'However, our findings, which consolidate data from a large number of studies, should also provide reassurance that rates of discontinuation symptoms are not as high as some previous single studies and reviews have suggested.'

The research found stopping taking imipramine, paroxetine and venlafaxine was associated with a higher risk of severe symptoms compared with other antidepressants.

Dr Sameer Jauhar, consultant psychiatrist at King's College London, said previous estimates of withdrawal symptoms have been high.

He added: 'This new, thorough review and meta-analysis indicates rates are much lower, and also occur in people coming off placebo, as opposed to antidepressants.

'When accounting for placebo, the rates of withdrawal symptoms are around 14 per cent, and 2 per cent for severe withdrawal.

'It should be acknowledged that this only pertains to those taking part in trials, though this is the best evidence we have.

'Clinically, doctors will still need to have conversations about stopping medications and doing this safely, though it will be gratifying to know rates of withdrawal are nowhere near as high as reported.'

WHAT IS DEPRESSION?

While it is normal to feel down from time to time, people with depression may feel persistently unhappy for weeks or months on end.

Depression can affect anyone at any age and is fairly common – approximately one in ten people are likely to experience it at some point in their life. 

Depression is a genuine health condition which people cannot just ignore or 'snap out of it'.

Symptoms and effects vary, but can include constantly feeling upset or hopeless, or losing interest in things you used to enjoy.

It can also cause physical symptoms such as problems sleeping, tiredness, having a low appetite or sex drive, and even feeling physical pain.

In extreme cases it can lead to suicidal thoughts.

Traumatic events can trigger it, and people with a family history may be more at risk.

It is important to see a doctor if you think you or someone you know has depression, as it can be managed with lifestyle changes, therapy or medication. 

Source: NHS Choices 

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