How challenging is it to cease taking antidepressants? According to numerous online posts and scientific research, it can be quite difficult and doctors may not fully realize the challenges involved. However, the prevalence of discontinuation symptoms is not clearly understood. To address this, researchers have conducted a systematic review and meta-analysis. Their findings indicate that one out of every three individuals experiences symptoms after stopping antidepressant treatment, but half of these symptoms are due to negative expectations (the nocebo effect).
How hard is it to stop taking antidepres rnrn1 in 3 people report symptoms after stopping antidepressants, but half of those symptoms are due to negative expectations. The difficulties of discontinuing these medications are often underestimated by doctors, even though Internet posts and scientific studies suggest otherwise. Researchers from Charité — Universitätsmedizin Berlin and University Hospital Cologne conducted a systematic review and meta-analysis to determine the commonality of discontinuation symptoms, as it is unclear.cebo effect).
Officially, antidepressants are not considered to be addictive. Unlike other addictive substances, such as drugs, taking antidepressants does not make the body need higher and higher doses to have the same effect. However, many patients experience symptoms like dizziness, headache, or insomnia when they stop taking these medications for their mood. This phenomenon was not paid much attention by researchers for a long time, but there are now a significant number of studies trying to measure how common these symptoms are.
“The results of these studies vary widely in some cases,” says Prof.Christopher Baethge, a researcher at the Department of Psychiatry and Psychotherapy at University Hospital Cologne and the Faculty of Medicine at the University of Cologne, stated that there has been a lot of discussion, some of it quite emotional, within the research community and the general public in recent years about how prevalent and severe the discontinuation symptoms actually are. A look at prescription figures shows just how relevant this topic is. According to the most recent Arzneiverordnungs-Report, which summarizes data on drug prescriptions, nearly 1.8 billion daily doses of antidepressants were prescribed in Germany in 2022.
A Thorough Meta-Analysis Provides Clarity
In order to provide a more reliable answer to this question, a team led by Christopher Baethge and Dr. Jonathan Henssler, who heads the Evidence-Based Mental Health research group at the Department of Psychiatry and Neurosciences at Charité, conducted a thorough review of existing studies and re-evaluated them through a process known as a meta-analysis. This groundbreaking study offers the most comprehensive assessment to date of the outcomes of discontinuing antidepressant treatment. “Our analysis reveals that, on average, one out of every three individuals will experience symptoms after ceasing antidepressant treatment.”Henssler mentioned that while antidepressants are commonly used to treat depression, only half of the symptoms experienced by patients can be attributed to the drug itself. The researchers conducted a review of over 6,000 studies and selected 79 of them for re-analysis using statistical methods. They analyzed data from approximately 21,000 people who had been either given an antidepressant or a placebo and then surveyed for discontinuation symptoms. The results showed that 31 percent of patients treated with the active drug reported symptoms, while 17 percent of those who received a placebo also reported symptoms.About one in six or seven people experiences genuine withdrawal symptoms from drugs, according to Henssler. The placebo group helps rule out drug effects, indicating that the symptoms may have occurred by chance or as a result of the nocebo effect. The nocebo effect is similar to the placebo effect and can lead to the perception of “side effects” from treatments that are actually inactive, purely due to the expectation of negative effects.
we consider non-specific symptoms and the impact of expectations, about 1 in 6 or 7 individuals experiences discontinuation symptoms as a direct result of antidepressant medication,” Henssler summarizes the findings of the study. “Most of the time, the symptoms are mild. The vast majority of those affected will be able to stop taking antidepressants without experiencing significant symptoms. This means that in most cases, there is no need for a lengthy or gradual tapering off process.”
Rare occurrence of severe symptoms
The study revealed that severe discontinuation symptoms are rare, affecting only 1 in 35 people, orClose to three percent of individuals experienced these types of symptoms, which were more prevalent when they stopped taking medications such as imipramine, paroxetine, venlafaxine, and desvenlafaxine. The researchers did not have enough data to evaluate the situation for several commonly used antidepressants.
Baethge emphasizes the importance of monitoring and counseling by healthcare professionals for anyone looking to stop taking antidepressants, as well as receiving personalized support for withdrawal symptoms. It is crucial for the patient and prescriber to make decisions together even before starting a treatment plan.
BEGINNING is crucial for good treatment. We anticipate that our findings will provide support for patients and healthcare professionals and help reduce some of the uncertainty surrounding these issues today.”
Study overview
The meta-analysis considered 79 studies, including randomized placebo-controlled trials and observational studies without a control group. Out of the 21,002 patients involved, 16,532 were given an antidepressant, and 4,470 received a placebo. Aside from the researchers from Charité and University Hospital Cologne, other researchers from the Medical Center — University of Freiburg and Unive also contributed to the study.The meta-analysis involved researchers from University Hospital Carl Gustav Carus in Dresden.
