May 22, 2025

expert reaction to online survey of antidepressant withdrawal

An online survey published in Psychiatry Research looks at the antidepressants withdrawal effects. 

(comment on the subject more generally, in case useful) A spokesperson for the Royal College of Psychiatrists, said:

“Treatment options will depend on a patient’s type of depression, how long it has lasted, and whether they have experienced depression in the past.

“Medication is just one of the recommended treatment options for people with anxiety and depressive conditions. We know that people greatly benefit from holistic treatment from specialist practitioners who are trained in the biological, social and psychological determinants of mental illness.

“Antidepressants are a clinically recommended treatment, and they are effective at reducing the symptoms of moderate to severe depression, particularly when used in combination with talking therapies.

“Long-term use of antidepressants should only be considered for people that have recurrent depression and repeated, severe relapses after stopping antidepressants. For those patients, the beneficial effects of continuous use of antidepressants are more likely to balance the potential risks. However, this should be reviewed regularly, and multiple attempts should be made to stop taking these medications after prolonged periods of established wellbeing.

“Most people will be able to stop taking antidepressants without significant difficulty by reducing the dose (known as ‘tapering’) over a few weeks or months. Some people can experience withdrawal symptoms that last longer and may be more severe, particularly when the medication is stopped suddenly.

“Ultimately, the use of antidepressants, should always be a shared decision between a patient and their doctor based on clinical need and the preferences of the patient. We would advise all those thinking of stopping their antidepressants to talk to their doctor first, as these medications should not be stopped abruptly.”

Dr Gemma Lewis, Associate Professor of Psychiatric Epidemiology and Wellcome Trust and Royal Society Sir Henry Dale Fellow, UCL, said:

“This type of study is highly susceptible to bias and the findings should not be used to inform practice. The number of people included in the study was very small, compared to the number of people who use this NHS service. The study was an online survey done at one point in time. These types of studies are at a much higher risk of bias than studies which use larger samples, follow people over time, and have a control group. It was also impossible for the authors to distinguish withdrawal symptoms from symptoms of depression and anxiety.”

Prof Anthony Kendrick, Professor of Primary Care, University of Southampton, said:

“The percentage of people reporting severe withdrawal symptoms of 15% is likely to be an overestimate, as the response rate to the survey was only 18%, and it was retrospective, so people who have had memorable withdrawal problems in the past would be more likely to respond. Also, giving people a list of symptoms to choose from elicits a greater number than asking them to report symptoms themselves, spontaneously.

“The recent systematic review by Henssler et al in Lancet Psychiatry looked at prospective studies and included many which asked for spontaneously reported symptoms. However, the proportion of 3% reporting severe withdrawal symptoms found in that study is likely to be an underestimate as it included many short-term studies of only around 6-12 weeks of antidepressant use. 

“Overall we might conclude that the evidence so far indicates that a minority of people experience severe withdrawal symptoms – somewhere between 3% and 15%.”

References

Henssler, J., Schmidt, Y., Schmidt, U., Schwarzer, G., Bschor, T., Baethge, C., 2024. Incidence of antidepressant discontinuation symptoms: a systematic review and meta-analysis. Lancet Psychiatry 11, 526–535. https://doi.org/10.1016/S2215-0366(24)00133-0

‘Antidepressants withdrawal effects and duration of use: a survey of patients enrolled in primary care psychotherapy services’ by Mark Horowitz et al. was published in Psychiatry Research at 23:59 UK time on Wednesday 21 May. 

Declared interests

Dr Gemma Lewis: No COIs.

Prof Anthony Kendrick:I have received funding from the NIHR for the REDUCE programme on internet and telephone support for discontinuing antidepressants, and I was a member of the guideline committee for the NICE guideline on depression in adults which made recommendations on managing antidepressant discontinuation.