Antidepressant withdrawals are real and patients know it. Experts are now acknowledging this and warning against prolonged intake of antidepressants.
Severe Symptoms Of Withdrawal
Based on existing guidelines, most people should be able to withdraw from the drugs after four weeks, but withdrawal symptoms can last much longer and can be more severe for some patients, especially those who have been taking antidepressants pills for a long time.
The National Institute for Clinical Excellence in the UK is currently gathering more evidence to update its guidelines to reflect the range of symptoms that patients experience when coming off medication for depression.
"Existing NICE guidelines fail to acknowledge how common withdrawal is and wrongly suggest that it usually resolves within one week. This leads many doctors to misdiagnose withdrawal symptoms, often as relapse, resulting in much unnecessary and harmful long-term prescribing," said Dr. James Davies from the University of Roehampton.
A new position statement on antidepressants and depression by the Royal College of Psychiatrists indicated that "the routine use of antidepressants for mild and sub-threshold depressive symptoms among adults is not generally recommended." The College also proposed that "there should be greater recognition of the potential in some people for severe and long-lasting withdrawal symptoms on and after stopping antidepressants in NICE guidelines and patient information."
"As psychiatrists, we are duty-bound to take on board the concerns of patients who've experienced more severe and long-lasting side effects of these medications," said Wendy Burn, president of the Royal College of Psychiatrists. Burn hoped that their position would be reflected in the new NICE guidelines. The College also outlined recommendations to promote the optimal use and management of antidepressants.
Common symptoms of withdrawal from antidepressant include anxiety, confusion, exhaustion, dizziness, stomach cramps, and fatigue. The psychiatrists are also advising to wean off patients who have been stuck on medication for years.
Millions Of People Taking Antidepressants
Prescription for antidepressants in the UK doubled from 40 million in 2007 to more than 82 million in 2017. About 4 million people in England may experience withdrawal symptoms when they stop taking antidepressants. An estimated 1.8 million may experience such severe symptoms, which include anxiety, sleeping problems, and hallucinations.
The College further underscored that there must always be a discussion with the patient about the potential benefits and harm, including withdrawal when prescribing antidepressants. Discontinuation of antidepressants often involves tapering dosage or slowly decreased at a rate that is tolerable for the patient, to reduce the risk of severe symptoms which may occur for several months.
"Ongoing monitoring is also needed to distinguish the features of antidepressant withdrawal from emerging symptoms which may indicate a relapse of depression," the College said in the statement.