Researchers have warned that medical guidelines in the UK and US on antidepressant withdrawal urgently need to be updated to show it is more common and severe than currently stated.
A study, published in the Journal of Addictive Behaviours, examined 23 studies which used different methods and sample sizes to analyse the incidence, severity and duration of antidepressant withdrawal reactions.
It found that withdrawal rates from 14 studies ranged from 27% to 86% with a weighted average of 56%. In four large studies of severity, 46% of those who experienced withdrawal reactions gave them the most extreme severity rating.
Seven of 10 studies found a significant proportion of people experienced withdrawal reactions for more than two weeks while some did so for several months.
The results contradicted the National Institute for Health and Care Excellence and the American Psychiatric Association’s guidelines on depression which say antidepressant withdrawal reactions are “self-limiting” and typically resolved between one and two weeks.
The researchers said: “We recommend that UK and USA guidelines on antidepressant withdrawal be urgently updated as they are clearly at variance with the evidence on the incidence, severity and duration of antidepressant withdrawal, and are probably leading to the widespread misdiagnosing of withdrawal, the consequent lengthening of antidepressant use, much unnecessary antidepressant prescribing and higher rates of antidepressant prescriptions overall.
“We also recommend that prescribers fully inform patients about the possibility of withdrawal effects.”
One of the researchers, Dr James Davies, said: “This new review of the research reveals what many patients have known for years – that withdrawal from antidepressants often causes severe, debilitating symptoms which can last for weeks, months or longer.
“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.”
Sir Oliver Letwin MP, chair of the All-Party Parliamentary Group for Prescribed Drug Dependence, said: “This systematic review provides important new data on antidepressant withdrawal which will be considered by Public Health England as part of their current review into prescribed drug dependence.
“The data suggests that existing medical guidelines in this area should be urgently updated to reflect the fact that antidepressant withdrawal is much more common, severe and long-lasting than previously stated. Furthermore, we hope that other medical bodies will take note of this new research and update their own guidance accordingly.”