Why We’re Skeptical About This Research on Antidepressant Withdrawal Symptoms | Letters

You recently reported on a research review claiming that only about 15% of people experience withdrawal symptoms when they stop taking antidepressants and that only 3% experience severe withdrawal symptoms (withdrawal symptoms from antidepressants experienced by 15% of users, research shows, June 7). We believe this is misleading. a previous review we conductedmentioned in your report, found that the overall withdrawal rate was 56%, with 25% experiencing severe withdrawal symptoms.

We fear that both your report and Prof. Carmine Pariante’s article on the review you also published (The myth that antidepressants are addictive has been debunked – they are an essential tool in psychiatry, June 8) will mislead both doctors and the public a dangerous false sense of comfort.

The recent review was mainly based on studies with patients of an average of 25 weeks of antidepressant use; Many of the included studies were funded by pharmaceutical companies, and almost half only assessed the use of antidepressants for up to twelve weeks. The typical antidepressant user takes these medications for several years, not a few months or weeks. Because we know that long-term use increases both the risk and severity of withdrawal symptoms, the findings of this study are not relevant to the majority of real antidepressant users.

This review took issue with the inclusion of online surveys on antidepressants in our previous review. The online surveys found that the number of withdrawals was about the same as the other types of surveys we included. The studies were independent of the influence of pharmaceutical companies, were many times larger than more traditional drug trials and, crucially, included hundreds of the more typical long-term antidepressant users. Our research obviously showed that the longer one takes the medication, the greater the chance of withdrawal symptoms when one stops.

Most of the drug company-funded short-term studies in the recent review did not systematically assess withdrawal effects and instead relied on subjective reports from doctors (including regarding severity). A more objective measure of withdrawal symptoms, which is standard in any robust study, was used in only six of the 79 studies in the review. As a result, it is likely that the incidence and severity of withdrawal have been further minimized, making any uncritical acceptance of the findings of this study irresponsible from a clinical point of view.

If the findings of this study are accepted uncritically, it could reduce the likelihood of the NHS providing vital support to those experiencing severe and long-lasting withdrawal symptoms, as recommended by Public Health England, the World Health Organization and the United Nations. Minimizing harm benefits no one, least of all those most in need.
Prof John Read
University of East London
Dr. James Davies
University of Roehampton

After decades of anxiety and depression, in my terms, I gave in and asked my GP to prescribe antidepressants. I had already embraced talk therapy, a healthy lifestyle, and relaxation techniques. I was also dealing with a long-term seriously ill husband and traumatic family issues. Life as I knew it had diminished beyond recognition.

It took about a week for the side effects to go away, and several weeks for me to feel significantly better. That was seven years ago – and my experience has been life-changing. I don’t lack emotion; I don’t feel numb or euphoric. I am now dealing with the death of my husband, and the antidepressants have not robbed me of the grieving process. In my case, antidepressants help me in the same way as other essential medications. I don’t crave a larger dose, and what I have is a decent quality of life.
Lynne Collins
Leigh-on-Sea, Essex

I was prescribed antidepressants (Citalopram) in my late 40s (I’m now 74). At the time I didn’t think I was depressed, but two doctors told me I was. In retrospect, I can clearly see that my low mood and fatigue were symptoms of menopause. (I recently met someone my age who has also been taking Citalopram since age 40, which was also prescribed for what we now clearly call menopausal symptoms.)

Over the years I have tried three times to gradually come off the medication. Each time I became extremely depressed and suicidal. The last time I tried I reduced my intake by one tablet per week for a whole year. I then removed the second tablet and six weeks later I was a crying, desperate mess.

My local GPs were unable to help and appear to be unaware of the impact of the drug. I’m no longer trying to get rid of it. Life is too short to sacrifice my mental well-being again. Ironically, by trying to get off Citalopram, I now know what depression really is, and I know I didn’t have it when I was prescribed it.
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