Withdrawal from Antidepressants Greater than Previously Thought
ACP-UK Welcomes Publication of New Review & Peter Kinderman Comments
The ACP-UK strongly welcomes publication of this new systematic review of research into the effects of withdrawal from antidepressant medication, which was commissioned by the All Party Parliamentary Review Group for Prescribed Drug Dependence. It shows that effects are considerably more widespread, severe and long-lasting than current guidelines suggest (see press release below for more information). Too often antidepressant medication is all that is offered to patients presenting to their GP with low mood. We hope that research of this kind empowers patients to discuss a range of therapeutic options with their GP, working collaboratively and in an informed way to consider which of these would be most helpful for them.
Professor Peter Kinderman, ACP-UK member and former President of the British Psychological Society, comments in response to publication of the review. He says:
“We urgently need to see mental health policies based on the promotion of fundamental human rights and sound scientific evidence. This important and timely review of the distressing experiences of people withdrawing from antidepressant medication should lead to action. It should inform the work of Public Health England and NICE as they review the guidelines for professionals in this area, it should inform the practice of GPs and psychiatrists when considering the prescription of medication… and, of course, the effective psychological therapies and other interventions available. It should inform the public statements of professional bodies.
Of course, one study alone needs to be seen in context. That’s why bodies like Public Health England and NICE undertake careful and detailed reviews. But, as a former President of the British Psychological Society, as a member of the Council for Evidence Based Psychiatry, as a practicing clinical psychologist, and as someone who has myself used mental health services, I strongly welcome the publication of this report, and hope it will lead to positive changes.”
Read the press release from the All Part Parliamentary Review Group for Prescribed Drug Dependence, 2 October 2018 below
Millions at risk from antidepressant withdrawal, new review concludes
The Journal of Addictive Behaviors has today published a new systematic review which shows that antidepressant withdrawal is much more widespread, severe and long-lasting than indicated by current guidelines, with millions of antidepressant users in the U.K. potentially affected. ‘A Systematic Review into the Incidence, Severity and Duration of Antidepressant Withdrawal Effects: Are Guidelines Evidence-Based?’ was undertaken by Dr James Davies, University of Roehampton and Professor John Read, University of East London, on behalf of the All Party Parliamentary Group for Prescribed Drug Dependence.
The review indicates that an average of 56% of patients who stop or reduce their antidepressants experience withdrawal symptoms, with 46% of these reporting their symptoms as severe. Furthermore, most of the studies reviewed on duration found that a significant proportion of patients experienced withdrawal symptoms for more than two weeks, and that it is not uncommon for patients to experience symptoms for several weeks,
months, or longer. According to one study, 40% of patients experience symptoms for at least 6 weeks, and another indicates that 25% experience symptoms for at least 3 months.
Based on this data, the authors estimate that around 4 million people in England may experience symptoms when withdrawing from antidepressants, and around 1.8 million may experience these as severe. In all, these findings contradict current national clinical guidelines (issued by NICE – the National Institute for Health and Care Excellence), which state that antidepressant withdrawal symptoms ‘are usually mild and self-limiting over about 1 week but can be severe'[1].
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 APPG for Prescribed Drug Dependence, commented: ‘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.’
The review can be found at http://prescribeddrug.org/wp-content/uploads/2018/10/Davies-Read.pdf or by clicking on the image above. For more information contact Luke Montagu at [email protected] or 07970 060145 For information on the APPG for Prescribed Drug Dependence: prescribeddrug.org
[1] NICE, 2009, 1.9.2.1 in CG90