Recent research published in the Lancet Psychiatry has shed light on the prevalence of withdrawal symptoms among individuals discontinuing antidepressants. The study reveals that approximately one in six to seven individuals faces a 15% chance of experiencing withdrawal symptoms upon cessation of antidepressant use. Around 20% of patients encounter antidepressant discontinuation syndrome when abruptly stopping or significantly reducing their dosage after a month of continuous use.
This systematic review and meta-analysis explored the complexities of antidepressant withdrawal, indicating that anywhere from 27% to 86% of individuals, whether under medical supervision or discontinuing antidepressants independently, encounter withdrawal symptoms.
Depression is one of the leading causes of disability worldwide. According to the World Health Organization (WHO), more than 264 million individuals of all ages suffer from depression globally. Characterized by a range of symptoms, including sadness, pessimism, decreased energy, and suicidal thoughts lasting at least two weeks, depression is a leading cause of functional disability. Antidepressants are crucial medications for depression treatment, but their withdrawal symptoms have garnered attention since their introduction to the market. These symptoms encompass physical discomforts such as gastrointestinal issues, disruptions in sleep patterns, and neurological manifestations like paraesthesia or akathisia. Mood-related symptoms, resembling those of affective relapse, are also prevalent, collectively termed withdrawal syndrome.
Recent research, led by Gastaldon et al., has provided further insights into the prevalence and demographic disparities of antidepressant-related withdrawal syndrome. The study reported over 31,000 instances of withdrawal syndrome associated with antidepressants, highlighting disproportionate reporting among different medications. Severe withdrawal syndrome was notably more frequently reported in specific demographics, including males, adolescents, individuals on polypharmacy, and those with prolonged antidepressant use.
Another study by Gastaldon et al. analyzed 406 cases of neonatal withdrawal syndrome across 15 antidepressants, revealing significant disparities compared to other drug classes. Additionally, research led by Quilichini J. emphasized that antidepressants with shorter half-lives pose a greater risk of withdrawal syndrome, particularly among individuals aged 18–44, females, and those prescribed specific medications such as paroxetine, desvenlafaxine, venlafaxine, and duloxetine.
These studies underscore the need for tailored support during antidepressant cessation to mitigate associated challenges. It is crucial to consider the potential for severe and prolonged withdrawal effects when prescribing or discontinuing antidepressants. Due to these risks, discontinuation of these medications should be approached with caution, and patients should be closely monitored to manage any emerging withdrawal symptoms effectively.
Reference
- Henssler J, Schmidt Y, Schmidt U, Schwarzer G, Bschor T, Baethge C. Incidence of antidepressant discontinuation symptoms: a systematic review and meta-analysis. The Lancet Psychiatry [Internet]. 2024 Jun 5 [cited 2024 Jun 12]; 0(0). Available from: https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(24)00133-0/fulltext
- Use of Antidepressants among Patients Diagnosed with Depression: A Scoping Review [Internet]. [cited 2024 Jun 13]. Available from: https://onlinelibrary.wiley.com/doi/epdf/10.1155/2021/6699028.
- Gastaldon C., Schoretsanitis G., Arzenton E., Raschi E., Papola D., Ostuzzi G., et al. Withdrawal Syndrome Following Discontinuation of 28 Antidepressants: Pharmacovigilance Analysis of 31,688 Reports from the WHO Spontaneous Reporting Database. Drug Saf. 2022;45(12):1539–49.
- Gastaldon C, Arzenton E, Raschi E, Spigset O, Papola D, Ostuzzi G, et al. Neonatal withdrawal syndrome following in utero exposure to antidepressants: a disproportionality analysis of VigiBase, the WHO spontaneous reporting database. Psychol Med. 2023 Sep;53(12):5645–53.
- Quilichini JB, Revet A, Garcia P, Bouquié R, Hamard J, Yrondi A, et al. Comparative effects of 15 antidepressants on the risk of withdrawal syndrome: A real-world study using the WHO pharmacovigilance database. J Affect Disord. 2022 Jan 15; 297:189–93.