Staying on antidepressants reduces risk of relapse

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Experts say some people can benefit from taking antidepressant medication for longer.
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  • Researchers report that more than half of participants in a recent study relapsed into depression after stopping antidepressants.
  • Experts say some people need to keep taking antidepressants for longer, while others can avoid relapses after they stop taking the drugs.
  • They say people who stop taking antidepressants should see their doctor first and maybe attend therapy sessions for at least a while.

According to a new study, the majority of people who stop taking antidepressants over the long term relapse into depression within a year.

But that might not be as bad as it sounds.

Researchers at University College London found that 56% of people who stopped taking long-term antidepressants such as citalopram, sertraline, fluoxetine and mirtazapine had a relapse within 12 months.

This compares to a relapse rate of 39% among people who continued to take their medications.

Conversely, the study found that 44% of participants who stopped taking antidepressants did not relapse.

“Prescriptions for antidepressants have increased dramatically over the past few decades as people are now taking antidepressants for much longer,” said Gemma Lewis, PhD, lead author of the study and lecturer in mental health sciences at the ‘University College London, in a statement.

“Until now, we didn’t know if antidepressant treatment was still effective when someone had been taking it for many years. We have found that taking antidepressants over the long term effectively reduces the risk of relapse. However, many people can stop their treatment without relapsing, although at this time we cannot identify who these people are, ”she said.

“The good news is that people don’t necessarily have to keep taking medication for the rest of their lives. For people who experience negative side effects from their medications, this is great, ”Dr. Nima Fahimian, medical director of TMS & Brain Health in Los Angeles, told Healthline.

The randomized, double-blind, controlled study involved 478 people in England who had been taking long-term antidepressants – most for 3 years or more – but felt well enough to try to quit.

Half of the study participants stopped taking their medication, while the rest continued. The withdrawal group received reduced doses for several weeks before switching to placebo pills.

“Our results add to the evidence that for many patients long-term treatment is appropriate, but we also found that many people were able to effectively stop taking their medications when they were reduced in 2 months,” said Lewis.

The severity of relapses was not measured. However, 59% of people who relapsed chose not to resume their medication after the study ended.

The researchers said this could indicate that the relapse or accompanying withdrawal symptoms may not have been severe enough to prompt people to resume taking antidepressants.

“Many patients taking long-term antidepressants have absolutely no idea what they would be without antidepressants,” said Paul Lanham, researcher of the study’s “lived experience”, in a statement. “Some won’t want to know it, but others will. These results show that continuing to take antidepressants reduces the risk of relapse, but this does not guarantee well-being, and some people can stop antidepressants without a relapse.

The study authors urged people taking antidepressants to discuss with their doctor first any decision about stopping the use of these drugs.

“Keeping taking antidepressants will always be a matter of risk and reward: how serious is your depression and are you particularly at risk for suicide? Said Fahimian.

“If you tend to go through severe phases of depression, where a person cannot continue working, has to go on disability or attempts suicide, the slight increase in the likelihood of preventing relapses is probably worth it. . If the depression is generally milder and the side effects of the antidepressants are not particularly tolerable, we can argue for stopping, ”he said.

People who choose to stop taking antidepressants would likely benefit from counseling, Fahimian said.

“Therapy could help, and most likely does, alleviate some of the negative effects of stopping drugs,” he said. “Most studies have shown that counseling with medication is far superior to medication alone. Ultimately, it varies from case to case, individual history and genetics.

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