Recent research and antidepressant users’ lived experience show that antidepressant withdrawal symptoms may be severe and long-lasting. Patients and their prescribers need accurate information on withdrawal risks and tapering guidance from the FDA.
A mounting body of evidence has found that many patients who attempt to stop taking antidepressants experience physical, mental, and emotional withdrawal symptoms that are more severe and longer-lasting than the conventional medical view of mild symptoms lasting only two to three weeks. It is long past time for the U.S. Food and Drug Administration (FDA) to address this issue, correct the widespread misinformation, and issue guidance to prescribers on how to discontinue antidepressants, says the Citizens Commission on Human Rights (CCHR), an international mental health watchdog organization.
Even though withdrawal symptoms have been documented for more than 40 years for older antidepressants and for more than 30 years for newer generation antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), there is still a lack of scientific studies of withdrawal.
While some people may experience mild, short-lived withdrawal symptoms, for others the symptoms may be so severe and long-lasting that normal functioning is impossible, even when the antidepressant dosage has been tapered slowly and gradually.
A 2019 study revealed that more than half (56%) of people who attempt to come off antidepressants experience withdrawal symptoms, with nearly half (46%) of them describing those symptoms as severe. The researchers also found that it is not uncommon for the withdrawal effects to last for several weeks or months.
A separate study pegged the average duration of withdrawal symptoms at 90.5 weeks for SSRIs and 50.8 weeks for serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressants.
There is also evidence of a growing number of long-time users who have been unable to come off their antidepressants because of the debilitating withdrawal symptoms they experienced when trying to stop.
“Some 15.5 million Americans have taken antidepressants for at least five years,” according to science reporter Benedict Carey, writing in the New York Times in 2018. “The rate has almost doubled since 2010, and more than tripled since 2000.”
“What you see is the number of long-term users just piling up year after year,” said Dr. Mark Olfson, a professor of psychiatry at Columbia University, quoted in Carey’s article.
Antidepressant withdrawal symptoms include anxiety, dizziness, headache, flu-like symptoms, nausea, insomnia, irritability, hallucinations, muscle tremors, electric shock-like sensations (“brain zaps” or “body zaps”), mania, emotional blunting, and sexual dysfunction that can be long-lasting or even permanent.
A new study focused on the emotional and social effects of withdrawal. Researchers found that withdrawal had a significant negative impact on the emotional and social functioning and overall well-being of those going through withdrawal from antidepressants. More than half of the study participants said their relationships were negatively affected, such as by angry outbursts.
Psychiatrist Joanna Moncrieff, M.D., recently co-authored an article about why antidepressant withdrawal should be taken seriously. Moncrieff with colleagues previously conducted the landmark 2022 study which found no scientific support for the theory that depression is caused by a chemical (serotonin) imbalance in the brain.
The recent article points out that updated guidelines have been issued by British medical authorities, advising that after long-term use, antidepressant users wanting to stop should be tapered off the drugs gradually over months and sometimes years, with the dose reduced by smaller and smaller amounts, known as “hyperbolic tapering.” The U.S., however, has not yet updated its guidance, which still recommends stopping the drugs relatively rapidly, the authors report.
CCHR calls on the FDA to address this issue and provide updated guidance on discontinuing antidepressants, as well as updated antidepressant prescribing information. Patients and their prescribers need accurate and complete information on the risks associated with discontinuing antidepressants so they can make fully informed decisions about starting or stopping the drugs. Some 45 million Americans are currently taking antidepressants.
The FDA should also update its antidepressants webpage for consumers, which only mentions “withdrawal symptoms” once, listing them as a “less common” side effect.
WARNING: Anyone wishing to discontinue or change the dose of an antidepressant or other psychiatric drug is cautioned to do so only under the supervision of a physician because of potentially dangerous withdrawal symptoms.