A new report finds that antidepressant withdrawal effects and how long they last may have been seriously understated.
Currently in the UK, official guidance says that once people come off antidepressants, they should expect only “mild” and “self-limiting” withdrawal symptoms that will last for approximately one to two weeks. The guidelines do not rule out the possibility of more severe withdrawal symptoms, but they are classed as rare.
This is in part to be expected, as SSRIs are a relatively new class of antidepressants that were marketed on their effectiveness but also their safety. They were billed as rarely causing side-effects while being used to treat mental health problems, as being a low overdose hazard and also having a much less aggressive grip on patients who are coming off the drugs.
But a new review says that current guidelines on supposedly low level side-effects are out of step with real world usage, and what’s more they could be leading to misdiagnoses.
The review, conducted by researchers as part of the All Party Parliamentary Group for Prescribed Drug Dependence, looked at 24 pieces of research that together comprised the experiences of around 5,000 patients. Publishing in the “Journal of Addictive Behaviours” the researchers found that current guidelines vastly underestimated the likelihood of withdrawal symptoms, and what’s more they miss the rate at which people would experience severe symptoms.
Symptoms of withdrawal often include: dizziness, vertigo, nausea, problems concentrating, insomnia and other such problems. The guidelines issued in the UK in 2004 and readopted in 2009 said that these symptoms were likely to be minimal. The review found that the symptoms were, in fact, far more common than that.
What’s more, patients report other symptoms, like increases in anxiety, prolonged sleep problems, and even experiencing hallucinations. Once weighted and properly adjusted, the results of the studies suggest that an average of 56 percent of patients will experience withdrawal and 46 percent will experience prolonged and/or more aggressive withdrawal symptoms.
This has a knock-on effect of leading patients to seek treatment, where doctors will potentially prescribe other drugs to help manage their withdrawal symptoms or return them to the same medications, because of an expected relapse.
“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,” Dr James Davies of the University of Roehampton told the Guardian. “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.”
This research has been welcomed by mental health professionals, who say that more research is urgently needed into post-treatment mental healthcare.
Professor Wendy Burn, President of the Royal College of Psychiatrists, told the BBC, ”Antidepressants are an effective, evidence-based treatment for moderate to severe depression, and are a life-saver for many people. But not enough research has been done into what happens when you stop taking them. As this review shows, for many people the withdrawal effects can be severe, particularly when antidepressants are stopped abruptly.”
Parliamentary groups and NICE have both said they will consider these findings as part of their ongoing review of the guidance provided alongside treatment.
Antidepressant use has increased dramatically in the past few decades. Part of the reason for that is better mental health awareness and diagnoses. The good news is that large data reviews have confirmed that while we may not be completely sure how antidepressants work, they do perform far better than placebos, meaning that this isn’t snake oil.
Still, there is a growing worry about over-prescription of antidepressants, particularly among young people. Furthermore, there is concern that antidepressants have oftentimes been used as a quick fix without proper mental health support or exploring other health issues that may play a part in our mental health. This is something this latest research may also speak to in that, until now, much of the guidance surrounding antidepressants has been dictated by the drug companies who profit from these drugs.
The United States’ recommendations rely heavily on the same evidence that the UK used for its NICE recommendations, meaning that it is current policy that withdrawal from antidepressants is usually mild and will last for only one to two weeks. The US, therefore, should urgently carry out its own reviews, because this data reveals that quite clearly this is not the case, and it could be putting people’s health in jeopardy.
Source: care2.com
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