One in six people who stop taking antidepressants experience withdrawal symptoms.

One of the risks of taking certain medications is stopping them. When it comes to potent drugs that cause hitch patients. This dependence must be constantly monitored. Medicines in a first aid kit used in psychiatry fall into this category.

For the one who stop taking antidepressantsrisk of experiencing one or more withdrawal symptoms, also called withdrawal syndrome, such as dizziness, headache, nausea, insomnia and irritability, directly related to discontinuation of the drug, is 15%. According to a systematic review and meta-analysis published in the journal Lancet Psychiatry.

Given the number of patients who require this type of pharmacological treatment, it is important to know what happens when they have to stop. “This job confirms what we already knewthat is, this a real phenomenon and this happens with some frequency with some drugs, but not with all.” Eduard Vieta, head of the psychiatry and psychology service at the Hospital Clínic, CIBERSAM researcher and professor at the University of Barcelona, ​​explains to SMC that we are faced with “a high-quality meta-analysis examining a clinically relevant phenomenon such as the appearance of symptoms of rebound and discomfort This happens quite often when stopping treatment with antidepressants.

The analysis by Jonathan Henssler and Christopher Bethge’s team also found that withdrawal symptoms, which patients describe as severe and which could lead to stopping or restarting antidepressant treatment, were observed in about 3% (one in 35) of patients who stopped treatment. antidepressants.

For his part, Alberto Ortiz Lobo, MD and psychiatrist at the Carlos III Day Hospital – University Hospital of La Paz (Madrid), as reported by SMC, notes that “ unusual increase in antidepressant prescriptions It should alert us to how we turn human and everyday discomfort into a disease that we treat with psychotropic drugs.” Side effects “during his consumptionbut also in withdrawala problem that was barely reported just a few years ago.

“Exists strong evidence that antidepressants can be effective for many people suffering from depressive disorder, either alone or in combination with other treatments such as psychotherapy. However, They don’t work for everyone Some patients may experience unpleasant side effects,” explains Hensler. For patients who have recovered with antidepressants, “the decision by doctors and patients may be to stop taking them in a timely manner. That’s why, It is important for both doctors and patients to have an accurate picture and is based on evidence of what can happen when patients stop taking antidepressants,” adds the author of the work.

How was the analysis carried out?

This is a comprehensive approach to identifying symptoms of antidepressant treatment discontinuation, including data from more than 20,000 patients collected from 79 randomized controlled trials And observational studies. About 16,532 people stopped taking antidepressants, 4,470 received placebo, the average age was 45 years, and 72% were women.

The aim of the study was to distinguish between symptoms caused directly by stopping medication and other “non-specific” symptoms that may be related to patient or professional expectations (nocebo effect).

Previous studies have shown that mMore than half of patients experience withdrawal symptoms when stopping antidepressants., and that half of the symptoms are serious. However, many of these estimates are based on observational studies that cannot reliably determine cause and effect. On the other hand, well-conducted randomized controlled trials (in which half of the study participants are given a placebo or dummy pill and the other half are given a drug) can more reliably distinguish symptoms caused directly by the drug from those not caused by it. directly caused by taking the drug.

He target this study was review all available data to establish probable incidence withdrawal symptoms directly caused by stopping antidepressants, the likely incidence of severe symptoms, and differences between different types of antidepressants.

What drugs are observed and what symptoms appear?

Overall, the analysis found that a third (31%) of people who stopped taking an antidepressant experienced at least one symptom, such as dizziness, headache, nausea, insomnia and irritability. Severe symptoms occurred in approximately 3% (one in 35). Stop taking imipramine (Tofranil), paroxetine (Seroxat) and (des)venlafaxine (Pristiq) has been associated with an increased risk of severe symptoms compared with other antidepressants.

However, “it still does not address one of the main problems in this sense, which is to have a strong and clinical argument for distinguishing whether the anxiety-depressive symptomatology that often occurs when stopping antidepressants may be a consequence of withdrawal or withdrawal symptoms.” reappearance of symptoms of the underlying disorder.” That’s what Diego Hidalgo, a psychiatrist and researcher at the bipolar and depressive disorders unit of the Barcelona Hospital Clinic, says, reports SMC.

In this regard, Ortiz emphasizes that “it is striking that throughout this article this phenomenon is referred to as withdrawal symptoms (a euphemism commonly used by the pharmaceutical companies that sell them) rather than as withdrawal syndromewhich is the usual term for indicate the physical and psychological reaction after reducing or stopping substance use. which act on the central nervous system, as is the case with antidepressants.