Patients Should Be Warned About Antidepressant Withdrawal Symptoms, Say Psychiatrists

Guidance needs to reflect patient experience, the Royal College of Psychiatrists said.

Patients seeking treatment for depression should be informed of potential “severe and long-lasting withdrawal symptoms” when coming off medication, leading doctors have said.

The Royal College of Psychiatrists said official guidance on stopping medical treatment for depression needs to reflect “the full range of patients’ experiences”.

Current guidelines from the National Institute for Health Care Excellence (NICE) – which are being consulted on – suggest most people should be able to come off antidepressants over four weeks.

But the college said it was “increasingly apparent” that some patients suffer from severe symptoms when doing so, such as restlessness, difficulty sleeping and altered sensations for longer.

Wendy Burn, president of the Royal College of Psychiatrists, said she hoped the college’s position would be reflected in the new guidelines, which were last issued in 2009.

“We know that Nice is working on updating its guidelines and want to see them more in keeping with what we’re hearing from some patients – and GPs – about the range of experiences of coming off antidepressants,” she said.

“As psychiatrists, we are duty-bound to take on board the concerns of patients who’ve experienced more severe effects of these medications.”

The report from the college, published on Thursday, said use of this medication should be “underpinned by a discussion with the patient… about the potential level of benefits and harms, including withdrawal”.

It added: “There should be greater recognition of the potential in some people for severe and long-lasting withdrawal symptoms on and after stopping antidepressants in Nice guidelines and patient information.”

A total of 70.9 million medication items were given out in 2018 in England to treat conditions including depression and anxiety, according to data published by NHS Digital.

This is almost double the number dispensed a decade ago in 2008, when there were 36 million. It’s also a rise from 67.5 million in 2017 and 64.7 million in 2016.

The figure includes all items dispensed by the NHS in England, except those given out in hospitals or private prescriptions.

Burn added: “Antidepressants can be very effective for treating moderate to severe depression, particularly in combination with talking therapies, and what we want is guidance that best supports their use.”