NEW DELHI– Gradually reducing antidepressant medication while providing structured psychological support can be an effective way for adults who have recovered from depression to safely stop treatment, according to a new study published on Friday.
Antidepressants are generally recommended for six to nine months following a first episode of moderate to severe depression or anxiety to reduce the risk of relapse. However, growing concerns about long-term use, potential overprescribing and withdrawal symptoms have increased interest in evidence-based approaches to stopping these medications.
To examine the most effective strategies, researchers from the University of Verona in Italy conducted a large systematic review and network meta-analysis of 76 randomized controlled trials involving 17,379 adults. The findings were published in The Lancet Psychiatry.
The study does not suggest that antidepressants are unnecessary or that psychotherapy alone is sufficient, the researchers noted. Instead, it highlights the importance of individualized deprescribing, combining slow, personalized tapering of medication with structured psychological support.
“By incorporating a substantially larger evidence base, a broader range of deprescribing strategies, and direct head-to-head comparisons, our new review clarifies the scientific evidence about the most effective way to come off antidepressants for individuals successfully treated for depression and could change how coming off antidepressants is managed globally,” said lead author Professor Giovanni Ostuzzi of the University of Verona.
He stressed that patients should not discontinue medication without medical guidance. “We encourage anyone considering coming off antidepressants to discuss the process with their doctor first to jointly find the best strategy for them,” Ostuzzi said.
The researchers estimated that slow tapering combined with psychological support could prevent one relapse for every five patients compared with abrupt discontinuation or rapid tapering, which were found to be the least effective approaches. This difference represents a clinically meaningful benefit, the study said.
Continuing antidepressants at a reduced dose also appeared more effective than stopping abruptly or tapering quickly in preventing relapse, though the evidence supporting this approach was less robust.
The analysis found no significant differences among the various deprescribing strategies in terms of reported side effects or dropout rates, suggesting that gradual tapering with support does not increase treatment burden.
The findings underscore the need for personalized, carefully managed plans when patients and clinicians decide it is appropriate to discontinue antidepressant medication. (Source: IANS)
