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Antidepressants ‘must be tapered off’ to avoid withdrawal symptoms | Mental Health


GPs whose patients want to stop taking antidepressants should reduce the dose of their medicines in stages to reduce the risk and severity of withdrawal symptoms, the medicine watchdog has said.

Around one in six UK adults (16%) suffer from moderate to severe depression, according to the Office for National Statistics. In England alone, 21.4 million antidepressants were prescribed between July and September 2022, according to the NHS Business Services Authority.

A new draft quality standard for care of adults with depression from the National Institute for Health and Care Excellence (Nice) – the first update in 11 years – includes specific guidance to help adults to permanently stop antidepressants.

Nice’s independent advisory board, which includes experts in treating adults with depression, recommends the gradual withdrawal of antidepressants in patients who want to stop taking the drugs.

A phased reduction in medication, known as tapering, helps reduce withdrawal effects and long-term drug dependence, according to Nice.

The committee said primary care and mental health professionals should follow the recommendations of the Nice guideline on stopping antidepressants, including agreeing with their patient whether it is right for them to stop taking the drug and, if applicable, the speed and duration of the withdrawal.

According to the Nice expert panel, any withdrawal symptoms must have resolved or be tolerable before proceeding with the next dose reduction.

Professor Allan Young, director of the Center for Affective Disorders at King’s College London, said: “This is not new guidance on how depression is treated, but a document which outlines the main areas of care which, according to Nice, can be improved.”

Dr Paul Chrisp, director of the Nice recommendation centre, said: “There are millions of people taking antidepressants. If a person decides they want to stop taking this medicine, they should be helped by their GP or mental health team to do this in the safest and most appropriate way.

“In many cases, people experience withdrawal symptoms, and the time it takes them to safely stop these medications can vary, which is why our committee’s helpful and usable statement for staggered withdrawal over time of these drugs should be welcome.

“But it should be emphasized that there is no one-size-fits-all approach to getting rid of antidepressants. How this is done should be left to the individual and their healthcare professional to agree on. a way it can work and only when the side effects can be safely managed.

Lucy Schonegevel, from the charity Rethink Mental Illness, said: “Antidepressants can alleviate the debilitating symptoms of several mental health conditions, helping to improve a person’s quality of life.

“But there may come a point in an individual’s recovery when they feel ready to stop their medication, and we welcome this advice highlighting how important it is for healthcare professionals to help people to slowly reduce their dose at a rate that is comfortable for them.”

theguardian Gt

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