A reanalysis of antidepressant withdrawal data has challenged claims that discontinuation symptoms are uncommon, finding that more than half of patients may experience withdrawal effects when stopping their medication.
The study, published in Psychological Medicine, examined a widely cited 2024 review that suggested only around 15% of patients experience antidepressant withdrawal symptoms. However, researchers led by Professor Joanna Moncrieff from University College London found significant flaws in the original analysis.
The findings come amid growing public and scientific interest in alternative treatments for depression, including cannabis and psychedelics, as patients and researchers seek options with potentially fewer withdrawal complications.
“We are concerned that some psychiatrists tend to minimise the adverse effects associated with antidepressants, particularly their dependence-inducing effects,” said Professor Moncrieff, a professor of critical and social psychiatry. “This may be because psychiatrists see the medical treatment of depression as central to the enterprise of psychiatry, and therefore feel the need to defend the reputation of antidepressants come what may.”
Flawed methodology identified
The researchers discovered that the original review by Henssler and colleagues relied heavily on pharmaceutical industry-sponsored studies where withdrawal was assessed through spontaneous adverse event reporting rather than systematic measurement tools.
Of the 62 studies examined, only five used structured questionnaires specifically designed to assess withdrawal symptoms. When the team analysed just these five higher-quality studies, they found that between 55% and 69% of participants experienced withdrawal symptoms after stopping antidepressants.
“The majority of studies were not proper studies of withdrawal but had looked at withdrawal only casually and incidentally,” Professor Moncrieff explained. “In fact, very few of the studies had used a proper measure of withdrawal symptoms.”
Industry influence on research
The analysis revealed that 74% of the studies in the original review had definite or probable pharmaceutical company funding, accounting for 96.2% of all participants. Many studies also had potential for misclassifying withdrawal symptoms as relapse of the underlying condition.
The researchers identified several methodological problems, including short observation periods, brief treatment durations before discontinuation, and the use of questionable measures for severe withdrawal symptoms.
Real-world implications
The findings suggest that current clinical understanding of antidepressant withdrawal may significantly underestimate its frequency. This has important implications for the millions of people prescribed these medications, with data showing that 1 in 4 people in the UK are prescribed antidepressants.
As awareness of withdrawal complications grows, researchers are increasingly investigating alternative treatments. Recent studies have shown promising results for both cannabis and psychedelics in treating depression. A study published earlier this year found that cannabis use was associated with significant reductions in anxiety and depression, whilst separate research demonstrated that vaporised DMT reduced depression symptoms, with 86% of patients reporting rapid relief after just one treatment.
“Evidence from surveys and thousands of patient reports points to the fact that antidepressant withdrawal is a significant clinical problem,” Professor Moncrieff said. “Attempts to minimise it are worrying because it means that the many people who suffer from severe withdrawal reactions will not receive the understanding and support they need.”
The researchers noted that most studies examined involved short-term antidepressant use of 12 weeks or less, meaning the findings may not reflect withdrawal effects in long-term users who represent a significant portion of patients.
The study authors called for higher-quality, independent research on antidepressant withdrawal, particularly studies measuring symptoms with the same rigour used to evaluate drug efficacy.
“There is little good quality data on antidepressant withdrawal, so it is difficult to make estimates about its frequency,” Professor Moncrieff said. “I hope to set up a study that can explore antidepressant withdrawal in more detail and also how to help people avoid severe withdrawal symptoms.”
