PARIS, Dec 11 \u2014 The best way for people with depression to stop taking antidepressants once their condition improves is to slowly taper off the medication while also receiving psychological support, new research suggested today.<\/p>\n
More than five per cent of the global population is estimated to suffer from depression, according to the World Health Organisation, and a range of drugs to treat the condition have been widely prescribed for decades.<\/p>\n
But how exactly to stop taking these drugs has proved a difficult problem.<\/p>\n
\u201cAs soon as an antidepressant is changed or reduced, it is a source of anxiety for the person,\u201d Christine Villelongue, co-head of the France Depression association, told AFP.<\/p>\n
However, \u201cthere are no guidelines: very often, when medication is stopped, there is no follow-up,\u201d she added.<\/p>\n
In recent years a process called \u201cdeprescribing\u201d which gradually reduces the dose has gained traction with psychiatrists concerned about overprescription, long-term side effects, withdrawal symptoms or the risk of a relapse.<\/p>\n
Now, a large-scale study has been published in The Lancet Psychiatry journal evaluating the available evidence across 76 different randomised controlled trials which included 17,000 people.<\/p>\n
It found that the most effective way for a patient to stop taking antidepressants was to gradually lower the dosage alongside seeing a psychologist.<\/p>\n
Compared to suddenly stopping or tapering off too quickly, this recommendation could prevent a relapse in one out of every five patients, the study said.<\/p>\n
The worst option, in all cases, was abruptly stopping.<\/p>\n
\u201cOur findings suggest that while antidepressants are effective in preventing depressive relapses, they do not need to be a long-term treatment for everyone,\u201d study co-author Debora Zaccoletti from Italy\u2019s University of Verona said in a statement.<\/p>\n
However, some specialists urged caution.<\/p>\n
\u201cEven with very slow tapering, discontinuation of antidepressant therapy continues to be associated with risk of relapse,\u201d Jonathan Henssler of Charite Berlin university hospital said in a linked comment.<\/p>\n
The study therefore highlights the \u201cbenefit of psychotherapy,\u201d he added.<\/p>\n
French psychiatrist Maeva Musso emphasised that getting off antidepressants was too often overlooked.<\/p>\n
\u201cThroughout my residency, which I only recently completed, this topic was never addressed,\u201d she told AFP.<\/p>\n
When patients \u201cexpress a desire to reduce their medication, it is still often interpreted by the medical community as a denial of their disorder,\u201d Musso added.<\/p>\n
However, Villelongue pointed out that the psychological support called for by the research is not a realistic option for everyone.<\/p>\n
The study\u2019s conclusions are based \u201con an ideal world, but the reality on the ground is quite different,\u201d she said.<\/p>\n
\u201cSometimes the psychiatrist is unavailable \u2014 you go a month of two without seeing them,\u201d she said.<\/p>\n
\u201cIn the meantime, if the person is tapering off medication and is struggling, they have no one to talk to.\u201d \u2014 AFP<\/p>\n
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