Adults taking antidepressants who want to come off their medication should not go cold turkey and should instead use a “staged” approach, experts have said. A staggered reduction of medicine, known as tapering, could cut the likelihood and severity of withdrawal symptoms, according to the National Institute for Health and Care Excellence (Nice).
Patients who wish to come off the drugs permanently should first agree with their doctor whether it is right to stop taking the medication, and, if so, the speed and duration of withdrawal from it, according to a new draft quality standard from the health body. Any withdrawal symptoms need to have been resolved, or to be tolerable, before making the next dose reduction, according to Nice’s panel of experts.
There were an estimated 21.4 million antidepressant drugs items prescribed to patients in England between July and September 2022, according to data from the NHS Business Services Authority. Meanwhile, the Nice quality standard, which sets out priority areas for quality improvement for the care of adults with depression, also calls for more action to support people of all ethnicities access mental health services.
Dr Paul Chrisp, director of the Centre for Guidelines at Nice, said: “There are millions of people taking antidepressants. If an individual decides they want to stop taking this medication, they should be helped by their GP or mental health team to do that in the safest and most appropriate way.
“In many cases people experience withdrawal symptoms, and the length in time it takes them to safely come off these drugs can vary, which is why our committee’s useful and useable statement for a staged withdrawal over time from these drugs is to be welcomed. But it should be stressed there is no one-size-fits-all approach to coming off antidepressants.
“The way it should be done has to be down to the individual and their healthcare professional, to agree a way which it can work and only when side-effects can be safely managed. Our guideline on depression signposts to information produced by the Royal College of Psychiatrists, which can offer practical advice to help people safely come off this medication.”
Lucy Schonevegel, associate director for policy and practice at the charity Rethink Mental Illness, said: “Antidepressant medications can alleviate the debilitating symptoms of several mental health conditions, helping to improve someone’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 guidance underlining how important it is for medical professionals to support people to reduce their dosage slowly at a pace appropriate for them.
“However, we need to look at this as part of the wider picture. Currently, pressures on mental health services mean many people are struggling to access or are not being referred to other suitable treatments such as talking therapy. Government must ensure mental health services have the resources they need so that people aren’t held back in their recovery."
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