Tapering Off Antidepressants Reduces Recurrence
Gradually tapering antidepressants prevents recurrence of depression better than abruptly stopping the drugs, according to a new study. When antidepressants are gradually withdrawn, the patient is less likely to experience panic attacks or a recurrence of depression.
“The benefit of gradual discontinuation appeared to be greater with the older [antidepressants, rather] than the newer ones, but latency to new illness was similar with all antidepressant types,” according to the paper published in the American Journal of Psychiatry.
The study followed 398 patients with major depression, panic disorder, or bipolar disorder for an average of 2.8 years. The patients took antidepressants for an average of 8.5 months. All patients were free of symptoms when they stopped taking the drugs. The 188 patients in the “abrupt” group completely quit taking medication within 7 days. The 210 patients in the “gradual” group tapered the dosage over 14 days or longer. All patients were treated in Belmont, Massachusetts at McLean Hospital.
On average, patients who quit abruptly had a recurrence within 3.77 months, while those who quit more gradually had a recurrence within 9.07 months, or more than twice as long.
Researcher Ross Baldessarini, M.D. noted that primary care physicians should realize the dangers inherent in abruptly discontinuing the medication. In the U.S., most antidepressants are prescribed by family doctors.
These results support similar findings for other disorders. Research has shown that rapidly discontinuing treatment with lithium is often associated with an early, severe episode of mania or depression. In schizophrenic patients, abruptly stopping antipsychotic drugs was associated with new episodes of psychosis.
This study is particularly I portent because often when a patient stops medication against medial advice, they abruptly discontinue it rather than tapering off. Such sudden changes by patients can have severe consequences. “Stopping abruptly or rapidly was almost always the patient’s decisions” according to the researchers.
Dr. Baldessarini suggests that when prescribing antidepressants to a patient for the first time, the doctor cautions the patient of the consequences of abruptly going off the medication.
Patients in the study were also taking lithium or anticonvulsants, a typical antipsychotics or benzodiazepines. None of those drugs was discontinued during the study.
By Joni Holderman, [email protected], contributing reporter for Mental Health News.