In recent years, more people – including doctors and government health bodies – have started to acknowledge something that many long-term antidepressant users have been saying for years: coming off these medications isn’t always as simple as it sounds. For some, it can be downright brutal.
While these drugs can be life-changing and even lifesaving for people struggling with depression and anxiety, there’s a growing concern that the side effects of stopping them – known as withdrawal – have been underestimated for far too long. And much of the blame, experts say, lies in how the drugs were initially studied and how that data was interpreted.
A Problem Hidden in Plain Sight
For decades, the official line – backed by medical guidelines and drug companies alike – was that withdrawal symptoms from antidepressants were “mild and short-lived.” This belief was largely based on research where patients had only taken the medication for about 8 to 12 weeks.
But here’s the catch: those studies don’t reflect what’s happening in the real world.
Millions of people have been on these medications for years, sometimes even decades. According to a BBC investigation, about 2 million people in England have been on antidepressants for over five years. In the United States, that number balloons to 25 million.
When people who’ve used antidepressants long-term try to come off them, many report severe and long-lasting withdrawal symptoms—from intense mood swings and fatigue to nausea, insomnia, and what some describe as “brain zaps.” These aren’t just bad days. For many, it’s disabling.
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What the New Research Shows
A recent study surveyed patients in the UK’s National Health Service (NHS) and found something staggering:
- Those who had been on antidepressants for over two years were ten times more likely to experience withdrawal symptoms than those who had only taken them for six months or less.
- They were five times more likely to have severe symptoms.
- And 18 times more likely to suffer long-lasting symptoms – sometimes for months.
In contrast, people who took antidepressants for less than six months usually had mild, short-term symptoms that went away within four weeks. But for long-term users, two-thirds experienced moderate to severe withdrawal. One in four described their symptoms as severe, and nearly one-third said their symptoms lasted more than three months.
Even more concerning: 80% of these long-term users were unable to stop taking the medication, even though they had tried.
The Flawed Studies That Set the Standard
So, why wasn’t this known earlier? The answer lies in the studies that helped shape public health guidelines. Many of these were short-term trials, often funded by pharmaceutical companies. Participants typically stayed on the drugs for only a few weeks before researchers assessed how they felt when they stopped.
Imagine testing car safety by driving at just 5 km/h into a foam wall. That might be fine for short-term users. But people who’ve been driving at full speed – or in this case, taking antidepressants for years – face a completely different scenario when they try to stop.
Despite this, a new review published in the journal JAMA Psychiatry seems to follow the same outdated script. Many of the review’s senior authors had received payments from drug companies. Unsurprisingly, they concluded that antidepressants do not cause significant withdrawal issues.
Their analysis was based on 11 studies:
- 6 lasted only 8 weeks
- 4 lasted 12 weeks
- Only 1 lasted more than 6 months
Even though they found slightly more symptoms in people who stopped taking the drugs, they dismissed it as “not clinically significant.” They even suggested that the symptoms might be caused by the nocebo effect – where someone expects to feel worse, and so they do.
But Is It Really the Nocebo Effect?
That explanation doesn’t hold much water for many experts. While some people might feel dizzy or get headaches even when they stop taking a placebo (a sugar pill), those symptoms tend to be mild.
By contrast, withdrawal from antidepressants can be intense. Some patients need emergency medical care. A U.S. study even found that over 60% of people who stopped taking antidepressants after 11 months experienced withdrawal symptoms. That’s a number hard to ignore.
The new review also failed to include several well-conducted studies – including ones sponsored by drug companies themselves – that showed high rates of withdrawal.
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What About Depression Returning?
Another argument made in the review is that symptoms like low mood or anxiety after stopping the drugs might just be the original depression coming back, not withdrawal.
That’s possible, but the way the data was collected makes this a weak conclusion. In many of the five studies they looked at, participants were not specifically asked about withdrawal or returning depression – they were just told to report anything they noticed. That leaves a lot of room for error and underreporting.
Why This Matters
The danger here isn’t just academic. If health professionals continue to rely on outdated or incomplete data, millions of people could be left without proper guidance and support when trying to come off antidepressants.
And for those stuck in a withdrawal loop, this isn’t just uncomfortable—it’s life-altering. They may feel misunderstood, dismissed, or even misdiagnosed with a relapse of their mental health condition when what they’re really experiencing is withdrawal.
Encouragingly, governments like the UK’s have started to take this seriously. Antidepressant withdrawal is now officially recognized there as a public health concern.
A Call for Better Research and Honest Conversation
The takeaway? Antidepressant withdrawal is real, serious, and often long-lasting, especially for long-term users. It deserves more thoughtful research and fewer dismissive conclusions based on short-term studies.
Just like you wouldn’t design a parachute by only testing it on people jumping from a two-foot step, we shouldn’t base public health guidelines on data from people who used antidepressants for just a few weeks.
If we’re going to support mental health in a truly holistic way, we need to treat the challenges of coming off medication with the same care and attention we give to starting it.
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Final Thought
Antidepressants can be powerful tools for healing. But stopping them, especially after years of use, can be far more complicated than we’ve been led to believe. The more honest we are about the potential challenges, the better we can support those trying to navigate them.
