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Letters Antidepressant withdrawal

Clinical guidelines on antidepressant withdrawal urgently need updating

BMJ 2019; 365 doi: https://doi.org/10.1136/bmj.l2238 (Published 20 May 2019) Cite this as: BMJ 2019;365:l2238

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Antidepressant withdrawal guidance must be updated to reflect evidence
  1. James Davies, reader1,
  2. John Read, professor2,
  3. Michael P Hengartner, senior lecturer3,
  4. Fiammetta Cosci, associate professor4,
  5. Giovanni Fava, professor5,
  6. Guy Chouinard, professor6,
  7. Jim van Os, professor7,
  8. Antonio Nardi, professor8,
  9. Peter Gøtzsche, professor9,
  10. Peter Groot, researcher10,
  11. Emanuela Offidani, assistant professor11,
  12. Sami Timimi, visiting professor12,
  13. Joanna Moncrieff, reader13,
  14. Marcantonio Spada, professor14,
  15. Anne Guy, researcher15
  1. 1Department of Life Sciences, University of Roehampton, London SW15 4JD, UK
  2. 2School of Psychology, University of East London, London, UK
  3. 3School of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland
  4. 4Department of Health Sciences, University of Florence, Florence, Italy
  5. 5School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
  6. 6Psychiatry Department, University of Montreal, Montreal, Canada
  7. 7Department of Psychiatry and Psychology, Maastricht University Medical Centre, Maastricht, Netherlands
  8. 8Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
  9. 9Institute for Scientific Freedom, Copenhagen, Denmark
  10. 10Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, Netherlands
  11. 11Department of Psychology, Pennsylvania State University, University Park, PA, USA
  12. 12School of Health and Social Care, University of Lincoln, Lincoln, UK
  13. 13Division of Psychiatry, University College London, London, UK
  14. 14School of Applied Sciences, London South Bank University, London, UK
  15. 15All-Party Parliamentary Group for Prescribed Drug Dependence, Houses of Parliament, London, UK
  1. jp.davies{at}roehampton.ac.uk

In February 2018 the international debate on antidepressant withdrawal was reignited.1234 In response to a letter published in the Times by Davies et al on the benefits and harms of antidepressants,1 the Royal College of Psychiatrists publicly stated that, “[for] the vast majority of patients, any unpleasant symptoms experienced on discontinuing antidepressants have resolved within two weeks of stopping treatment.”2

To support this claim the college referred to guidelines from the National Institute for Health and Care Excellence (NICE), which state that “[withdrawal] symptoms are usually mild and self-limiting over about 1 week.”5

When Davies et al issued a freedom of information request to NICE asking for the evidence for its one week claim NICE was able to provide only two short review articles, neither …

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