Re: Half of people who stopped long term antidepressants relapsed within a year, study finds
Dear Editor
The reporting (1) of the long-awaited ANTLER study (2) has raised great alarm amongst those of us who, for years, have been working to support people who wish to come off antidepressants – and have been raising awareness of the actual patient experiences of taking antidepressants ‘as prescribed’. The study itself (2) actually reinforces and confirms just what we have seen happening – to all too many people. Almost all of the references in the NEJM paper (2) are up to 2016 when the ANTLER study protocols were established, so there feels to be a complete time-warp – with the study seemingly designed to conclude that long-term antidepressants are ‘a good thing’ and omitting, even in the Discussion, the emerging evidence of issues with antidepressant withdrawal.
Our 2020 Patient Voice article (3) tracks what is happening to people – and how antidepressant withdrawal is frequently mis-diagnosed as ‘relapse’ or the onset of another medical condition.
“The experience of this sample brings to light, for the first time, the extent to which antidepressant withdrawal symptoms are mistaken for relapse, due to the widespread lack of awareness of withdrawal symptoms amongst GPs.”
Stevie Lewis has written for BJGP ‘Four research papers that I wish my GP had read before prescribing antidepressants’ (4), and Ed White has written about his own research showing that tens of thousands of patients are turning to Facebook groups for support to taper antidepressants (5).
There seems to be very little interest by those working within Primary Care to investigate this hugely important issue – or to provide prescribers with up-to-date information and guidance about how antidepressants may be more safely tapered. My own letter to BJGP journal (6) refers to updated information – which seems to be otherwise ‘not being seen’ by overwhelmed GPs.
The ‘new research’ (2) is already desperately out-of-date and will unfortunately seriously compound the problems faced by patients – most especially that of being disbelieved by their prescribers when they run into difficulties, further eroding doctor/patient relationships.
A new book, ‘Antidepressed’ by Beverley Thomson (7), is due for release shortly and offers a readable comprehensive roundup of information essential for those involved in prescribing or taking antidepressants – as well as including a number of patient experience accounts which were published for our Scottish petition (8).
(1) Mahase E. Half of people who stopped antidepressants relapsed within a year, study finds. BMJ 2021;374:n2403 Half of people who stopped long term antidepressants relapsed within a year, study finds | The BMJ
(2) Lewis G et al. Maintenance or Discontinuation of Antidepressants in Primary Care N Engl J Med 2021; 385:1257-1267 DOI: 10.1056/NEJMoa2106356 https://www.nejm.org/doi/full/10.1056/NEJMoa2106356?query=recirc_inIssue...
(3) Guy A, Brown M, Lewis S, Horowitz M. The ‘patient voice’: patients who experience antidepressant withdrawal symptoms are often dismissed, or misdiagnosed with relapse, or a new medical condition. Therapeutic Advances in Psychopharmacology. January 2020. doi:10.1177/2045125320967183 The ‘patient voice’: patients who experience antidepressant withdrawal symptoms are often dismissed, or misdiagnosed with relapse, or a new medical condition - Anne Guy, Marion Brown, Stevie Lewis, Mark Horowitz, 2020 (sagepub.com)
(4) Lewis S. Four research papers I wish my GP had read before prescribing antidepressants. British Journal of General Practice 2021; 71 (708): 316-317. DOI: https://doi.org/10.3399/bjgp21X716321 Four research papers I wish my GP had read before prescribing antidepressants | British Journal of General Practice (bjgp.org)
(5) White E. Tapering antidepressants: why do tens of thousands turn to Facebook groups for support? British Journal of General Practice 2021; 71 (708): 315. DOI: https://doi.org/10.3399/bjgp21X716309 Tapering antidepressants: why do tens of thousands turn to Facebook groups for support? | British Journal of General Practice (bjgp.org)
(6) Brown M. Letter: Four research papers … prescribing antidepressants. British Journal of General Practice 2021; 71 (710): 397. DOI: https://doi.org/10.3399/bjgp21X716837 Four research papers … prescribing antidepressants | British Journal of General Practice (bjgp.org)
(7) Thomson B. Antidepressed. 2021 ISBN 9781578269235 Antidepressed by Beverley Thomson: 9781578269235 | PenguinRandomHouse.com: Books
(8) Petition PE01651. Prescribed drug dependence and withdrawal. Scottish Parliament 2017 - 2021
PE01651: Prescribed drug dependence and withdrawal - Getting Involved : Scottish Parliament
Rapid Response:
Re: Half of people who stopped long term antidepressants relapsed within a year, study finds
Dear Editor
The reporting (1) of the long-awaited ANTLER study (2) has raised great alarm amongst those of us who, for years, have been working to support people who wish to come off antidepressants – and have been raising awareness of the actual patient experiences of taking antidepressants ‘as prescribed’. The study itself (2) actually reinforces and confirms just what we have seen happening – to all too many people. Almost all of the references in the NEJM paper (2) are up to 2016 when the ANTLER study protocols were established, so there feels to be a complete time-warp – with the study seemingly designed to conclude that long-term antidepressants are ‘a good thing’ and omitting, even in the Discussion, the emerging evidence of issues with antidepressant withdrawal.
Our 2020 Patient Voice article (3) tracks what is happening to people – and how antidepressant withdrawal is frequently mis-diagnosed as ‘relapse’ or the onset of another medical condition.
“The experience of this sample brings to light, for the first time, the extent to which antidepressant withdrawal symptoms are mistaken for relapse, due to the widespread lack of awareness of withdrawal symptoms amongst GPs.”
Stevie Lewis has written for BJGP ‘Four research papers that I wish my GP had read before prescribing antidepressants’ (4), and Ed White has written about his own research showing that tens of thousands of patients are turning to Facebook groups for support to taper antidepressants (5).
There seems to be very little interest by those working within Primary Care to investigate this hugely important issue – or to provide prescribers with up-to-date information and guidance about how antidepressants may be more safely tapered. My own letter to BJGP journal (6) refers to updated information – which seems to be otherwise ‘not being seen’ by overwhelmed GPs.
The ‘new research’ (2) is already desperately out-of-date and will unfortunately seriously compound the problems faced by patients – most especially that of being disbelieved by their prescribers when they run into difficulties, further eroding doctor/patient relationships.
A new book, ‘Antidepressed’ by Beverley Thomson (7), is due for release shortly and offers a readable comprehensive roundup of information essential for those involved in prescribing or taking antidepressants – as well as including a number of patient experience accounts which were published for our Scottish petition (8).
(1) Mahase E. Half of people who stopped antidepressants relapsed within a year, study finds. BMJ 2021;374:n2403 Half of people who stopped long term antidepressants relapsed within a year, study finds | The BMJ
(2) Lewis G et al. Maintenance or Discontinuation of Antidepressants in Primary Care N Engl J Med 2021; 385:1257-1267 DOI: 10.1056/NEJMoa2106356 https://www.nejm.org/doi/full/10.1056/NEJMoa2106356?query=recirc_inIssue...
(3) Guy A, Brown M, Lewis S, Horowitz M. The ‘patient voice’: patients who experience antidepressant withdrawal symptoms are often dismissed, or misdiagnosed with relapse, or a new medical condition. Therapeutic Advances in Psychopharmacology. January 2020. doi:10.1177/2045125320967183 The ‘patient voice’: patients who experience antidepressant withdrawal symptoms are often dismissed, or misdiagnosed with relapse, or a new medical condition - Anne Guy, Marion Brown, Stevie Lewis, Mark Horowitz, 2020 (sagepub.com)
(4) Lewis S. Four research papers I wish my GP had read before prescribing antidepressants. British Journal of General Practice 2021; 71 (708): 316-317. DOI: https://doi.org/10.3399/bjgp21X716321 Four research papers I wish my GP had read before prescribing antidepressants | British Journal of General Practice (bjgp.org)
(5) White E. Tapering antidepressants: why do tens of thousands turn to Facebook groups for support? British Journal of General Practice 2021; 71 (708): 315. DOI: https://doi.org/10.3399/bjgp21X716309 Tapering antidepressants: why do tens of thousands turn to Facebook groups for support? | British Journal of General Practice (bjgp.org)
(6) Brown M. Letter: Four research papers … prescribing antidepressants. British Journal of General Practice 2021; 71 (710): 397. DOI: https://doi.org/10.3399/bjgp21X716837 Four research papers … prescribing antidepressants | British Journal of General Practice (bjgp.org)
(7) Thomson B. Antidepressed. 2021 ISBN 9781578269235 Antidepressed by Beverley Thomson: 9781578269235 | PenguinRandomHouse.com: Books
(8) Petition PE01651. Prescribed drug dependence and withdrawal. Scottish Parliament 2017 - 2021
PE01651: Prescribed drug dependence and withdrawal - Getting Involved : Scottish Parliament
Competing interests: No competing interests