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Rapid response to:


Half of people who stopped long term antidepressants relapsed within a year, study finds

BMJ 2021; 374 doi: (Published 30 September 2021) Cite this as: BMJ 2021;374:n2403

Rapid Response:

Re: Half of people who stopped long term antidepressants relapsed within a year, study finds

Dear Editor

This study will reassure those who wish to continue on their antidepressants and to the pharmaceutical companies that produce these drugs. However, as a jobbing GP actually treating these patients I am less reassured. For many patients who have been on anti-depressants for more than a few years a 2 month tapering period is insufficient. We have become increasingly aware that many of the symptoms these patient experience on stopping their anti-depressants are due to the drug withdrawal itself rather a return of the "illness". It also important to reflect on the study's finding that 39% of those who continued on their anti-depressants suffered relapses.
It is my experience that with a significantly longer taper (the sort of tapers we use for benzodiazepine users) together with active support many can stop the medication. I also worry that there is not enough of a concern with regard to possible permanent changes in brain chemistry, down -regulation of 5HT and beta-1 receptors as well as changes in serotonin receptor sensitivity with long-term use of these drugs. This might not be a problem over decades but we just do not know.
Depression and anxiety is a biopsychosocial illness and for many of our patients addressing the non-biological aspects although much more difficult is infinitely more rewarding. We must beware the easy option of just writing a prescription and moving on to the next patient.

Competing interests: No competing interests

15 October 2021
Gary Singh Marlowe
de Beauvoir Surgery