Antidepressant discontinuation does not cause severe symptoms in most people, study finds

The prevalence of antidepressant discontinuation symptoms is lower than clinical guidelines suggest, according to a systemic review and meta-analysis published in JAMA Psychiatry.

The analysis of 29 randomised clinical trials (RCTs), published on 9 July 2025, revealed that the average number of discontinuation symptoms observed one week after patients stopped taking antidepressants was “below the threshold for clinically significant discontinuation syndrome”.

Patients who stopped taking antidepressants experienced an average of one more symptom on the 43-symptom ‘Discontinuation-Emergent Signs and Symptoms’ scale compared with those who continued taking the medicine or who had taken a placebo, the results showed.

According to the authors, the meta-analysis included studies looking at symptoms following abrupt or tapered discontinuation of antidepressants.

“Mood worsening was not associated with discontinuation; therefore, later presentation of depression after discontinuation is indicative of depression relapse,” they said.

Data from 17,828 participants were used in total, all of whom were followed up for durations ranging from 1 day to 52 weeks.

The most common discontinuation symptom was dizziness when compared to placebo discontinuation, while nausea, vertigo and nervousness were also reported.

Discussing the limitations of the study, the authors said: “Participants in most studies were taking the antidepressant for a relative short period.”

However, they added that “there remains limited evidence on the usefulness of longer tapering methods”.

“Our findings do cast a degree of doubt on the need for routine use of longer-term tapering regimens, such as hyperbolic.”

In June 2024, a study published in The Lancet Psychiatry, which looked at both RCTs and observational studies, found that around one-third (31%) of patients who stopped taking an antidepressant experienced at least one symptom after discontinuation, while severe symptoms occurred in about 3% of patients.

National Institute for Health and Care Excellence (NICE) guidance states that adults with depression who are stopping antidepressant medication should reduce the dose in stages, which “helps to reduce withdrawal effects”.

Steve Bazire, honorary professor at the University of East Anglia School of Pharmacy, said the study findings appear to back up The Lancet Psychiatry paper, which was published in June 2024.

“Both [studies] conclude that about 30% people get one new symptom when stopping, but only 3% get serious problems. Interestingly, the figures were 15% and 1%, respectively, for stopping placebo,” he said.

“I agree that antidepressants need to be treated with respect — as do people’s brains, too — and that antidepressants should be stopped slowly over a few weeks or so: perhaps longer if you’ve been taking them much longer. But I found the figures quoted by NHS England two years ago, of ‘around half may experience long-lasting and severe symptoms of withdrawal which may subsequently lead to inappropriate long-term use’, as being at odds with my and other’s clinical experience.”

Bazire added that he had concerns about some clinicians’ use of the word ‘withdrawal’ instead of ‘discontinuation’, which could lead to the public thinking that this means that antidepressants are addictive.

“I’m not sure the general population fully understands the fine distinctions of the definitions here, and so are put off antidepressants,” he said.

Karen Shuker, president of the College of Mental Health Pharmacy, said: “There has been considerable debate around the potential for withdrawal symptoms when stopping antidepressants, and ongoing research in this area is both necessary and welcome. This new systematic review and meta-analysis builds on previous findings, including those published in The Lancet Psychiatry in 2024, and offers further reassurance.

“The data show that while withdrawal symptoms can occur, they are generally mild and not clinically significant for most people. Importantly, the study adds to our understanding of how different antidepressants may vary in their likelihood of causing symptoms.”

Sameer Jauhar, reader in affective disorders and psychosis at Imperial College London and lead author of the study, said: “Our work should reassure the public because we replicated other findings, from high-quality studies, and have highlighted the clinical symptoms to look out for.

“Despite previous concern about stopping antidepressants, our work finds that most people do not experience severe withdrawal, in terms of additional symptoms.”