Researchers have discovered the safest way to stop taking antidepressants

The most effective and safe way to stop taking antidepressants after improvement is to gradually reduce the dosage under psychological support, according to a major new study published in The Lancet Psychiatry.

Depression affects more than 5% of the world's population, according to the World Health Organisation. Antidepressants have been used for decades, but the question of how to properly discontinue them is still one of the most complex and under-researched in clinical practice.

Why cancelling antidepressants is alarming

According to experts, any change in dose or substitution of the drug often becomes a source of severe anxiety for patients. In many cases, however, people are left without further follow-up after discontinuing therapy.

In recent years, more and more psychiatrists are talking about the need for so-called deprescribing - a controlled and slow reduction of doses to avoid withdrawal, side effects and relapse of depression.

What the large-scale study showed

The authors of the new analysis examined data from 76 randomised clinical trials involving about 17,000 patients with depression in remission.

The results showed:

• gradual reduction in antidepressant dosage combined with psychotherapy gives better results;

• compared to abrupt withdrawal or too rapid dose reduction, this approach reduces the risk of relapse in one in five patients;

• abrupt discontinuation was theworst option in all cases.

Antidepressants are not always lifelong therapy

According to study co-author Deborah Zaccoletti from the University of Verona, the findings show that although antidepressants do help prevent relapses, they do not necessarily need to be taken for life by all patients.

At the same time, the experts emphasise that even with very slow dose reduction, the risk of symptoms returning does not completely disappear, which only reinforces the importance of psychotherapeutic support.

The problem of access to psychological support

Some experts point to the gap between recommendations and reality. Psychological support, cited as a key element of safe withdrawal, is not available to everyone.

Patients often face a shortage of specialists, long gaps between counselling sessions and a lack of support at a critical time when symptoms may increase with dose reduction.

In addition, a patient's desire to reduce or stop taking antidepressants is sometimes still perceived as a denial of illness rather than a recognised stage of recovery.

What is important for patients to remember

The authors and commentators of the study emphasise: the decision to discontinue antidepressants should only be made in conjunction with a doctor. Stopping therapy on your own can be dangerous and increase the risk of relapse.

The study only emphasises the need for a systematic approach in which drug therapy and psychotherapy complement each other - especially in the withdrawal phase.