How common are antidepressant withdrawal effects?

Withdrawal from antidepressants, if present, can range from mild and short in short duration to severe and long lasting, and can cause significant problems with daily functioning. Typical antidepressant withdrawal reactions include increased anxiety, insomnia, nausea, loss of balance, sensory symptoms, hyperarousal and flu-like symptoms. Less common withdrawal symptoms can include diarrhoea, headaches, muscle spasms, dizziness, hallucinations, confusion, irritability, sexual dysfunction, mania or hypomania, or emotional blunting. Traditionally antidepressant withdrawals are believed to typically ensue within a few days of discontinuation and be self-limiting, lasting a few weeks.

A recent systematic review of 14 studies investigating the incidence, duration and severity of withdrawal from antidepressants found on average, across studies, 56% of patients (range 27% to 86%) reported antidepressant withdrawal reactions (Davies & Read, 2018). Of patients who reported withdrawal symptoms 45.7% rated them as severe. The review also found the duration of withdrawal symptoms varied significantly, ranging from a few days to several months, and concluded “a significant proportion” of the people who experience withdrawal symptoms do so for more than 2 weeks. The studies included in the review varied in their sample size and methodology and included a wide range of different antidepressants.

The systematic review indicates that antidepressant withdrawal effects may be far more widespread and significant than previously identified. The authors of the review express concerns that misunderstanding of withdrawal symptoms may inadvertently lead to misdiagnosis of a relapse of depression or anxiety leading to patients being put back on medication, having their medication switched or being given a higher dose. The article concludes that a revision of current clinical guidelines is required.

Reference: Davies, J., & Read, J. (2018). A systematic review into the incidence, severity and duration of antidepressant withdrawal effects: Are guidelines evidence based? Addictive Behaviours, http://doi.org/10.1016/j.addbeh.2018.08.027