A newly published study by University College London (UCL) researchers reveals that individuals who have taken antidepressants for more than two years are vastly more likely to suffer severe and long-lasting withdrawal symptoms when discontinuing the medication, compared to those prescribed antidepressants for less than six months. The findings, which come at a critical time as antidepressant prescriptions have soared worldwide, suggest that the duration of use is a key driver for withdrawal difficulty, potentially prompting a significant shift in how these medications are prescribed and managed both globally and in Thailand.
Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), have become common treatments for depression and anxiety in Thailand, mirroring international trends. According to the new research, the odds of experiencing withdrawal symptoms jump tenfold for long-term users versus short-term users, and one in four of those taking antidepressants for over two years reported severe symptoms. This news holds particular significance for Thai healthcare providers and patients since mental health awareness and acceptance of psychiatric treatment have increased post-pandemic, leading to more people on long-term medication regimens.
The UCL study, published in Psychiatry Research, surveyed 310 adults in England who had accessed National Health Service (NHS) psychological therapy and tried to stop their prescribed antidepressants. While 62% of participants found antidepressants helpful, 79% experienced at least one withdrawal symptom, with 45% describing them as moderate or severe. Strikingly, among long-term users (over two years), 64% reported moderate or severe withdrawal, 30% endured symptoms lasting more than three months, and 12% suffered withdrawal for over a year. In contrast, most short-term users’ (less than six months) symptoms resolved within a month, and only 7% of this group faced severe withdrawal.
Lead researcher, a visiting clinical researcher at UCL Division of Psychiatry, commented: “Our findings confirm what many researchers have long suspected, that the likelihood of experiencing withdrawal symptoms when coming off antidepressants is largely determined by duration of use. This is one reason to use antidepressants for no longer than necessary—because doing so may make it harder to stop using them later on.” Senior author, a professor at UCL Division of Psychiatry, further emphasized: “Withdrawal symptoms are commonly experienced by people coming off antidepressants, so we would advise that people who want to stop taking the medication should do so in consultation with an informed health professional” (Neuroscience News, UCL News).
The study found that 38% of all respondents failed to fully discontinue antidepressants when they tried, but for those on medication more than two years, the figure shot up to 79%. Besides emotional symptoms like anxiety and sadness, 76% of all participants suffered “non-emotional” withdrawal such as dizziness, headache, nausea and vertigo—symptoms that can be easily misattributed to a relapse of depression or anxiety. These findings are particularly salient for Thai psychiatrists, who frequently confront the challenge of distinguishing between withdrawal and relapse in clinical practice, especially since “brain zaps” (sudden electrical sensations) or nausea may be misinterpreted as a return of psychiatric illness.
The study also addresses the controversial question of whether antidepressants are being prescribed for longer than necessary. Around half of UK patients on antidepressants have taken the medication for at least a year, with the number slightly higher in the US. While the current Thai clinical guidelines recommend regular medication reviews, anecdotal evidence from mental health charities and online forums indicates that Thai patients often remain on antidepressants for multiple years, sometimes without regular assessment of the need for continued use.
Internationally, organizations like the Royal College of Psychiatrists (UK) and the US Centers for Disease Control and Prevention have called for “judicious use” and periodic re-evaluation of antidepressant therapy. In Thailand, the Department of Mental Health under the Ministry of Public Health has urged family physicians and psychiatrists to educate patients about medication duration and tapering plans, especially as mental health literacy grows and more people seek treatment through universal healthcare or private means (Ministry of Public Health, Bangkok Post).
Medication withdrawal can be particularly distressing for older Thais or those living in upcountry regions, where access to continuous psychiatric support is limited and community health resources are stretched. Traditional beliefs in Thailand, which often equate mental illness with spiritual or social imbalance, may further complicate the withdrawal process, as some families encourage sudden discontinuation to pursue alternative therapies, increasing the risk of abrupt withdrawal. The study’s findings thus underline the importance of gradual, medically supervised tapering—a challenge with some antidepressant types, as no standardized protocol exists and individuals may respond differently.
In terms of public health implications, this research signals the need for healthcare professionals in Thailand to prioritize periodic reviews of antidepressant prescriptions, openly discuss potential withdrawal symptoms, and develop individualized discontinuation plans. “Doctors and patients alike must recognize that stopping antidepressants, particularly after long-term use, is often not a straightforward process,” said a senior psychiatrist at Maharaj Nakorn Chiang Mai Hospital. “Withdrawing too quickly without professional guidance can result in symptoms that disrupt patients’ daily lives, work, and family harmony.”
Looking ahead, the UCL authors and global experts alike call for more research into best practices for tapering, especially among long-term users. Programs that integrate Western psychiatric medicine with Thai cultural approaches—such as meditation, family involvement, and community support—may prove more effective in managing withdrawal. Collaborative care models, in which pharmacists, family doctors, and mental health nurses work together to monitor symptoms and guide medication reduction, are already being piloted in select Bangkok public hospitals (WHO-SEARO, Thai Journal of Psychiatry).
The research also raises policy questions for Thailand’s universal healthcare scheme (UCS) and social security system, regarding the need for updated prescribing guidelines and coverage of newer, less withdrawal-prone medications. Advocates for patient-centered care urge the government to invest in training frontline providers on antidepressant withdrawal prevention and management.
For Thai readers, these findings highlight the importance of regular dialogue with healthcare providers before starting or discontinuing medication. Individuals on antidepressants should avoid abrupt cessation and instead request a personalized tapering plan from their prescriber. Family members can assist by observing behavioral changes and encouraging follow-up with a doctor if withdrawal symptoms arise. Building awareness through community workshops, online mental health forums, and temple-based counseling groups can also help destigmatize withdrawal and promote safer practices. Mental health patients, professionals, and policy makers must work together to ensure every Thai receives informed, compassionate care based on the latest science.
For those considering stopping antidepressants, consult your psychiatrist or family physician, ask about safe tapering options, and do not adjust your medication without medical advice. If you experience physical or psychological symptoms during withdrawal, report them promptly so your medication plan can be adjusted. By staying informed, seeking professional guidance, and engaging family or community supports, Thai patients can reduce the burden of withdrawal and maintain well-being.
Sources: