Recent findings from University College London show that people on antidepressants for more than two years are far more likely to experience severe and lasting withdrawal when stopping the medication than those who used them for under six months. With antidepressant prescriptions rising worldwide, the study suggests the duration of use strongly drives withdrawal difficulty and could influence prescribing and tapering practices in Thailand.
In Thailand, antidepressants such as SSRIs are commonly prescribed for depression and anxiety, reflecting international trends. Data from the UCL study indicate that long-term users have a tenfold higher risk of withdrawal compared with short-term users, and about one in four people who have taken antidepressants for more than two years report severe withdrawal symptoms. The growing acceptance of mental health treatment in Thai communities after the pandemic makes these findings highly relevant for patients and clinicians.
The UCL study, published in Psychiatry Research, surveyed 310 adults who had accessed NHS psychological therapy and attempted to discontinue their antidepressants. While a majority found the medications helpful, most experienced withdrawal symptoms. Among long-term users, 64% reported moderate or severe withdrawal, 30% had symptoms lasting beyond three months, and 12% endured withdrawal for more than a year. Short-term users largely saw symptoms resolve within a month, with only a small share experiencing severe withdrawal.
Lead researcher, a visiting clinical researcher at UCL Division of Psychiatry, commented that duration of use largely determines withdrawal risk, reinforcing the principle of using antidepressants for the shortest duration necessary. A senior author stressed that withdrawal is common and advised stopping only under the guidance of an informed health professional.
Across all respondents, 38% were unable to fully discontinue when attempting to stop, rising to 79% among those on medication for more than two years. In addition to mood-related symptoms, many participants reported non-emotional withdrawal such as dizziness, headaches, nausea, and vertigo—symptoms easily mistaken for a relapse. This distinction is particularly important for Thai clinicians who must differentiate withdrawal from relapse, as misinterpretation can lead to unnecessary treatment changes.
The study also raises questions about the length of antidepressant use. In the UK, about half of patients take antidepressants for at least a year, with higher figures in some other countries. Thai clinical guidelines already encourage regular medication reviews, but reports from mental health charities and public forums suggest many patients remain on antidepressants for years without formal reassessment.
International bodies, including the Royal College of Psychiatrists and the U.S. Centers for Disease Control and Prevention, advocate cautious prescribing and periodic reevaluation. In Thailand, the Department of Mental Health under the Ministry of Public Health urges doctors to educate patients about how long to take medications and how to taper safely, especially as mental health awareness grows and public health systems expand access to care.
Withdrawal can be particularly challenging for older adults and people in rural areas where access to continuous psychiatric support is limited. Traditional Thai beliefs about mental illness—often tied to social or spiritual imbalance—can complicate withdrawal, with some families encouraging abrupt cessation to seek alternative therapies. The findings emphasize the importance of gradual, medically supervised tapering, though standardized tapering protocols remain elusive and individual responses vary.
From a public health standpoint, the study urges Thai healthcare professionals to prioritize regular review of antidepressant prescriptions, openly discuss potential withdrawal symptoms, and tailor discontinuation plans to the individual. A senior psychiatrist from a major Chiang Mai hospital underscored that stopping antidepressants after long-term use is not straightforward and should be guided by a clinician to prevent disruption to daily life and family harmony.
Experts call for more research into tapering best practices, particularly for long-term users. Integrating Western psychiatric care with Thai cultural approaches—such as mindfulness practices, family involvement, and community support—could improve withdrawal management. Collaborative care models, involving pharmacists, family doctors, and mental health nurses, are already being explored in Bangkok’s public hospitals to monitor symptoms and guide safe reductions in medication.
Policy considerations include updating prescribing guidelines under Thailand’s universal health coverage and social security systems, and ensuring access to medications with lower withdrawal risk where appropriate. Advocates emphasize patient-centered care and training for frontline providers on withdrawal prevention and management.
For Thai readers, the key takeaway is to discuss medication duration and tapering plans with your prescriber before starting or stopping antidepressants. Do not quit abruptly. Family members can help observe changes and encourage timely medical follow-up if withdrawal symptoms occur. Community programs, temple-based counseling, and online support groups can help destigmatize withdrawal and promote safer practices.
If you are considering stopping antidepressants, consult your psychiatrist or family physician, ask about safe tapering options, and avoid changing your medication without medical advice. Report any withdrawal symptoms promptly so your treatment plan can be adjusted. Staying informed and seeking professional guidance, with supportive family or community networks, can reduce withdrawal burdens and preserve well-being.
In summary, long-term antidepressant use appears linked to more challenging withdrawal, prompting a re-evaluation of prescribing and tapering practices in Thailand and beyond. Integrated care models and culturally attuned support systems may offer the best path forward for safe, effective management.