Rethinking Antidepressant Withdrawal: What Long-Term Use Means for Thai Patients
A recent review in JAMA Psychiatry has reignited debate among mental health professionals about withdrawal risks for people who discontinue antidepressants, especially after extended use. This discussion is timely for Thailand, where more patients rely on long‑term therapy and guidelines continue to adapt to evolving evidence.
Antidepressant withdrawal involves a spectrum of physical and psychological symptoms that can occur when reducing or stopping medication. Earlier guidelines, including NICE in the UK, described withdrawal as brief and mild. Newer research paints a more nuanced picture, particularly for long‑term users. The JAMA Psychiatry review analyzed eleven trials, most of which examined short‑term use, and found slightly more withdrawal symptoms in those stopping antidepressants than in placebo groups. The authors attributed much of this to the nocebo effect—the power of negative expectations to trigger symptoms—rather than withdrawal itself.
