#Withdrawalsymptoms

A newly published review in JAMA Psychiatry has sparked controversy among mental health experts, raising concerns that it significantly underestimates the risks faced by long-term users of antidepressants when they attempt to discontinue their medication. The debate centers on the review’s focus on short-term, industry-funded studies and has important implications for millions worldwide, including a growing cohort of patients in Thailand who rely on antidepressant therapy.

Antidepressant withdrawal — the range of physical and psychological symptoms experienced when stopping or reducing dosage — has come under increased scrutiny as more people use these medications for extended periods. While previous medical guidelines, such as those from the UK’s National Institute for Health and Care Excellence (NICE), described withdrawal as “brief and mild,” recent scrutiny has revealed a more complex picture, particularly for long-term users. The new JAMA Psychiatry review, authored in part by academics with ties to pharmaceutical companies, concludes that withdrawal symptoms from antidepressants are generally not clinically significant for most users, especially those on the medication for only eight to twelve weeks. Its analysis, based on eleven trials — the vast majority of which involved short-term use — found slightly more withdrawal symptoms in those stopping antidepressants than in placebo groups, but the authors attribute much of this to the “nocebo effect” (the power of negative expectations to trigger adverse symptoms) rather than to withdrawal itself.

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.

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.

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.