Evidence on antidepressant withdrawal: an appraisal and reanalysis of a recent systematic review
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Authors
Moncrieff, Joanna
Hobday, Harriet
Sørensen, Anders
Read, John
Plöderl, Martin
Hengartner, Michael P.
Kamp, Caroline Barkholt
Jakobsen, Janus Christian
Juul, Sophie
Davies, James
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Issue Date
22/07/2025
Type
Journal article
Language
Keywords
Mental Health
Alternative Title
Abstract
Background
There has been debate about the frequency and severity of antidepressant withdrawal effects.
Methods
We set out to appraise and reanalyze an influential systematic review by Henssler and colleagues that concluded that withdrawal effects are not particularly common and rarely severe. We repeated the meta-analysis, including only studies where data were derived from systematic measures of withdrawal symptoms.
Results
Most data in the Henssler review are derived from pharmaceutical industry-sponsored efficacy studies in which withdrawal was a minor consideration. Shortcomings of the review include the use of spontaneously reported adverse events to estimate withdrawal symptoms, potential misclassification of withdrawal symptoms as relapse, inclusion of data from retrospective case-note studies, short duration of prior antidepressant use, short observation periods, the overlooking of differences between placebo and drug withdrawal effects, and the use of questionable proxies for severe withdrawal. There were also discrepancies and uncertainties in some figures used. In our reanalysis, we included only the five studies that used a systematic and relevant method to assess the incidence of any withdrawal symptom. Prior treatment was short-term (12 weeks or less) in all but one of these. The pooled percentage was 55% (95% confidence interval, CI, 31% to 81%; N = 601) without subtracting nocebo effects, with high heterogeneity.
Conclusions
Henssler's review is based on unreliable data and does not provide an adequate basis for the evaluation of antidepressant withdrawal effects. Further good-quality research on antidepressant withdrawal is required.
Description
Citation
Psychological Medicine. 2025;55:e191. doi:10.1017/S0033291725100652
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Journal
Psychological Medicine
Volume
55