Guardian News and Media/London
Half of all those taking antidepressants experience withdrawal problems when they try to give them up and form millions of people in England, these are severe, according to a new review of the evidence commissioned by MPs.
Guidance from the National Institute of Health and Care Excellence (Nice), which says withdrawal symptoms “are usually mild and self-limiting over about one week” urgently needs to be changed, say the review authors.
Dr James Davies from the University of Roehampton and Prof John Read from the University of East London say the high rate of withdrawal symptoms may be part of the reason people are staying on the pills for longer. They cannot cope, so carry on taking the drugs, or their doctors assume they have relapsed and write another prescription.
The review was commissioned by the all-party parliamentary group for prescribed drug dependence and follows a long debate about the Nice guidance, which critics say is out of date.
Modern antidepressants of the SSRI class, such as Prozac (fluoxetine) and Seroxat (paroxetine), were marketed in part on their safety. People were unable to harm themselves by overdosing as they could on benzodiazepines like valium and stopping the drugs was said to be easier.
There have been plenty of anecdotal accounts of withdrawal symptoms, which include dizziness, vertigo, nausea, insomnia, headaches, tiredness and difficulties concentrating. But the Nice guidance said in 2004 that the withdrawal symptoms were slight and short-lived and was re-adopted without further evidence in 2009. It is similar to the US guidance, which says symptoms usually resolve within one to two weeks.
The review, published in the journal Addictive Behaviors, focused on 14 studies of antidepressants that had relevant data on withdrawal symptoms. The studies, which were diverse, showed that between 27% and 86% of people suffered from them, with a weighted average of 56%.
Antidepressants are now some of the most commonly prescribed drugs in the UK and US, say the authors. “In the UK, usage has risen since 2000 by 170%, with over 7mn adults (16% of the English adult population) being prescribed an antidepressant in England alone last year,” says the review.
About half of antidepressant users have been taking the pills for longer than two years. In England, that is 3.5mn people – 8% of the population. In the US, 13% of the population (37mn adults) were on them by 2011-2014, official data shows. Half have been taking them for five years or more.
“This new review of the research reveals what many patients have known for years – that withdrawal from antidepressants often causes severe, debilitating symptoms which can last for weeks, months or longer,” said Dr James Davies.
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