Patients express anger at doctors’ ignorance of the effects of antidepressant withdrawal

Despite the staggering increase in antidepressant prescribing and long-term use, many medical professionals remain clueless about how to support patients safely stop antidepressant medications and cope with withdrawal symptoms.

A recently published study highlights the frustration felt by antidepressant users who have suffered from a lack of professional support and suggestions on how doctors and health care systems can better support people coming off antidepressants.

While helpful for some, antidepressants can have negative side effects that prompt many to stop their antidepressants. This process, however, is described as very challenging due to stopping antidepressants or the physical and emotional symptoms that can emerge days, weeks or months after stopping antidepressants, sometimes outweighing problems for which medications have been taken. prescribed.

This difficult process and the well-documented lack of support from healthcare professionals have forced patients to seek advice from online peer support groups, where people share their lived experiences of antidepressant withdrawal and provide support for others.

The need for support is not surprising since it is estimated that about half of the tens of millions of people taking antidepressants will experience withdrawal symptoms when trying to reduce or eliminate them, write researchers John Read, Mark Horowitz, Joanna Moncrieff and Stevie Lewis, who has experience with antidepressant withdrawal and is a member of The Lived Experience advisory group for prescription drug addiction.

To inform health services about which supports are most needed during the process of tapering or stopping antidepressants, an anonymous survey was administered to members of online abstinence support groups. Seven hundred and eight members completed the following sentence: A public health service to help people stop taking antidepressants should include….

The team of researchers went through all the responses and categorized them according to themes. Participants came from 31 countries, more than half of which lived in the United States or the United Kingdom.

The following seven themes occurred most: role of the prescriber, information, other supports/services, strong negative feelings towards doctors/services, etc., informed consent on prescription, pharmaceutical companies and public health campaign. The most common response is that physicians need to be better informed about withdrawal symptoms and how to help patients come off antidepressants gradually and safely. Additionally, doctors need to believe patients about their withdrawal symptoms and not assume that the symptoms are due to their diagnosis of depression.

Many respondents highlighted the need for clinicians to create a personalized plan that includes scheduled tapering. Other respondents highlighted the challenges of not having doses small enough to taper off, one participant explicitly noted the need for easy-to-use methods that would be safer than the current method of counting tiny beads or grinding tablets and weighing the powder . Another attendee expressed, I still have no idea how I will accurately divide a coffee table into ten identical pieces.

Some respondents also reflected on the initial prescribing of medications and criticized doctors for advertising antidepressants as completely safe and failing to provide informed consent regarding the risk of withdrawal symptoms. In reference to this, many respondents suggested a public health campaign to raise awareness of the dangers of antidepressant withdrawal. Other supports and services mentioned included 24-hour crisis support and helplines, psychotherapy and counseling, support groups, and patient-led services.

This paper also provides 125 direct quotes from participants, illustrating the strong feelings about an entire healthcare system, including pharmaceutical companies, that have contributed to their suffering as users of antidepressants. For example, respondents wrote:

At some point in time, someone will take this fight to where it needs to be at the throats of big pharmaceutical companies. I hope I live to see that day… It is actually a crime that pharmaceutical companies can have these drugs on the market for 30+ years and not make blatantly obvious the effects they can have on the human body.

One expressed the need for doctors to believe that withdrawal is very real and very dangerous and can last a very long time after the drug has stopped.

Another shared that the doctors and pharmacist seem to know nothing useful and that their comments and advice on the effects of the drug are more harmful than good.

It is important to note that this survey is not representative of all people taking and choosing to stop antidepressants. The results also do not adequately represent the views of all service users because the majority of participants identified as White/Caucasian and had college degrees. However, findings like this should serve as a call to action for the healthcare system to properly educate physicians about abstinence and advocate for those who choose to stop using antidepressants.

Mad In America and similar allies, such as the International Institute of Psychiatric Drug Withdrawal (IIPDW), support this cause and have several resources at their disposal:

• The MIA Drug Withdrawal Resource page has information on withdrawal guides, educational courses, research studies, and personal withdrawal studies. Here you can also find a list of providers who help people get off their psychiatric medications.
• MIA also has a summary of antidepressant withdrawal protocols
• And the IIPDW now has a 1-hour training video explaining the ins and outs of safely tapering antidepressants, which will allow [prescribing medical professionals] to convert this guide into better clinical care.

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Read, J., Lewis, S., Horowitz, M., and Moncrieff, J. (2023). The need for antidepressant withdrawal support services: recommendations from 708 patients. Research in psychiatry, 326115303. https://doi.org/10.1016/j.psychres.2023.115303 (Link)