Antidepressants can be a lifesaving medication for people struggling with a serious mental health disorder. But if you’ve been doing great on antidepressants for what feels like forever, it’s fair to wonder whether you could still be OK without them or if you should stick with the status quo.
Here’s the thing: Antidepressants aren’t a medication that you should just suddenly stop. (It can raise the risk of flu-like symptoms, brain zaps (an electric shock sensation), and mood changes, among other issues.) And it’s also crucial to work with your prescribing doctor about whether they think it’s a good idea for you to even try to go off your medication. But if you’re both on board with giving this a go, new research published in The Lancet Psychiatry spells out the best framework forward to lower your risk of falling back into depression.
It’s very important to stress this upfront: Many people rely on antidepressants to stay mentally healthy, and you shouldn’t feel pressured to go off your medication if it’s working for you. But if you’ve been thinking about going off your antidepressants, it’s nice to know that there’s a science-backed path forward. Here’s what you need to know.
The research looked at several ways of going off antidepressants.
For the scientific review, researchers analyzed data from 76 randomized controlled trials involving more than 17,000 adults who had hit full or partial remission from depression or anxiety while they were on antidepressants. (Meaning, they no longer had symptoms, had less severe symptoms, or had less symptoms overall.) The analysis followed the patients for 10 to 11 months after they started to taper the medication or continued taking it.
The researchers looked at five major strategies that people used: abruptly going off the medication, tapering over four weeks or less, tapering slowly over more than four weeks, lowering the dose to half or less of what was considered the minimal effective dose, and continuing to take the antidepressants as usual. Some of these strategies had psychological support, like talk therapy; some didn’t.
After crunching the data, the researchers found that the most effective way of going off antidepressants and preventing a relapse in depression was doing slow tapering (again, over more than four weeks), combined with therapy sessions. Here’s the surprising part: That protective effect at preventing a relapse in depression was on par with staying on the antidepressant at a standard dose. (But, again, this was in people who had already stopped having symptoms of depression (or mostly stopped experiencing them) while taking their antidepressants.)
