Discontinuing Antidepressants: How Can Clinicians Guide Patients and Drive Research?

Recent media reports have refocused attention on the syndromic manifestation experienced by some patients as they discontinue their antidepressant medication ("discontinuation syndrome"). This attention has been accompanied by criticisms that mainstream psychiatry has either ignored or minimized these symptoms and exposed patients to potentially harmful and addictive treatments. Yet, there has been very limited original research on the prevalence of discontinuation syndrome in the last decade. There is growing concern that labeling antidepressants as addictive may drive down the use of these medications and exacerbate the mental health crisis in which depression is often undiagnosed and undertreated. Hence, the onus of guiding patients through questions and concerns related to the use and discontinuation of antidepressants has fallen mainly on primary care and psychiatric clinicians. This report discusses some common decisional uncertainties relevant to antidepressant discontinuation and recommends a shared decision-making approach. Further, this report seeks to outline a roadmap for clinicians to drive research on this important yet understudied topic.