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Stopping antidepressants: when and how
1Mayne Academy of General Practice, The University of Queensland, Brisbane.
Australian Prescriber
|June 18, 2026
Summary
Stopping antidepressants requires careful consideration to avoid withdrawal symptoms. Gradual dose reduction (tapering) is recommended, with strategies varying based on individual risk factors and medication type.
Area of Science:
- Pharmacology
- Clinical Pharmacy
- Psychiatry
Background:
- Antidepressant use is widespread, with many Australians using them long-term.
- Prolonged use increases risks of adverse effects, necessitating careful review.
- Assessing the need for continued antidepressant therapy is crucial.
Purpose of the Study:
- To review the risks associated with prolonged antidepressant use.
- To inform decisions regarding the appropriateness of discontinuing antidepressant medication.
- To discuss strategies for minimizing antidepressant withdrawal symptoms.
Main Methods:
- Review of clinical guidelines and literature on antidepressant discontinuation.
- Analysis of factors influencing antidepressant withdrawal.
- Description of tapering strategies for various patient risk levels.
Main Results:
- Abrupt cessation of antidepressants can lead to withdrawal symptoms, particularly with longer treatment durations and specific drugs (e.g., duloxetine, venlafaxine, paroxetine).
- Gradual dose reduction (tapering) is essential to mitigate withdrawal.
- Optimal tapering approaches are not definitively established, with individualized strategies necessary.
Conclusions:
- Discontinuation of antidepressants should be based on a comprehensive assessment of risks and benefits.
- Slowly decreasing the dose (tapering) is key to minimizing withdrawal symptoms.
- Tailored tapering plans, potentially involving very small dose decrements over extended periods, may be required for some patients.
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