Photo Credit: Liudmila Chernetska

The following is a summary of “Incidence of antidepressant discontinuation symptoms: a systematic review and meta-analysis,” published in the June 2024 issue of Psychiatry by Henssler et al.

Antidepressant discontinuation symptoms are becoming important in clinical practice. However, its incidence has not yet been studied.

Researchers conducted a retrospective study evaluating the incidence of antidepressant discontinuation symptoms among patients who had discontinued both antidepressants and placebo, as documented in the published literature.

They searched Medline, EMBASE, and CENTRAL databases (October 13, 2022) for studies on stopping or tapering antidepressants or placebos in people with mental health issues. Studies on newborns and those using antidepressants for physical conditions such as pain syndromes due to organic disease were excluded. Data was pooled in random-effects meta-analyses, and the primary outcome was to analyze and find the incidence of severe and discontinuation symptoms. Sensitivity and meta-regression analyses tested a selection of methodological variables. 

The results showed 6,905 articles in 79 studies with 21,002 patients (72% female, 28% male, mean age 45 [19.6-64.5]). Data on ethnicity were not consistently reported. From 16,532 patients discontinuing antidepressants and 4470 patients discontinuing placebo, the incidence of at least 1 antidepressant discontinuation symptom was 0.31 (95% CI 0.27-0.35) in 62 studies and 0.17 (0.14-0.21) in 22 studies groups after discontinuing placebo. The difference in incidence of antidepressant and placebo groups was 0.08 [0.04-0.12]. The incidence of severe symptoms was 0.028 (0.014-0.057) for antidepressants compared with 0.006 (0.002-0.013) for placebo. Desvenlafaxine, venlafaxine, imipramine, and escitalopram had higher symptom rates, and imipramine, paroxetine, and either desvenlafaxine or venlafaxine were associated with higher severity of symptoms. 

Investigators concluded that about 15% of patients may experience discontinuation symptoms, which can be influenced by subjective factors. The findings help inform clinicians and patients about the likelihood of symptoms without causing unnecessary worry.

Source: thelancet.com/journals/lanpsy/article/PIIS2215-0366(24)00133-0/fulltext