Conversations with clients about antidepressant withdrawal and discontinuation

摘要

The issue of antidepressant withdrawal has received increased scientific and public interest over the last several years. Clinical practice guidelines suggesting that withdrawal symptoms tend to be mild and likely to resolve without treatment in a few short weeks are no longer consistent with the evidence, and ignore the experiences of some service users. Indeed, the latest changes to the National Institute for Care and Health Excellence (NICE) depression guidelines recommend that mental health providers inform clients about the potential for severe and long-lasting withdrawal symptoms. Facing rising rates of long-term antidepressant use across the US and UK, the lack of evidence of a favorable risk–benefit ratio for long-term use, and increased public awareness of these issues, mental health providers may benefit from guidance concerning how to initiate discussions about the risks of antidepressant withdrawal.