More Than Half Of People Relapse After Stopping Antidepressants

Written by Jim Folk
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Written by Jim Folk
Written by Jim Folk
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Medically reviewed by Marilyn Folk, BScN
Last updated October 6, 2021
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Over the years, many people have gone to their doctors or mental health professionals looking for relief from their anxiety and depression symptoms.

Since these professionals want to help, they often prescribe medication.

During their visit, patients often hear, “Take this medication, just until you feel better, and then you can come off.”

While this sounds encouraging, there is a problem. Many people can’t come off an antidepressant once it is used regularly, and that’s because there is a high relapse rate with antidepressants.

For instance, a recent study published in the New England Journal of Medicine found 52 percent of participants relapsed within one year when they stopped their antidepressant (even though they and their doctor thought they were well enough to stop).

Researchers for the study “Maintenance or Discontinuation of Antidepressants in Primary Care” concluded:

Among patients in primary care practices who felt well enough to discontinue antidepressant therapy, those who were assigned to stop their medication had a higher risk of relapse of depression by 52 weeks than those who were assigned to maintain their current therapy.

The research further discovered 39 percent of the study group relapsed even though they maintained their medication.

Another study published in 2020 found there was a 40% relapse rate when antidepressants were discontinued.[2] While another study published in 2015 found 40% of participants relapsed even though they maintained antidepressant treatment.[3]

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Yet another study found high rates of reoccurrence (60% – 63%) even while maintaining the medication.[4]

Even though patients are told that antidepressant treatment could be short-term (approximately 3 months), research shows most people who start an antidepressant stay on them long-term.

For instance, one study reports:

About two-thirds of outpatients with current anxiety and/or depressive disorder(s) receive psychopharmacological treatment, most notably antidepressants. Often, antidepressant use is long term. For example, in the Netherlands approximately 30% of patients taking antidepressants take them for more than 1 year. Similarly, in the UK nearly half of the patients taking antidepressants take them for more than 2 years, and in the US this is true for approximately two-thirds of relevant patients.

Moreover, only 10% of such patients discontinue antidepressants each year.[5]

Of that 10% that do discontinue, less than half stay off. So, the number of people who discontinue and stay off is even smaller than 10%.

Another study found:

…in the USA half of the antidepressant users (7% of the total population) have been taking them for more than five years (Mojtabi 2014). In Australia, the average duration of treatment with antidepressants is about four years (Kjosavik 2016). High antidepressant use has also been reported in people living in nursing homes. About 40% of Belgian nursing‐home residents take antidepressants daily (Bourgeois 2012), with similar rates seen in other European countries (Janus 2016), and the USA (Karkare 2011).[6]

These numbers are alarming considering the number of people who take antidepressants.

Julia Robinson writes in the Pharmaceutical Journal:[7]

More than 20 million antidepressants were prescribed between October and December 2020 — a 6% increase compared to the same three months in 2019 — according to statistics reported by the NHS Business Services Authority (NHSBSA).

Overall, the statistics showed that 23% more patients received an antidepressant item in the third quarter of 2020–2021 compared to the same quarter in 2015–2016.

According to the American Psychological Association, Lea Winerman reports 12.7% of Americans took antidepressants during the month of October in 2017.

Ana Sandoiu writing for MedicalNewsToday.com reports:

The use of antidepressants has soared in recent years. It is currently estimated that 1 in 10 people in the United States rely on antidepressants. Additionally, 1 in 4 women in their 40s and 50s are reported to take the drugs.[8]

Since then, the percentage of prescriptions for antidepressants has increased dramatically, and especially with the onset of COVID-19.

There are many reasons why people return to antidepressants once they have been discontinued. Three of the most common reasons are:

• Physical dependency and the side effects of coming off an antidepressant.
• Psychological dependency.
• Unidentified and unaddressed underlying factors that cause issues with mental health. If they aren’t addressed, it’s just a matter of time until they take a toll on the body again and symptoms return.

Because of the high relapse rate, researchers are now suggesting people don’t come off and stay on them long-term.

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But with all the side effects of antidepressants, is that really an option?

We don’t think so, especially when anxiety and depression (and other mental health disorders, including stress disorder and insomnia) can be overcome with the help of good self-help information and an experienced therapist.

This is especially true with the emergence of data showing physical and mental health problems caused by long-term antidepressant use.

For instance, research shows that antidepressant use can:

• Increase the risk of dying prematurely by 33 percent[9]
Increase the risk of committing violent crime
Increase the risk of sexual dysfunction
Increase the risk of gastrointestinal and intracranial bleeding
Increase the risk of falls and fractures
Increase the risk of developing diabetes in children
Increase the risk of dementia
Increase the risk of developing major depression
• Increase suicidality
• Increase heart arrhythmias
• Affect newborn brain activity
Increase autism risk by 87 percent when used during pregnancy
• Cause a host of side effects, many persisting throughout treatment
• Cause a 14% risk of having a heart attack or stroke[9]
• Cause an increased risk of blood clotting[10]
• Cause an increased risk of developing tics, muscle spasms, dyskinesia, parkinsonism, and akathisia.[11]

To name a few.

The list of long-term effects is lengthy, and unfortunately, often not discussed by the prescriber.

While there are certain instances where antidepressants can be helpful, those are in the small minority.

Consequently, antidepressants are prescribed far too often, with the patient being uninformed of the side effects, long-term dependency, and long-term health consequences.

Rather than prescribing powerful brain-altering drugs, it would be better if clinicians recommended therapy and supported their patients as they worked at making healthy behavioral change.

Plus, the cost to the medical system would be far less, and the impact on the longevity of the patient would be less severe.

These challenges can be avoided when recovery is worked at with good self-help information and professional therapy.

We understand the desire to quickly eliminate symptoms so that you can get on with your normal life. However, the cost of taking an antidepressant in the hopes of long-term relief is far greater than most people realize or are told about upfront.

One also has to consider that antidepressants only benefit one-third of people, while one-third experience no benefit, and another third feel worse.

Moreover, almost 21 percent of people taking antidepressants take multiple psychotropic medications (called polypharmacy), such as benzodiazepines, to manage the side effects of the antidepressant.[12]

Sadly, many people come to us so drugged with multiple psychotropic medications that they are barely coherent.

Finally, taking psychotropic medications also complicates the recovery process. It can add multiple layers of complexity, which could be avoided if the medications weren’t started in the first place.

If you are considering taking an antidepressant, we wanted to present some facts to help you make an informed decision before you start down a road you might not like where it ends up.

The combination of good self-help information and working with an experienced anxiety disorder therapist, coach, or counselor is the most effective way to address anxiety and its many symptoms. Until the core causes of anxiety are addressed – which we call the underlying factors of anxiety – a struggle with anxiety unwellness can return again and again. Dealing with the underlying factors of anxiety is the best way to address problematic anxiety.

Additional Resources

anxietycentre.com: Information, support, and coaching/counseling/therapy for problematic anxiety and its sensations and symptoms, including More Than Half Of People Relapse After Stopping Antidepressants.

References

1. Lewis, Gemma, et al. "Maintenance or Discontinuation of Antidepressants in Primary Care." The New England Journal of Medicine, 20, Sep 2021.
4. Cartwright, Claire, et al. "Long-term antidepressant use: patient perspectives of benefits and adverse effects." PubMed, 28 July 2016.
5. Bosman, Renski, et al. "Long-term antidepressant use: a qualitative study on perspectives of patients and GPs in primary care." British Journal of General Practice, Oct 2016.
6. Leeuwen, Ellen Van, et al. "Discontinuation of long‐term antidepressant use for depressive and anxiety disorders in adult." Cochrane Library, 3 Feb 2020.
7. Robinson, Julia. "Antidepressant prescribing up 6% in last three months of 2020." The Pharmaceutical Journal, 8 Mar 2021.
8. Sandoiu, Ana. "Antidepressants may raise death risk by a third." MedicalNewsToday, 19, Sep 2017.