Over a million Swedes use antidepressant medication. Many are helped, but studies show that it can be difficult to stop treatment.
According to a newly published analysis in the journal Lancet Psychiatry, one in six who stop taking their antidepressant medication experience discomfort. Dizziness, headaches, nausea, sleep disturbances, anxiety, and muscle cramps are among the most common symptoms. The researchers behind the study write that it is essential for both patients and healthcare professionals to be aware of the risks.
Previous meta-analyses have shown that a significantly higher proportion, up to 50 per cent, experience problems when stopping the medication. This study, therefore, shows that it is significantly fewer.
André Marx, a general practitioner who has long been engaged in antidepressant medication and recently published a book on the subject, points out that the new analysis includes studies that underestimate the prevalence of withdrawal symptoms.
Specialist clinic
André Marx previously ran the country's only publicly funded clinic specialising in tapering off antidepressant medication. The clinic was a pilot project, but was shut down in autumn 2023.
He believes that support from the healthcare system is lacking for patients who have difficulty stopping their treatment. According to him, both research and experiences from the patients he has met show that a very gradual tapering off often works. This can involve a gradual reduction over months, sometimes years.
Difficult to divide
According to the new study, the risk of withdrawal problems was higher for certain medications than others, including imipramine, paroxetine, and venlafaxine.
A challenge when tapering off is that the tablets are not always available in low doses, and it is difficult to divide them.
His tip to those who find it difficult to stop is to come well-prepared to their doctor.
1. Selective serotonin reuptake inhibitors (SSRIs). SSRIs increase the levels of the neurotransmitter serotonin in the brain.
Examples of medications are sertraline, escitalopram, fluoxetine, citalopram, and paroxetine.
2. Selective serotonin and noradrenaline reuptake inhibitors (SNRIs). SNRIs increase the levels of the neurotransmitters serotonin and noradrenaline in the brain. Used, for example, when one has not achieved sufficient effect from SSRIs.
Examples of medications are: venlafaxine/duloxetine, bupropion, and mirtazapine.
3. Tricyclic antidepressants (TCAs). TCAs increase the levels of the neurotransmitters serotonin and noradrenaline in the brain.
Examples of medications are: clomipramine, amitriptyline, nortriptyline.
Many of these medications can also work against anxiety.
Source: 1177, Uppdrag psykisk hälsa/SKR
