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Cited by 33Treatment of Major DepressionMental Health Treatment and AccessElectroconvulsive Therapy Studies

Newer generation antidepressants and withdrawal effects: reconsidering the role of antidepressants and helping patients to stop

Horowitz, Mark, Wilcock, Michael·2022·Drug and Therapeutics Bulletin
DOI 10.1136/dtb.2020.000080
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Abstract

In England, the prescribing of antidepressants, primarily the newer generation antidepressant classes, has steadily increased over recent years. There is ongoing debate about how the efficacy of these drugs is viewed, their place in therapy and the harms associated with stopping them. Much of the evidence of their efficacy comes from short-term placebo-controlled trials which tend not to include outcomes that are of greatest relevance to patients, such as social functioning or quality of life, but rather restrict outcomes narrowly to symptom measures. On such measures these studies do not demonstrate clinically significant differences from placebo for depression. A range of adverse effects are also recognised, often greater in naturalistic studies of long-term antidepressants users than those measured in short-term efficacy studies, including emotional numbing, sexual difficulties, fatigue and weight gain. There is increasing recognition that withdrawal symptoms from antidepressants are common and that these symptoms can be severe and long-lasting in some patients. Recent guidance on how to stop antidepressants in a tolerable way has been presented by the Royal College of Psychiatrists. We believe that increasing awareness about the difficulty that some patients have in stopping antidepressants should lead to more cautious prescribing practice, with antidepressants given to fewer patients and for shorter periods of time. This article discusses the perceived benefits and harms of antidepressant use.

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Crossref · 10.1136/dtb.2020.000080

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21 of 21 references verified0 citation errors · 0 not checkable

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  • Hyperbolic tapering has been adopted by NICE guidelines for several other classes of drugs including opioids and antidepressants, and suggested for higher risk patients in antidepressant tapering guidelines in Australia and Canada.

    “Hyperbolic tapering has been adopted by the NICE guidelines for several other classes of drugs including opioids and antidepressants, and suggested for higher risk patients in antidepressant tapering guidelines in Australia and Canada, based on the biological plausibility of this approach and emerging empirical evidence(Horowitz & Wilcock, 2022; Horowitz et al., 2021; Horowitz & Taylor, 2021; Jauc”

    From Pharmacological principles for safe benzodiazepine and Z-drug dose reduction (2026) · cites this paper as Horowitz & Wilcock, 2022

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  • Pharmacological principles for safe benzodiazepine and Z-drug dose reduction

    Horowitz, M., Lamberson, N., Brandt, J., Framer, A., Shapiro, B., Sørensen, A., Cadogan, C., Ritvo, A., & Taylor, D. (2026) · Psychological Medicine · doi:10.1017/s0033291726104887

    “…higher risk patients in antidepressant tapering guidelines in Australia and Canada, based on the biological plausibility of this approach and emerging empirical evidence(Horowitz & Wilcock, 2022; Horowitz et al., 2021; Horowitz & Taylor, 2021; Jauca, n.d.; NICE, 2022; Therapeutic Guidelines, 2025).”
    Self-citation

Authors
Horowitz, M., & Wilcock, M.
Affiliations
  • University College London (GB)
  • Royal Cornwall Hospital Trust (GB)
Corresponding author
Horowitz, Mark
ORCID
Venue
Drug and Therapeutics Bulletin
Publisher
BMJ
Published
2021-12-20
Volume
60
Issue
1
Pages
7-12
ISSN
  • 0012-6543 (ISSN-L)
  • 1755-5248
DOI
10.1136/dtb.2020.000080
OpenAlex
W4200458010
Cited by
33
References
21
Citations by year
2026: 5 · 2025: 10 · 2024: 7 · 2023: 7 · 2022: 4
FWCI
0.57
Type
journal article
Language
en
Open access
closed
Locations
  • Drug and Therapeutics Bulletin (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
Keywords
antidepressant withdrawal symptoms, antidepressant discontinuation, depression, antidepressant efficacy, antidepressant side effects, emotional numbing, sexual dysfunction, weight gain, fatigue, quality of life, social functioning, prescribing patterns
MeSH terms
Antidepressive Agents, England, Humans, Quality of Life

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