AYESHA RASCOE, HOST:
About 11% of adults in the U.S. take antidepressants. And in recent years, more patients have come forward to talk about how they've struggled with symptoms of withdrawal after they stop taking the medication. A new study released last week renewed debate about the scale of this problem with antidepressants and the gaps in what we know. NPR's Will Stone has been covering this topic and joins me. Hi, Will.
WILL STONE, BYLINE: Hey there.
RASCOE: Let's start with this new research. Why did this study get a lot of attention?
STONE: Well, it's wading into a very controversial topic in psychiatry, especially in the U.K. There's increasing concern about how often people struggle with symptoms when they stop antidepressants, most commonly prescribed being SSRIs.
So this study was just published in a top medical journal, JAMA Psychiatry. It analyzed existing data from about 50 clinical trials that amounts to more than 17,000 patients and found a person who goes off these medications experiences, on average, one more symptom compared to those who stop a placebo or continue with the treatment within the first week.
Basically, the authors conclude it's below the threshold for what's considered clinically significant. Dr. Sameer Jauhar led the study and is a psychiatrist at Imperial College London.
SAMEER JAUHAR: It's finding that there are clinical symptoms of withdrawal that you don't see with placebo - namely nausea, vertigo, dizziness - that maps on to the pharmacological basis for the drugs and that these exist. They're just not very common.
STONE: One thing to note is this work was not really designed to quantify overall just how often these symptoms happen.
RASCOE: So do we have an answer to that question? How often do people have withdrawal symptoms?
STONE: Well, the short answer is not really. There's not good data here. There was another analysis of the existing evidence last year that found 15% of patients had withdrawal symptoms when you factored in placebo, and most of these were not severe. Now, the fundamental problem here is there really aren't high-quality trials that have specifically focused on measuring withdrawal symptoms, and the data out there tends to be from people who were on the drugs for a short period of time.
RASCOE: And what's the matter with focusing on people on it for a short period of time?
STONE: Well, the main critique from researchers and patients is that the biggest problems come in when people are on these drugs for years. One prominent voice in this debate is John Read. He's a clinical psychologist at the University of East London. He's very critical of this new study and its conclusions.
JOHN READ: They're saying it is not a clinically significant phenomenon. And that's not something you can compromise on. That is completely inaccurate, outrageous and misleading to the public.
STONE: Now, the backstory here is Read worked on another review study back in 2019. They found about half of people have withdrawal symptoms and that many were severe. They did not just include high-quality randomized controlled trials, though. They factored in patient surveys. And the pushback there, from Dr. Jauhar and others, is this led to an overinflated and alarmist picture.
RASCOE: It really sounds like there's a lot of uncertainty here. How are others in psychiatry reacting?
STONE: Yeah, without some new trials, this isn't going to be resolved in any definitive way. I spoke to Awais Aftab about this. He's a psychiatrist at Case Western Reserve University who was not involved in any of these studies. He thinks the methodology in the JAMA study was solid, but he worries the authors underplayed the extent of the problem.
AWAIS AFTAB: The danger there is that the profession and the public can take the wrong message from looking at this paper and say, oh, withdrawal is not a big issue. It's not a big deal. That would absolutely be the wrong conclusion. The study opens more questions than it answers.
STONE: Aftab says this has become incredibly polarized. On the one hand, psychiatrists are legitimately worried this could discourage people from taking antidepressants, which can be lifesaving. But on the other, and NPR just reported on this, there is a movement of patients who describe debilitating symptoms after stopping these medications.
RASCOE: That's NPR's Will Stone. Thank you so much for talking with us today.
STONE: Thank you.
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