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Page 1 of 49

  • Evidence on antidepressant withdrawal: an appraisal and reanalysis of a recent systematic review

  • Joanna Moncrieff, Harriet Hobday, Anders Sørensen, John Read, Martin Plöderl, Michael Hengartner, Caroline Kamp, Janus Jakobsen, Sophie Juul, James Davies, Mark Horowitz
  • Journal:
    Psychological Medicine / Volume 55 / 2025
    Published online by Cambridge University Press:
    22 July 2025, e191
    • Article
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  • Background

    There has been debate about the frequency and severity of antidepressant withdrawal effects.

    Methods

    We set out to appraise and reanalyze an influential systematic review by Henssler and colleagues that concluded that withdrawal effects are not particularly common and rarely severe. We repeated the meta-analysis, including only studies where data were derived from systematic measures of withdrawal symptoms.

    Results

    Most data in the Henssler review are derived from pharmaceutical industry–sponsored efficacy studies in which withdrawal was a minor consideration. Shortcomings of the review include the use of spontaneously reported adverse events to estimate withdrawal symptoms, potential misclassification of withdrawal symptoms as relapse, inclusion of data from retrospective case-note studies, short duration of prior antidepressant use, short observation periods, the overlooking of differences between placebo and drug withdrawal effects, and the use of questionable proxies for severe withdrawal. There were also discrepancies and uncertainties in some figures used. In our reanalysis, we included only the five studies that used a systematic and relevant method to assess the incidence of any withdrawal symptom. Prior treatment was short-term (12 weeks or less) in all but one of these. The pooled percentage was 55% (95% confidence interval, CI, 31% to 81%; N = 601) without subtracting nocebo effects, with high heterogeneity.

    Conclusions

    Henssler’s review is based on unreliable data and does not provide an adequate basis for the evaluation of antidepressant withdrawal effects. Further good-quality research on antidepressant withdrawal is required.

Principles of Medicine in Africa
  • 5th edition
  • Edited by David Mabey, Martin W. Weber, Moffat Nyirenda, Dorothy Yeboah-Manu, Jackson Orem, Laura Benjamin, Michael Marks, Nicholas A. Feasey
  • Published online:
    18 June 2025
    Print publication:
    05 June 2025
  • Principles of Medicine in Africa combines clinical medicine with a rich understanding of the major environmental and cultural influences on health and disease, providing comprehensive guidance for anyone intending to practise medicine in Africa. Presenting disease in the context of family and culture, the effects of inequality and problems of limited resources are addressed. The authors have a wealth of experience in front line healthcare in Africa and provide practical, evidence-based management guidelines for all the common and less common conditions likely to be encountered. This fifth edition has been thoroughly updated to incorporate the latest research findings and management guidelines and there has been much greater involvement of African physicians in the writing and editorial process. The chapters on cancer and non-communicable diseases have been expanded and new chapters have been added on digital health, critical care in a resource-limited setting, antimicrobial resistance, COVID-19 and other emerging infectious diseases.

Page 1 of 49