A review published recently in JAMA Psychiatry provides a much-needed spotlight on the withdrawal effects associated with antidepressants. It’s a hot topic, and one that has been dominating discussions around mental health. This comprehensive review looked at data from 38 studies, comprising more than 17,000 patients. Importantly, it targeted a rich observation window of over 15 days. These results highlight the burdens and difficulties patients encounter when tapering off antidepressant drugs.
According to the review, withdrawal symptoms most often begin during the first two weeks after discontinuation of the medication. Dr. Ramya Raman, Vice President and Western Australia Chair at the Royal Australian College of GPs, stresses the importance of identifying these symptoms early. She notably highlights that the first-line treatment for those ages 12 to 25 should not be antidepressant medication. Rather, psychological therapies and other therapeutic supports associate first to combat anxiety disorders and depression in this age cohort.
Dr. Raman, who was dealing with suicidal ideation and mood swings of her own at the time, narrated how Sertraline helped her recover. That was her tipping point where she felt medication was needed to take her life back to where she could function.
Previously, we very seldom had thorough candid conversations about discontinuation symptoms with young people starting on antidepressants. To be at that table weren’t in things that Dr. Raman added. We’ve moved away from that model. It is something that we are just recognizing more and there’s a lot more research being done right now.
Similarly, Sonya Morrissey, the National GP Advisor at Headspace, reiterated that while antidepressants are not the primary approach for treating young people, they may be employed under certain circumstances.
At Headspace, we’re particularly interested in supporting that sub-group of young people who are 12 to 25. For anxiety disorders and depression, we want to see psychological therapies and other support offered in the first instance rather than antidepressant medication. Many of these youth continue to suffer from symptoms that fail to benefit from psychotherapy. When these symptoms are more severe, greatly affecting their everyday lives, we usually reach for an antidepressant medication to remedy the situation.
Kizzy, a young adult navigating her mental health journey, expressed her confusion regarding the use of antidepressants and the withdrawal process. As she reflected on her original aversion to medication, she found out that she actually needed it to live.
I was very, very – I mean, quite opposed to any form of medication at first.” Kizzy said. Eventually, I hit a breaking point, drowning in suicidal ideation and unable to get out of bed. Cut to six months later, and I was persuaded to try this drug called Sertraline.
The review’s international team of researchers indicated that while withdrawal symptoms can include brain fog, dizziness, nausea, headaches, sleep disturbances, and mood changes, understanding and preparation can mitigate these effects.
We’re hearing about some pretty peculiar symptoms that patients are starting to feel. Patients have unanimously found the phenomenon that we have dubbed “Brain Z” to be the most upsetting. As one insider put it, the bridges question is perhaps the most dramatic thing they talk about. They experience this weird electric Z feeling in their brain or along their spine.
In his recently published article, Professor Paul Fitzgerald, Director of the School of Medicine and Psychology at Australian National University, made a very important observation. He underscored that our responsibility extends to ensuring supportive patient care during this transition. He noted that a gradual weaning off medication under a trusted healthcare provider reduces the risk of significant withdrawal symptoms.
Watch as Professor Fitzgerald shares more about our holistic, community-centered approach. We look at the duration of a patient’s wellness and their baseline mood. What other systemic issues might be contributing to where they find themselves today? What mechanisms of support are they using to support one another?
The implication of these findings from this important new comprehensive review is clear. We need much more research focusing specifically on antidepressant withdrawal symptoms long-term. These nuances in discontinuation further emphasize the importance of ongoing education among healthcare providers and bolstering patient support mechanisms.
Sonya Morrissey raised concerns about differentiating between withdrawal symptoms and a return of underlying conditions when a patient discontinues medication.
What do you do when somebody’s stopping a medication and their underlying symptoms of their condition worsen? ” she wondered. In those circumstances, it can be extremely challenging to know for certain.
