Stopping antidepressants or not?

Anderson K 1 , Looi JC 2 , Allison S 3 , Bastiampillai T 4 , Kisely S 5 , Maguire PA 6 Show all authors , Woon L 7

Affiliations 

  • 1 BMed, FRACGP, MTh, SFHEA, Associate Professor, Academic Unit of General Practice, ANU Medical School, Garran, ACT
  • 2 MBBS, MD, DMedSc, FRANZCP, AFRACMA, Associate Professor of Neuropsychiatry, Old Age Psychiatry and Psychiatry and Head, Academic Unit of Psychiatry and Addiction Medicine, The Australian National University School of Medicine and Psychology, Canberra Hospital, Canberra, ACT; Coordinator, Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT
  • 3 MBBS, FRANZCP, Member, CAPIPRA, Canberra, ACT; Associate Professor of Psychiatry, College of Medicine and Public Health, Flinders University, Adelaide, SA
  • 4 BMedSc, MBBS, FRANZCP, Member, CAPIPRA, Canberra, ACT; Professor of Psychiatry, College of Medicine and Public Health, Flinders University, Adelaide, SA; Clinical Professor of Psychiatry, Department of Psychiatry, Monash University, Melbourne, Vic
  • 5 MD, PhD, DMedRes, FRANZCP, FRCPsych, FAFPHM, FFPH, FAChAM, Member, CAPIPRA, Canberra, ACT; Professor of Psychiatry, School of Medicine, The University of Queensland, Princess Alexandra Hospital, Brisbane, Qld; Professor of Psychiatry, Metro South Addiction and Mental Health Service, Brisbane, Qld; Professor, Departments of Psychiatry, Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia
  • 6 MBBS, PhD, FRANZCP, Senior Lecturer in Psychiatry, Academic Unit of Psychiatry and Addiction Medicine, The Australian National University School of Medicine and Psychology, Canberra Hospital, Canberra, ACT
  • 7 MD, DrPsych, Lecturer in Psychiatry, Department of Psychiatry, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia; Postgraduate Student, Academic Unit of Psychiatry and Addiction Medicine, The Australian National University School of Medicine and Psychology, Canberra, ACT; Clinical Observer, Canberra Hospital; Canberra, ACT
Aust J Gen Pract, 2025 Mar;54(3):91-94.
PMID: 40043283 DOI: 10.31128/AJGP-09-23-6967

Abstract

BACKGROUND: Recently, there has been media and public interest regarding discontinuation of antidepressant treatment, especially in primary care. In this context, we provide a primary care update on the maintenance or discontinuation of antidepressant medication for the treatment of moderate-to-severe depression in adults.

OBJECTIVE: This article aims to provide a primary care update on the maintenance or discontinuation of antidepressant medication for the treatment of moderate-to-severe depression in adults. To this end, we performed a qualitative narrative review and provide commentary on recent research and systematic reviews.

DISCUSSION: In primary care, recent research has shown that there are substantial risks of depressive relapse resulting from antidepressant discontinuation. For a first episode of moderate-to-severe depression, antidepressants should be continued for 9-12 months after remission. Systematic reviews indicate that, overall, there is limited evidence of benefits from ceasing antidepressant treatment for recurrent depression. The existing evidence base on antidepressant withdrawal is limited in quality and extent, providing some evidence of harms, such as relapse, and not necessarily any gains, although reducing the burden of adverse effects is a consideration. There is a benefit-to-risk ratio in any decision to continue or withdraw antidepressant treatment.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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