Antidepressant relapse: People with depression who want to come off antidepressants after their symptoms improve may do best by reducing the dose slowly and pairing that process with psychological support, according to new research.
Depression affects a significant share of the global population, and antidepressants have been prescribed for decades. But clinicians and patients have long debated the safest way to stop these medicines, especially because changing or reducing doses can trigger anxiety, withdrawal symptoms and concerns about relapse.
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The new analysis, published in The Lancet Psychiatry, reviewed evidence from 76 randomised controlled trials involving about 17,000 people. Researchers found that the most effective approach to stopping antidepressants was gradual tapering combined with psychotherapy or structured psychological support.
The study reported that this strategy reduced the likelihood of relapse compared with abruptly stopping or tapering too quickly. Researchers estimated that, compared with faster or sudden discontinuation, a supported, gradual taper could prevent relapse in roughly one in five patients. Across the evidence reviewed, the poorest outcomes were consistently linked to stopping medication suddenly.
The authors said the findings reinforce that antidepressants can play an important role in preventing relapse, but may not need to be lifelong treatment for every patient. At the same time, experts cautioned that relapse risk can remain even with slow tapering, underlining the value of close monitoring and psychological support during the process.
Clinicians and patient advocates also noted a practical challenge: access to therapy and consistent follow-up is not equally available everywhere. Some patients may struggle to get timely appointments, and gaps in care can leave people vulnerable if withdrawal symptoms or low mood return while they are reducing medication.
The researchers and commentators emphasised that discontinuing antidepressants should be treated as a planned clinical process rather than a sudden decision, with individualised tapering schedules and support based on a patient’s history, relapse risk and access to care.