Quitting Antidepressants Found Safer Than Feared – Most Withdrawal Symptoms Are Mild and Brief

Key Points

• People discontinuing antidepressants report, on average, only a modest increase in symptoms: about one extra symptom in the first week, which is below clinical severity thresholds.
• The most common symptoms were dizziness, nausea, vertigo, and nervousness, but no increase in depressed mood.
• This review provides reassurance that withdrawal is real but usually mild, transient, and distinct from relapse, but continued caution and support remain essential.

Study at a Glance

• Systematic review and meta-analysis of nearly 50 randomized clinical trials (≈17,800 participants) involving adults discontinuing six common antidepressants.
• Primary Outcomes: Average increase of 0.8–1.4 withdrawal symptoms in the first week; common effects included dizziness, nausea, vertigo, and nervousness—no increase in depressive symptoms.

What’s New vs Prior Evidence

For years, antidepressant withdrawal has been one of the most debated topics in psychiatry and patient advocacy. Personal stories and some earlier surveys painted a dire picture, with claims that more than half of people quitting medication suffered severe or long-lasting symptoms. But those estimates often came from uncontrolled settings, anecdotal reporting, or highly selective groups rather than rigorous trials. This new meta-analysis, the largest of its kind, offers a clear corrective by relying solely on randomized, placebo-controlled studies. It finds that withdrawal is real but usually mild, transient, and distinct from relapse, i.e., a conclusion that helps dispel fear and misinformation around stopping treatment.

Expert Comment

Dr. Susannah Murphy, Associate Professor of Psychiatry at the University of Oxford, commented through the Science Media Centre:

“People taking antidepressants are understandably concerned about what might happen when they stop, particularly about the possibility of withdrawal symptoms. This study is an important contribution to the field, providing a comprehensive review of the current evidence on antidepressant discontinuation. Using rigorous methods and placebo-controlled comparisons provides welcome clarity in a field where sometimes there has been more heat than light. What stands out is that most people do not experience severe withdrawal symptoms – this should reassure clinicians and patients when making tapering plans. We still need research on long-term outcomes and real-world taper strategies, but this is a solid foundation. Clinicians should continue providing support during discontinuation, especially for vulnerable individuals. Overall, this study helps shift the conversation from fear to informed, individualized care.”

Who Could Benefit

• Patients on long-term antidepressants, who can feel reassured that stopping treatment is unlikely to trigger severe or lasting withdrawal.
• Clinicians, who now have stronger evidence to guide conversations about discontinuation and tapering plans.
• Mental health policymakers, who can support clear guidance and resources that reduce stigma and fear about stopping antidepressants.
• Support services, such as helplines and peer groups, which can align their advice with evidence-based expectations.

Limitations & Uncertainties

• Most data reflect short-term outcomes, mainly covering the first one to two weeks after stopping medication.
• Certain antidepressants, such as fluoxetine, were under-represented, which limits how widely the findings apply.
• Real-world discontinuation varies: patients may stop after years of use, taper at different speeds, or have complex histories that trials do not capture.
• Psychological expectations—the so-called nocebo effect may influence symptom reporting.

What Happens Next

Future studies need to examine longer-term discontinuation patterns and compare tapering methods under real-world conditions. Clinical guidelines can evolve to incorporate this evidence, balancing reassurance with ongoing support. Over time, better communication and education may help normalize discontinuation and reduce unnecessary anxiety for patients who want or need to stop antidepressants.

Summary

Stopping antidepressants usually causes only mild, short-lived symptoms like dizziness or nausea, and not depression itself. Most people report just one extra symptom in the first week compared to those who continue treatment. With medical support, quitting antidepressants is often much safer than many people fear.

Glossary

• Discontinuation Symptoms: Physical or mental changes that occur when stopping a drug, such as dizziness, nausea, or nervousness.
• Randomized Controlled Trials (RCTs): Studies that randomly assign participants to treatment or placebo groups to test outcomes in a fair, unbiased way.
• Residual Symptoms vs Relapse: Ongoing symptoms after stopping medication may reflect the return of depression (relapse) rather than withdrawal.
• Nocebo Effect: When negative expectations cause people to feel or report symptoms even without a biological cause.
• Meta-Analysis: A statistical method that combines results from multiple studies to reach stronger, pooled conclusions.

References

1. Kalfas, M., et al. (2025). Incidence and nature of antidepressant discontinuation symptoms: A systematic review and meta-analysis. JAMA Psychiatry, 82(9), 896–904. https://doi.org/10.1001/jamapsychiatry.2025.1362
2. Gaffney, T. (2025, July 9). Antidepressant withdrawal often mild, brief—not as bad as feared. STAT News. https://www.statnews.com/2025/07/09/antidepressant-withdrawal-new-jama-psychiatry-study-dispels-risk-of-quitting/
3. University College London. (2025, July 9). Largest review of its kind identifies antidepressant withdrawal symptoms. UCL News. https://www.ucl.ac.uk/news/2025/jul/largest-review-its-kind-identifies-antidepressant-withdrawal-symptoms
4. Science Media Centre. (2025, July 9). Expert reaction to systematic review and meta-analysis on antidepressant withdrawal symptoms. Science Media Centre. https://www.sciencemediacentre.org/expert-reaction-to-systematic-review-and-meta-analysis-on-antidepressant-withdrawal-symptoms/