Summary: A new UCL-led study shows that people who take antidepressants for more than two years are far more likely to experience withdrawal symptoms when they stop the medication. The study found that longer duration of use is associated with greater likelihood, severity, and persistence of withdrawal symptoms: among long-term users, 64% reported moderate or severe withdrawal and 25% reported severe effects.
In contrast, people who used antidepressants for six months or less generally reported little or no withdrawal, and most short-term users saw symptoms resolve within four weeks. These findings underline the need for careful prescribing, informed discussions about treatment duration, and research into effective tapering strategies to support safe discontinuation.
Key facts
- Duration matters: Use of antidepressants for more than two years raises the odds of experiencing withdrawal symptoms by approximately tenfold compared with use under six months.
- Severity and persistence: 64% of long-term users reported moderate or severe withdrawal; 25% reported severe symptoms and 12% experienced symptoms lasting over a year.
- Short-term outcomes: Most people who took antidepressants for six months or less reported no or only mild withdrawal, with only 7% reporting severe effects and the majority recovering within four weeks.
Source: UCL
Overview
Researchers from University College London surveyed 310 people in England who had used NHS primary care psychological services and had at some point tried to stop a prescribed antidepressant. The survey asked about a wide range of potential withdrawal symptoms and whether each was mild, moderate, or severe. The study aimed to estimate withdrawal effects in routine clinical practice and to examine which factors most strongly predict those effects.
Across the sample, 79% reported at least one withdrawal symptom and 45% reported symptoms classified as moderate or severe. Overall, 38% said they were unable to stop taking their antidepressant when they tried. Because emotional symptoms such as anxiety or low mood can overlap with relapse, the researchers distinguished non-emotional symptoms—such as dizziness, headache, vertigo, and nausea—and found that 76% experienced at least one non-emotional symptom and 43% reported four or more non-emotional symptoms.
Duration of use as the main factor
Analyses carried out by teams in the UCL Division of Psychiatry and the Division of Psychology & Language Sciences identified duration of antidepressant use as the key determinant of withdrawal incidence, severity, duration, and the ability to successfully discontinue medication. These differences were not explained by the severity of the underlying depression or anxiety disorder.
Compared with people who had taken antidepressants for six months or less, those who had been on them for more than two years were about ten times more likely to report any withdrawal effects. Among long-term users, 64% reported moderate or severe withdrawal (including 25% who reported severe effects). In contrast, among short-term users (six months or less) 73% reported no withdrawal or only mild symptoms, and only 7% reported severe withdrawal.
Duration also affected how long symptoms lasted: 30% of long-term users reported symptoms lasting more than three months and 12% reported symptoms lasting more than a year. Only 10.5% of short-term users experienced symptoms beyond three months; most short-term users recovered within four weeks.
What the authors say
Dr Mark Horowitz, the study’s lead author and a visiting clinical researcher in the UCL Division of Psychiatry, said the findings confirm that the likelihood of withdrawal is largely determined by how long someone has been taking antidepressants. He noted that while stopping antidepressants can be easier for short-term users, many people take these medications for years: half of UK antidepressant users have taken them at least a year, and a majority of users in the US have been taking them for over two years.
Senior author Professor Joanna Moncrieff (UCL Division of Psychiatry) advised that people who want to stop taking antidepressants should do so in consultation with an informed health professional, given how common withdrawal symptoms are.
Limitations and implications
The study had a response rate of 18% of eligible patients, which raises the possibility that people who experienced withdrawal were more likely to respond. The survey did not yield conclusive results about tapering methods because too few participants had tapered for more than four weeks. The authors note that other research suggests tapering can be beneficial and call for further study to identify the best tapering protocols and how they might reduce withdrawal risks.
About this mental health and psychopharmacology research news
Author: Chris Lane
Source: UCL
Contact: Chris Lane – UCL
Image: The image is credited to Neuroscience News
Original research (open access): Antidepressants withdrawal effects and duration of use: a survey of patients enrolled in primary care psychotherapy services by Mark Horowitz et al., published in Psychiatry Research (DOI: 10.1016/j.psychres.2025.116497).
Abstract
Antidepressants withdrawal effects and duration of use: a survey of patients enrolled in primary care psychotherapy services
Background
Previous studies of antidepressant withdrawal have often been limited by short drug exposure periods or self-selected samples. This study sought to estimate withdrawal effects in routine clinical practice among people who had attempted to stop antidepressant medication.
Methods
A survey was conducted among participants from NHS primary care psychological treatment services who had ever tried to stop an antidepressant. Regression models examined associations between personal and medication characteristics and reported withdrawal outcomes.
Results
Respondents (n = 310) were mostly female (78%), predominantly white (75%), with a mean age of 38.8 years (SD 12.4). The response rate was 18% of eligible patients. Sixty-two percent reported that antidepressants had been helpful.
Some degree of withdrawal symptoms was reported by 79% of participants; 45% reported symptoms they classified as moderate or severe, and 43% met a stringent definition of withdrawal syndrome by reporting four or more non-emotional withdrawal symptoms. Thirty-eight percent reported being unable to stop their antidepressant when they tried. Twenty percent reported symptoms lasting more than three months and 10% reported symptoms lasting more than a year.
In fully adjusted models, use of antidepressants for over 24 months prior to stopping was associated with markedly higher likelihood of withdrawal syndrome (OR=10.41, 95% CI 2.88–37.67), higher odds of severe withdrawal (OR=5.16, 95% CI 2.75–9.70), longer symptom duration (Beta=18.11, 95% CI 3.85–32.38), and much lower odds of being able to stop (OR=27.55, 95% CI 10.29–73.81), compared with use under six months.
Conclusion
Withdrawal symptoms from antidepressants were common in this sample and were severe and prolonged for a substantial proportion of users. Longer duration of use was strongly associated with greater likelihood of severe and protracted symptoms and with decreased ability to discontinue medication. A key limitation is the study’s low response rate, which may affect generalisability.