Discontinuing medicines in depression and anxiety

In the UK, over 7 million people are prescribed antidepressants every year. While prescribing rates are increasing — they have doubled in the past decade — this has not been associated with reduced incidence of either mental disability or suicide. 

Rates of non-adherence remain high and research suggests that up to half of patients may be taking antidepressants for longer than necessary.

Community pharmacists are ideally placed to discuss options with those patients who are thinking about stopping their antidepressant.

Key facts

• Antidepressant discontinuation or withdrawal symptoms can be debilitating and distressing 
• Coming off antidepressants gradually with hyperbolic dose reductions can minimise this risk 
• The speed of the dose reduction should be led by the person
  taking the antidepressant
• A sensitive approach is required for any conversation about reducing or stopping antidepressant use
• To facilitate small dose reductions, a variety of different dosage formulations may need to be used e.g. liquids 

Contributing author: Ami Hale MPharm PgDip and Nana Tomova MPharm, PgDip, MRes, pharmacist independent prescribers and lead pharmacists, community mental health teams, Sussex Partnership NHS Foundation Trust