Why we need extra care in coming off antidepressants

Psychiatrist Mark Horowitz's life 'exploded' when he ceased taking his medication for depression. It spurred him to find a better way to taper off the drugs safely

- Zoë Beaty

For decades, antidepressants have been the cornerstone of mental health treatment in Britain. For much of that time, they’ve been highly stigmatised - deemed to be symptomatic of weakness or dependency, or seen as a “zombie pill” that numbs emotions and drowns out personality. Now, more people are taking antidepressant medication than ever before: record numbers, in fact. In the UK, 8.89 million adults (almost one in six) were prescribed them – a slight increase from 8.7 million the year before. But, while prescriptions have soared, a parallel problem is becoming harder to ignore: what happens when patients try to stop taking them?

Or specifically, what happens when they try to stop taking SSRIs – selective serotonin reuptake inhibitors – the most common type of antidepressant. This class of drugs – you might recognise citalopram and fluoxetine (Prozac) – is prescribed not only for depression but for anxiety disorders, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD) and even chronic pain.

Compared with older drugs to treat the same illnesses, they’re much safer and, as many people find, are adept at relieving overwhelming symptoms that can all too often stop us in our tracks when it comes to day-to-day functioning.

They’re also quick to access and, broadly, seem to work for most people quite well. Around a third of those prescribed SSRIs find that they have a complete remission of their symptoms, while another third show “significant improvement” during longer-term treatment, according to meta-analyses published by Cambridge University Press.

Research also shows a significant reduction in relapse and a measurable improvement in quality of life for many. Yet, they’ve also long occupied a complicated space in society and psychiatry.