Tag: discontinuation symptoms

Reading of the Week: Antidepressant Discontinuation – the New JAMA Psych Study; Also, Obesity Meds and Nazaryan on His Father’s Depression

July 17, 2025 /

From the Editor

“New Research Questions Severity of Withdrawal From Antidepressants”

– The New York Times

“Antidepressant Pullback Symptoms Fewer Than Thought, Study Shows”

–  Bloomberg

Millions of North Americans take antidepressants – about one in seven Canadians – yet these medications remain controversial. A 2019 Lancet Psychiatry study, which drew heavily from online surveys, found that roughly half of patients who quit these meds experienced severe withdrawal symptoms, sparking much debate – and many, many questions from our patients.

How common are discontinuation symptoms? Which one is most commonly experienced? Michail Kalfas (of King’s College London) and his co-authors attempt to answer these questions with a new JAMA Psychiatry paper. They did a systematic review and meta-analysis by analyzing 50 studies involving almost 18 000 people. “This systematic review and meta-analysis indicated that the mean number of discontinuation symptoms at week 1 after stopping antidepressants was below the threshold for clinically significant discontinuation syndrome.” We consider the paper and its implications.

Celebrities use them; politicians discuss them; our patients ask about them. Are semaglutide and sister drugs game changers for those with mental health problems who struggle with obesity? To explore the opportunities and challenges of these new medications, in a new episode of Quick Takes, I speak with Dr. Mahavir Agarwal (of the University of Toronto), Lisa Schaefer (of Obesity Canada), and Dr. Sanjeev Sockalingam (of the University of Toronto). “Imagine a world where you have all the effects of antipsychotics, but none of the side effects.”

Finally, in the third selection, journalist Alexander Nazaryan discusses his father’s mental illness and its impact on his life. In a deeply personal essay for The New York Times, he notes the long shadow of illness. “My father never got to become a famous physicist or see his son go to M.I.T. Worse, he couldn’t ask for help until it was too late.”

DG

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Reading of the Week: Antidepressants & Discontinuation Symptoms – the New Lancet Psych Study; Also, Neuromodulation and Digital Health Technology

June 27, 2024 /

From the Editor

“Once I start taking them, I’m stuck.” When discussing the possible initiation of an antidepressant trial, a patient recently expressed his fear: that he wouldn’t be able to stop the medication because of discontinuation symptoms. These symptoms are debated. Some claim they are very common – though that’s not widely reported in the literature. 

How frequently do these symptoms occur? What percentage of patients experience severe symptoms? Are some antidepressants more associated with this problem than others? Dr. Jonathan Henssler (of the University of Cologne) and his co-authors attempt to answer these questions with an impressive, new systematic review and meta-analysis, published in Lancet Psychiatry. They drew on 79 studies involving more than 21 000 people. “The incidence of antidepressant discontinuation symptoms is approximately 15%, affecting one in six to seven patients who discontinue their medication.” We consider the paper and its clinical implications.

Will the stigma around ECT fade? Will ECT eventually be replaced by ketamine and MST? What’s the future of neuromodulation? We answer these questions and more in the second selection, the latest Quick Takes podcast interview. Dr. Daniel Blumberger, scientific director of CAMH’s Temerty Centre for Therapeutic Brain Intervention and professor at the University of Toronto, notes that ECT still has a unique place. “As far as medical treatments go, ECT is the safest medical procedure in all of medicine.”

And in the third selection, Dr. John Torous (of the Harvard University) and his co-authors focus on digital mental health in a new Viewpoint published in JAMA Psychiatry. They argue that we tend to both overstate and underappreciate the risks and benefits of digital mental health interventions. “Patients and clinicians should not assume wellness digital health technologies are always dangerous, nor should they assume health technologies are always safe.”

DG

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