Gradually reducing the dose of antidepressants together with psychological support can be as effective in preventing depression relapse as continuing medication treatment. A group of researchers reached this conclusion after analyzing the results of 79 randomized clinical trials. The respective study was published in The Lancet Psychiatry journal.

As the authors emphasized, this does not mean that antidepressants are unnecessary. On the contrary, research confirms their effectiveness. However, for some patients who have successfully achieved remission and wish to stop therapy due to side effects or not wanting to take medication for years, safe alternative strategies exist. An essential condition is gradual dose reduction combined with mandatory psychological support.

The meta-analysis included data from 17,379 adults who had partial or full remission of depression or anxiety disorders and were monitored for an average of about one year. The researchers compared five strategies: abrupt discontinuation of antidepressants (replaced with a placebo), rapid dose reduction (four weeks or less), slow dose reduction (more than four weeks), dose reduction without full discontinuation, and continuation of usual therapy.

And two of the aforesaid strategies showed the best outcomes: slow dose reduction with psychological support, and continuation of antidepressants at the standard dose. Both methods prevented relapse with comparable effectiveness.

According to the aforementioned authors’ calculations, gradual tapering of psychotherapy prevents one relapse for every five persons compared with abrupt discontinuation or rapid dose reduction.

Interestingly, even reduced doses were more effective than abrupt discontinuation. Inclusion of psychotherapy improved all treatment options, although the quality of evidence in this domain is low.

While no significant differences in side effects were found between strategies, the researchers noted a lack of data on symptoms and the impact of different approaches on quality of life.

According to the study authors, the conclusion is clear: antidepressants are effective, but not everyone needs to take them for years. And if you want to stop such therapy, it should be done gradually and always under professional supervision.