A depression relapse – the problem with coming off anti-depressants
Annabel Smith explains the new findings behind the relapsing of depression along with alternative therapies that could be used instead of anti-depressants.
Depression is an illness affecting an estimated 280 million people globally. It comes with a range of symptoms such as low mood, loss of interest in activities and in some cases thoughts about suicide. It is thought that the biological basis behind depression is an imbalance of certain neurotransmitters in the brain, such as serotonin and dopamine, meaning that signals cannot be passed along the nerves normally. The typical treatment involves psychological therapies such as cognitive behavioural therapy and/or antidepressant medication such as selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TAs). These drugs increase the concentration of specific neurotransmitters in the brain to restore the expected balance. Studies suggest that a combination of both drug therapy and psychological therapy is the most effective at treating major depression.
Studies suggest that a combination of both drug therapy and psychological therapy is the most effective at treating major depression.
There are various reasons as to why an individual may choose to come off antidepressants despite the potential efficacy. The drugs can come with a range of side effects such as drowsiness and anxiety. Additionally, most people prefer to have psychotherapy rather than drugs. Furthermore, if an individual feels free of depression symptoms for a period of time then they may feel they no longer need to take antidepressants.
It has been found through a meta-analysis that discontinuation of antidepressant treatment leads to higher relapse rates of depression compared to those who continued treatment. A study looked at 478 people in the UK who were considering stopping antidepressants. After a year, 56 per cent of people given placebo pills had a depression relapse compared with 39 per cent who continued on the medication. Although, this study does not look at individuals who choose to replace traditional antidepressants with another form of therapy. There is research being done in alternatives such as psilocybin or biotech implants in the brain which have shown some efficacy in treating depression. It may be that that the decision to stop antidepressants won’t lead to a relapse if the treatment is replaced with another therapy.
56 per cent of people given placebo pills had a depression relapse compared with 39 per cent who continued on the medication
Ultimately the decision to stop taking antidepressants lies with the individual’s personal preference informed with the advice from a medical professional. However, when starting antidepressants, the message should be relayed that there is a risk of relapse when stopping the medication. This will guide the individual towards making their own evidence-based decision. With the rise of alternative treatments, it may be that the decision to come off antidepressant medication may be made easier in the future.