This NEWS item by Jacqui Wise has just been published in the BMJ [full text below]. It reports on a Science Media centre briefing on this paper published in JAMA Psychiatry: Incidence and Nature of Antidepressant Discontinuation Symptoms: A Systematic Review and Meta-Analysis.
Jacqui Wise mentions some of the limitations of the paper which are obvious to even me as someone with very little experience in research. I am sure that others will have more informed comment to make on these limitations which have not been given any prominence in the media briefing.
What appears absent from both the original JAMA Psychiatry paper and the media briefing is where this leaves individuals like myself who are struggling to stop their antidepressant due to withdrawal effects. I for one feel ignored and as if the harm I live with does not matter. I am aware from petitions in relation to antidepressant withdrawal raised with the Scottish Parliament and the Welsh Parliament that I am far from alone. In Scotland it is the case that nearly 1 in 4 of the adult population is taking prescribed antidepressants. Even if only a small percentage of these people suffer withdrawal symptoms this is still a significant burden of ill-health.
I am particularly alarmed that this paper has concluded that, based on predominantly short-term studies [i.e. not reflecting real world use], a recurrence of depressive symptoms should be interpreted as relapse. This is not a conclusion that can be justified from this study. Just as concerning, some of the paper authors have recommended that existing guidelines should be amended to “reassure” patients.
This morning I woke up to hear the Chair of the UK Infected Blood Inquiry state that victims of the infected blood scandal are being “harmed further” as a consequence of system failings both in the past and in response to the recommendations of this inquiry. In relation to my experience of antidepressants I feel that my former profession [I am a retired psychiatrist] has failed to learn the lessons of making bold conclusions from data, that however well analysed, was never designed to look at the real world experience of antidepressants [i.e. generally taken for far longer than the period covered in most of the studies included in this meta-analysis].
I personally feel further harmed by the unbalanced presentation and bold conclusions arising from this paper. I also worry that premature changes to national guidelines will generate further unnecessary iatrogenic harm.
