Stopping antidepressants

Abstract

I was taught not to scratch if it’s not itchy! It is not necessary to change a patient’s treatment when his or her condition is stable. However, our complex world and the drive to precision treatment is forcing a rethink of these wise old words. In the context of depression, it means scratching at the stable patient’s treatment, and asking the question: “When is it safe to stop the antidepressant?” to which the answer is uncertain. There is a lack of external biomarkers, special investigations and research that can assist in determining the end-point of treatment. Therefore, the real question is: “How can the benefit of treatment be weighed up against the risk of not treating a person when Contemplating treatment discontinuation?” A multifactorial approach is needed to answer this question, and all of the available information considered in conjunction with the patient. Thereafter, a decision can be taken as to when and how to stop.