A RECENT UK study showed that a year after stopping antidepressants, 56 per cent of participants had a relapse of symptoms, compared to 39 per cent who remained on medication.
With the number of prescriptions for antidepressants having doubled in the last 20 years, mostly due to longer term use, does this study add weight to the argument that once you are on an antidepressant, it should be lifelong, similar to drugs for high blood pressure?
Antidepressants have been around since the 50s but there is now greater understanding of mental health issues.
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The Royal College of Psychiatrists states that for mild to moderate symptoms, talking therapies should be considered with medication reserved for moderate to severe presentations that have not responded to counselling.
Selective Serotonin Reuptake Inhibitors are the most commonly prescribed medications . First line drugs are citalopram, fluoxetine and sertraline.
It is important to warn patients that in the first two weeks of commencement, anxiety may get worse and they may experience physical side effects, including nausea, vomiting and palpitations.
At this point, if tolerated, a dosage increase may be appropriate. It can take eight weeks, to start noticing improvement and stopping medication should be considered at least six months after feeling well again.
It is safe to come off antidepressants, but this should be done when mental stability is well established, any factors for low mood have been addressed, and in discussion with your doctor. Higher doses require gradual reduction, rather than abrupt discontinuation.
Though the washout period in which the drug leaves the body may be as little as two weeks, withdrawal symptoms may last for months. Antidepressants are not without side effects both in the short and long term.
Successful outcomes rely on regular medication reviews. Though counselling may not work for all, I cannot emphasise enough the benefits of at least trying it.
Good mental health also relies on a regular routine, healthy diet, moderate exercise, stopping smoking and reducing alcohol consumption if excessive.
Though some may require antidepressants lifelong, at the present time this should not be considered the standard, and several do stop medication successfully, with the appropriate support, good insight, and an understanding of the withdrawal period.
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