The nature and impact of antidepressant withdrawal symptoms and proposal of the Discriminatory Antidepressant Withdrawal Symptoms Scale (DAWSS)

Background: We sought to understand more about the nature and possible consequences of antidepressant withdrawal. Methods: We surveyed members of 20 peer-led, online groups, assessing 31 commonly reported antidepressant withdrawal symptoms. Results: There were 1148 respondents, who were mostly white...

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Main Authors: Joanna Moncrieff, John Read, Mark Abie Horowitz
Format: Article
Language:English
Published: Elsevier 2024-04-01
Series:Journal of Affective Disorders Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2666915324000519
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author Joanna Moncrieff
John Read
Mark Abie Horowitz
author_facet Joanna Moncrieff
John Read
Mark Abie Horowitz
author_sort Joanna Moncrieff
collection DOAJ
description Background: We sought to understand more about the nature and possible consequences of antidepressant withdrawal. Methods: We surveyed members of 20 peer-led, online groups, assessing 31 commonly reported antidepressant withdrawal symptoms. Results: There were 1148 respondents, who were mostly white, female and educated. For 40 % of respondents, withdrawal symptoms had lasted more than 2 years and 80 % were moderately or severely impacted by them. One in four were unable to stop their antidepressant. Reported consequences of withdrawal included impaired work function (56 %), losing jobs (20 %), taking sick leave (27 %), and relationship breakdown (25 %). Both emotional and physical symptoms newly occurred or increased in severity following antidepressant withdrawal compared to before starting antidepressants. There was no difference in the nature of symptoms, severity or duration between people with physical or mental health diagnoses. We have proposed a potential Discriminatory Antidepressant Withdrawal Symptoms Scale (DAWSS), comprising the 15 symptoms most specific to withdrawal (including electric shock sensations, dizziness, akathisia or restlessness, vertigo, and vomiting), which requires further validation. Limitations: The sample was derived from peer support groups and is not representative of everyone who undergoes antidepressant withdrawal. The cross-sectional design precludes establishing causal relationships between variables. Conclusions: Our findings suggest there is a distinctive antidepressant withdrawal syndrome characterised by a range of emotional and physical symptoms, which can be severe, prolonged and have profound impact. The DAWSS may be helpful in distinguishing withdrawal from underlying conditions. Health services need to provide evidence-based clinical advice and support to people on long-term antidepressants.
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spelling doaj.art-2a0aab531b444e5595b5ea7b928aa5a82024-04-27T04:43:46ZengElsevierJournal of Affective Disorders Reports2666-91532024-04-0116100765The nature and impact of antidepressant withdrawal symptoms and proposal of the Discriminatory Antidepressant Withdrawal Symptoms Scale (DAWSS)Joanna Moncrieff0John Read1Mark Abie Horowitz2Division of Psychiatry, University College London, London, UK; Research and Development Department, North East London NHS Foundation Trust, London, UK; Corresponding author at: Division of Psychiatry, University College London, London, W1T 7BN, UK.School of Psychology, University of East London, London, UKDivision of Psychiatry, University College London, London, UK; Research and Development Department, North East London NHS Foundation Trust, London, UKBackground: We sought to understand more about the nature and possible consequences of antidepressant withdrawal. Methods: We surveyed members of 20 peer-led, online groups, assessing 31 commonly reported antidepressant withdrawal symptoms. Results: There were 1148 respondents, who were mostly white, female and educated. For 40 % of respondents, withdrawal symptoms had lasted more than 2 years and 80 % were moderately or severely impacted by them. One in four were unable to stop their antidepressant. Reported consequences of withdrawal included impaired work function (56 %), losing jobs (20 %), taking sick leave (27 %), and relationship breakdown (25 %). Both emotional and physical symptoms newly occurred or increased in severity following antidepressant withdrawal compared to before starting antidepressants. There was no difference in the nature of symptoms, severity or duration between people with physical or mental health diagnoses. We have proposed a potential Discriminatory Antidepressant Withdrawal Symptoms Scale (DAWSS), comprising the 15 symptoms most specific to withdrawal (including electric shock sensations, dizziness, akathisia or restlessness, vertigo, and vomiting), which requires further validation. Limitations: The sample was derived from peer support groups and is not representative of everyone who undergoes antidepressant withdrawal. The cross-sectional design precludes establishing causal relationships between variables. Conclusions: Our findings suggest there is a distinctive antidepressant withdrawal syndrome characterised by a range of emotional and physical symptoms, which can be severe, prolonged and have profound impact. The DAWSS may be helpful in distinguishing withdrawal from underlying conditions. Health services need to provide evidence-based clinical advice and support to people on long-term antidepressants.http://www.sciencedirect.com/science/article/pii/S2666915324000519AntidepressantsAntidepressant withdrawalProtracted antidepressant withdrawal syndromePAWSAkathisiaBrain zaps
spellingShingle Joanna Moncrieff
John Read
Mark Abie Horowitz
The nature and impact of antidepressant withdrawal symptoms and proposal of the Discriminatory Antidepressant Withdrawal Symptoms Scale (DAWSS)
Journal of Affective Disorders Reports
Antidepressants
Antidepressant withdrawal
Protracted antidepressant withdrawal syndrome
PAWS
Akathisia
Brain zaps
title The nature and impact of antidepressant withdrawal symptoms and proposal of the Discriminatory Antidepressant Withdrawal Symptoms Scale (DAWSS)
title_full The nature and impact of antidepressant withdrawal symptoms and proposal of the Discriminatory Antidepressant Withdrawal Symptoms Scale (DAWSS)
title_fullStr The nature and impact of antidepressant withdrawal symptoms and proposal of the Discriminatory Antidepressant Withdrawal Symptoms Scale (DAWSS)
title_full_unstemmed The nature and impact of antidepressant withdrawal symptoms and proposal of the Discriminatory Antidepressant Withdrawal Symptoms Scale (DAWSS)
title_short The nature and impact of antidepressant withdrawal symptoms and proposal of the Discriminatory Antidepressant Withdrawal Symptoms Scale (DAWSS)
title_sort nature and impact of antidepressant withdrawal symptoms and proposal of the discriminatory antidepressant withdrawal symptoms scale dawss
topic Antidepressants
Antidepressant withdrawal
Protracted antidepressant withdrawal syndrome
PAWS
Akathisia
Brain zaps
url http://www.sciencedirect.com/science/article/pii/S2666915324000519
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