When it comes to preventing depression or anxiety relapse, slowly tapering off an antidepressant while receiving psychological support is comparable to remaining on the medication, according to a report in Lancet Psychiatry.Both options are more effective and safer than fast tapering or sudden stopping of antidepressants.
Why It’s Relevant
While antidepressant medication is crucial for many patients with depression and/or anxiety, concerns persist over keeping people on medication indefinitely. There is also the countervailing risk of symptom relapse and withdrawal symptoms should patients stop their medications.
What Was Done
The researchers examined 76 clinical trials (17,379 participants, 67.5% female) that compared strategies for discontinuation of antidepressant medication in adults:
- Abrupt discontinuation
- Fast tapering (four weeks or less)
- Slow tapering (more than four weeks)
- Dose reduction to 50% or less
- Continuation of medication
Some of the trials included psychological support for the tapering patients.
By the Numbers
- Slow tapering with support and medication continuation both reduced relapse risk by about 50% compared with abrupt discontinuation—with moderate evidence to support the finding.
- Dose reduction reduced relapse risk by 38% compared with abrupt discontinuation, though this approach was supported by low levels of evidence.
- Slow tapering without support and fast tapering with or without support were not superior to abrupt discontinuation.
- A secondary analysis found that slow tapering (five to 12 weeks) and very slow tapering (12+ weeks) did not significantly differ in relapse prevention.
The Other Side
Just 5% of the 17,000+ included participants received psychological support, so firm conclusions cannot be made. The average follow-up period in this analysis was 46 weeks, so the risks of continuation or discontinuation after one year are not yet known. Data on withdrawal symptoms—which are a clinical consideration for tapering—were scarce.
What’s the Takeaway?
“We estimated that slow tapering plus psychological support can prevent about one relapse in every five individuals compared with abrupt stopping or fast tapering, a clinically meaningful benefit for mental health care,” the researchers wrote. “These findings highlight the need for updated clinical guidelines and further research to support personalized approaches to antidepressant deprescribing.”
Related Information
“Special Report: Antidepressant Withdrawal”
Source
Debora Zaccoletti et al. Comparison of antidepressant deprescribing strategies in individuals with clinically remitted depression: a systematic review and network meta-analysis. Lancet Psychiatry. Published December 11, 2025.
(Image: Getty Images/iStock/vladm)
