The condition, known as antidepressant continuation syndrome, includes headaches, insomnia, agitation, diarrhoea, anxiety, fatigue, and flu-like symptoms, the authors wrote in a clinical review in The Journal of the American Osteopathic Association, adding that "with extended use, [antidepressants] can be notoriously difficult to quit because they can produce a state of physical dependence."
The authors of the study warned that doctors in the US tend to over-prescribe antidepressants, leading to patients becoming dependent on the medication. According to 2017 CDC data, 12.7 percent of Americans who are 13 or older take antidepressant medication on a monthly basis – nearly doubling from 1999, when the number of users was 7.7 percent.
"I understand that many people feel safe in that their depression or anxiety is continuously managed by medication. However, these are mind-altering drugs and were never intended as a permanent solution," Mireille Rizkalla, PhD, the lead author of the review, said in a press release.
The study warned that the longer a person is taking antidepressants there is more risk of developing antidepressant discontinuation syndrome as the body becomes accustomed to the medication. A quarter of all antidepressant users have taken their medications for 10 or more years, according to the study.
The review authors said that patients might become dependent on antidepressant medication because doctors often don't equip them with plans for eventually weaning themselves off of the medication.
"I think we have a real problem with patient care management, when it comes to prescribing antidepressants," Rizkalla, a researcher at Midwestern University, said. "We tend to put patients on an SSRI and more or less forget about them," referring to selective serotonin reuptake inhibitors, a class of antidepressant drugs that help boost the brain's production of the hormone serotonin.
Rizkalla suggested doctors who provide prescriptions should also provide them with a plan for eventual discontinuation as well as suggestions for promoting their mental health with non-drug methods, like therapy, exercise, or meditation. The researchers also offered recommendations for how patients should control the use of antidepressants to avoid dependence and antidepressant discontinuation syndrome-related side effects.
The researchers suggested that people who take tricyclic antidepressants could gradually lower their dosage over three months, while people who use the SSRI paroxetine could take 10 milligrams fewer of their medication every five to seven days to avoid the symptoms.