Latest news with #JAMAPsychiatry
SBS Australia
4 days ago
- Health
- SBS Australia
One in seven Australians are on this medication and some have 'strange' symptoms coming off
Antidepressants are some of the most commonly prescribed medications globally and in Australia, but knowledge of how they work and how hard it is to come off them remains highly contested. Data from the Australian Institute of Health and Welfare shows nearly four million Australians — roughly one in seven — take antidepressants. A large systematic review of research into the process of withdrawing from the drugs was published this week, but it quickly faced backlash from some psychiatrists and experts. The authors found coming off antidepressants after short-term use was not associated with a "clinically significant" risk of withdrawal symptoms. However, long-term antidepressant use — that is longer than 12 months — is increasingly common and comes with a greater risk of harm. The review found withdrawal symptoms — such as dizziness, nausea, vertigo — occur in a minority of cases, but they are on average manageable and not severe, especially with proper clinical support. The authors suggest that depression after stopping antidepressants is probably a relapse of the original mental health condition, as the results were similar among placebo groups. The meta-analysis examined the findings of 50 randomised controlled trials, involving 17,828 participants. The review published in JAMA Psychiatry included 38 studies with an observation period longer than two weeks, the critical time frame during which withdrawal symptoms are expected to occur. The average age of the participants was 44, and 70 per cent were female. In Australia, women are prescribed antidepressants at 1.5 times the rate of men — a trend that's seen in other parts of the world. Some health professionals say the review provides useful insights, despite its limitations, while others have been highly critical. UK antidepressant researchers Mark Horowitz and Julie Moncrieff said the review "risks underestimating the potential harms to long-term antidepressant users by focusing on short-term, industry-funded studies." Several of the JAMA Psychiatry article's senior authors declared receiving payments from drug companies. Horowitz and Moncrieff argue that the article's "main analysis" is based on eleven trials, six of which looked at people who had taken antidepressants for eight weeks and four for 12 weeks. "There is growing recognition that stopping antidepressants — especially after long-term use — can cause severe and sometimes debilitating withdrawal symptoms, and it is now acknowledged by the UK government as a public health issue," they wrote in The Conversation. New resources have been developed to support people safely stopping the use of antidepressants over time usually months, through what's called a tapering plan. The Maudsley Deprescribing Guidelines, published last year and co-authored by Horowitz, has been accepted by the Royal Australian College of General Practitioners as an Accepted Clinical Resource. On again, off again antidepressant prescriptions Allied health professional Kizzy said she never wanted to be reliant on anti-depressants and has stopped taking them twice in the past. "I was initially quite resistant to any kind of medication, but I got to a point a couple of years ago ... where I was really struggling with suicidal thoughts and just being able to function and do things because of my mood, and all of these horrible feelings and thoughts I was having, and finally got convinced to try sertraline". She said she noticed the drug — a commonly prescribed antidepressant sometimes sold under the name Zoloft — was making her feel "numb". "My hope is that I can one day be not require antidepressants and still maintain this level of functioning and mental health," she said adding that her current medication "potentially affects" her liver. The United States National Library of Medicine says liver abnormalities reportedly occur in around 1 per cent of people who take sertraline, "but elevations are usually modest and infrequently require dose modification or discontinuation". Professor Paul Fitzgerald is the director of the School of Medicine and Psychology at Australian National University and a member of the Royal Australian and New Zealand College of Psychiatrists. He was not involved in the review. He said it's important to be aware of the more severe cases of side effects. "There are some unusual symptoms that patients experience. The most dramatic one the patients find quite disturbing is the phenomena that patients often talk about as brain zaps." "They get this very strange sensation of electrical zaps in their head or down their spinal cord, and if they haven't been warned about it, it can be quite distressing. It just seems strange." He said it's unclear from this latest review whether the symptoms recorded by researchers are a relapse of a previous mental health condition or withdrawal effects from discontinuing antidepressants. "What happens when somebody's stopping a medication and their underlying symptoms of their condition get worse? "In other words, start to experience more depression or more anxiety, and it can be really difficult to know under those circumstances. "Are those symptoms that they're experiencing some sort of discontinuation or is it really just the symptoms of the illness coming back because the treatment's been withdrawn?" Sonya Morrissey is the national GP adviser at Headspace, a platform supporting the mental health and wellbeing of younger people. She said that, in the past, patients weren't sufficiently warned about discontinuation symptoms of antidepressants. "It is something that we are, I think, recognising more and there's lots more research being done now, which is great, although there's not a significant amount of research yet in the cohort that we see, which is the 12 to 25 year olds," she said. She said antidepressants are not their first line of treatment at Headspace, but will be used occasionally if needed. LISTEN TO SBS News 11/07/2025 08:17 English The Royal Australian College of General Practitioners' Western Australia vice-president, Dr Ramya Raman, said the recently published meta-analysis still provides useful insight for GPs but said more research on withdrawing from long-term anti-depressant use was needed. She also highlighted the importance of a good doctor-patient relationship when withdrawing from psychiatric medication. "When weaning off of the medication and there is a trusted relationship with the GP, and a regular follow-up with that doctor, the risk of having the discontinuation symptoms are less of a concern compared to when patients actually abruptly stop it. Kizzy also said finding a GP with an interest in mental health can make a big difference when navigating the use of antidepressants and the withdrawal process. "I think it's important to find a GP who has a genuine interest in that area rather than just going to your generic GP, finding a regular one who you know can rely on, who can really support you and speak to you in a way that you're going to feel respected and really understood. "And I think that's a really important kind of foundation support to have because once you have that, then you will feel safe enough to be checking in with them, sharing all your concerns, talking about coming off or going on or switching medications and still be okay through all of that." Readers seeking crisis support can ring Lifeline on 13 11 14 or text 0477 13 11 14, the Suicide Call Back Service on 1300 659 467 and Kids Helpline on 1800 55 1800 (for young people aged up to 25). More information and support with mental health is available at and on 1300 22 4636.
SBS Australia
4 days ago
- Health
- SBS Australia
What are the withdrawal effects of antidepressants? A new review explores the issue
"I was initially quite resistant to any kind of medication, but I got a point a couple of years ago, I got to a point where I was really struggling with suicidal thoughts and just being able to function and do things because of my mood, and all of these horrible feelings and thoughts I was having, and finally got convinced to try Sertraline. And it definitely fairly immediately actually I noticed that I felt quite numb." Kizzy, who is an Allied Health professional is someone who engages with BEING Mental Health Consumers, an organisation advocating for people with lived experience of mental health issues. She says she never wanted to be reliant on anti-depressant medications, and has come off it twice now in the past. "My hope is that I can one day be not require antidepressants and still maintain this level of functioning and mental health I guess, and continue to improve, especially because there are still, for example, because it potentially affects my liver, like this current medication, I can't consume any alcohol, which is a healthy thing." A new review by academics published in JAMA Psychiatry examines antidepressant withdrawal symptoms. The international team of researchers analysed a large amount of data from over 50 studies involving more than 17,000 patients. The review found study participants who discontinued antidepressants experienced more symptoms - compared to those discontinuing placebo or continuing an antidepressant. Dr Ramya Raman is the Vice President and Western Australia Chair at the Royal Australian College of GPs. She says the decision to start and stop anti-depressants is a shared decision-making between patients and health professionals. "We look at how long a patient has been well and how their mood is actually going, what are some of the other factors that might be contributing to their current circumstances? What are their support systems around? Are they seeing a psychologist? Do they have other therapy in place for example with cognitive behavioural therapy or interpersonal skills training with their psychologist? And if they're doing really well with all of those and the patient actually says, I've been on these medications, I'm seeing the psychologist, I'm feeling a lot better, there's improvement, my family's telling me that there is improvement, I feel much better. My work has improved, my physical wellbeing has improved." Antidepressants are some of the most commonly prescribed medications globally and in Australia. Long-term use of the medication - that is longer than 12 months - is rising, and with it the understanding of the greater risk of harm. New resources have been developed to support safely stopping the use of antidepressants over time usually months, through what's called a tapering plan. The review published in JAMA Psychiatry included 38 studies which had an observation period longer than two weeks, the critical time frame during which withdrawal symptoms are expected to occur. The review found withdrawal symptoms - such as dizziness, nausea, vertigo - occur in a minority of cases, but they are on average typically not severe and manageable, especially with proper clinical support. Dr Raman says while there is room for further research on symptoms over a longer time period, the insight is useful for GPs. "In other words a weaning off of the medication and there is a trusted relationship with the GP in a regular follow up with that doctor, the risk of having the discontinuation symptoms are less the concern though when patients actually abruptly stop it. So the symptoms can include brain fogginess, dizziness, nausea, sometimes headache and sleep disturbances and of course mood changes and irritability can occur." Sonya Morrissey is the National GP Advisor at Headspace, a platform supporting the mental health and wellbeing of younger people. She says there is a growing understanding of how to support patients in their tapering plans - as they withdraw from using antidepressants "In the past, we would've not really talked to young people that we were prescribing antidepressants about the possibility of discontinuation symptoms. But it is something that we are, I think, recognising more and there's lots more research being done now, which is great, although there's not a significant amount of research yet in the cohort that we see, which is the 12 to 25 year olds. So that is a bit of a gap." She says antidepressants are not their first line of treatment at Headspace, but will be used occasionally, if needed. "In the cohort that we see at Headspace, which is young people age 12 to 25, antidepressant medication is not considered first-line treatment, for example, for anxiety disorders or for depression because they would be the psychological therapies and other supports. But for some young people who experience symptoms that either don't respond to those therapies or that are severe enough to be really impacting function, we will sometimes use antidepressant medication." Professor Paul Fitzgerald is the Director of the School of Medicine and Psychology at Australian National University, who is also a part of the Royal Australian and New Zealand College of Psychiatrists. He was not involved in the review. He says it is important to be aware of the more severe cases of side effects. "There are some unusual symptoms that patients experience. The most dramatic one the patients find quite disturbing is the phenomena that patients often talk about as Brain Z. They get this very strange sensation of electrical Z in their head or down their spinal cord, and if they haven't been warned about it, it can be quite distressing. It just seems strange." He says it's unclear from this latest review whether the symptoms are from their condition - or from discontinuation of antidepressant medication. "What happens when somebody's stopping a medication and their underlying symptoms of their condition get worse? In other words, start to experience more depression or more anxiety, and it can be really difficult to know under those circumstances. Are those symptoms that they're experiencing some sort of discontinuation or is it really just the symptoms of the illness coming back because the treatment's been withdrawn?" As a young adult in her mid-thirties, Kizzy says it can be challenging navigating the use of antidepressants and the withdrawal process. But she's found a way to use her voice and advocate to people who may be in a similar situation as her. She says what can make a big difference is finding a GP with an interest in mental health. "I think it's important to find a GP who has a genuine interest in that area rather than just going to your generic GP, finding a regular one who you know can rely on, who can really support you and speak to you in a way that you're going to feel respected and really understood. And I think that's a really important kind of foundation support to have because once you have that, then you will feel safe enough to be checking in with them, sharing all your concerns, talking about coming off or going on or switching medications and still be okay through all of that."
Yahoo
6 days ago
- Health
- Yahoo
Antidepressant withdrawal is rare, study finds. Here are the most common symptoms
Going off of antidepressants may not come with as many side effects as people think, an extensive new analysis has found. The study, published in the journal JAMA Psychiatry, is the largest review to date on antidepressant withdrawal symptoms, according to the researchers from the United Kingdom. It sought to understand what happens when people stop taking antidepressants, and to identify which symptoms come from discontinuing medication and which could reflect a potential relapse of depression or other mental health issues. 'Our work finds that most people do not experience severe withdrawal, in terms of additional symptoms,' Dr Sameer Jauhar, the study's lead author and a researcher at Imperial College London, said in a statement. The review included 50 randomised controlled trials – which are considered the gold standard in medical research – spanning about 17,800 people. On average, people who stopped taking antidepressants experienced symptoms such as dizziness, nausea, vertigo, and nervousness in the first two weeks. But most people had few enough symptoms that they were considered 'below the cutoff' for clinical withdrawal, the study found. People's moods also did not appear to get worse as a result of discontinuing their medicine, meaning it could instead be a sign that their depression is coming back, researchers said. Related Antidepressant prescriptions have increased among young French people since 2019, report finds The findings contradict another study published earlier this year that found antidepressant withdrawal symptoms were 'common, and severe and prolonged' for many patients. But Katharina Domschke, chair of the psychiatry and psychotherapy department at the University of Freiburg in Germany, said that study was 'methodologically much weaker' because it only included 310 patients and had a higher risk of bias in the results. The latest analysis is 'extremely welcome in terms of helping to destigmatise antidepressants,' added Domschke, who was not involved with the report. The study included several types of antidepressants, including agomelatine, vortioxetine, selective serotonin reuptake inhibitors (SSRIs) such as escitalopram, sertraline and paroxetine, and serotonin-norepinephrine reuptake inhibitors (SNRIs) like venlafaxine and duloxetine. Researchers tracked the number of symptoms that people experienced on a 43-item scale, comparing those who went off antidepressants against those taking placebos, or dummy treatments. Overall, patients who stopped antidepressants experienced one extra symptom – such as nausea or vertigo – than people who stopped placebos. For example, 20 per cent of people who stopped taking venlafaxine suffered from dizziness, compared with just 1.8 per cent of those on placebos. Related Pills or paintings? Swiss town lets doctors prescribe free museum visits as art therapy Different antidepressants also came with different severity and length of symptoms. People who went off of desvenlafaxine experienced the most symptoms, while patients who stopped vortioxetine were fairly similar to those who took placebo medicines. The review has some limitations. Most of the studies followed people for up to two weeks after they stopped taking antidepressants, making it difficult to draw conclusions about long-term effects. 'We still need more data on long-term users, individual vulnerability, and best practices for discontinuation,' Dr Christiaan Vinkers, a psychiatrist and stress researcher at Amsterdam University Medical Center who was not involved with the study, said in a statement. For now, Vinkers said, "the findings promote a more balanced and science-based understanding of antidepressant discontinuation".
Associated Press
01-07-2025
- Health
- Associated Press
Swedish Study Finds Attention-Deficit/Hyperactivity Disorder (ADHD) Medications Linked With Safer Outcomes
NEW YORK, NY - June 30, 2025 ( NEWMEDIAWIRE ) - A major Swedish study of 247,420 individuals with attention-deficit/hyperactivity disorder (ADHD) has found that medication treatment is consistently linked to lower rates of self-harm, accidents, and criminal behavior. The research, in JAMA Psychiatry, shows that people with ADHD experience fewer such adverse events during periods on medication compared to periods off medication. As expected, as less severe cases of ADHD are diagnosed and treated with medication, the reduction in adverse events narrows. Dr. Ryan Sultan - Director of Integrative Psychiatry and a Columbia University Psychiatry Assistant Professor and internationally recognized ADHD expert – authored an invited commentary on the findings. 'When used appropriately, ADHD medications help patients not just feel better, but live safer, more productive lives,' said Dr. Sultan. He noted that this growing body of evidence underscores how effective ADHD treatment yields real-world benefits beyond symptom relief. As the population of individuals treated for ADHD has risen, the study found that the medication's effect on reducing adverse events was less for the newly diagnosed than the previously diagnosed. In Sweden, ADHD medication use roughly tripled among youth and rose more than fivefold among adults from 2006 to 2020. During this period, the medication's impact on outcomes like injuries and crime, while still significant, became less pronounced. 'As we diagnose and treat more people with ADHD - including adults and women with milder symptoms - it's expected that the average drop in severe outcomes like arrests or accidents will be smaller,' Dr. Sultan explained. 'That doesn't mean the medication is less effective for individuals; it just means we're now helping a broader group, including those with less severe versions of ADHD. It underscores the importance of careful diagnosis and tailored treatment for each patient.' Mental health professionals today recognize that many adults, including women, who would have been overlooked in the past now benefit from ADHD treatment. This broader inclusion is positive, as reductions in adverse outcomes such as self-harm, accidents, and criminal behavior are only part of the benefits of ADHD treatment. Dr. Sultan emphasized that the primary goal of ADHD treatment is to improve patients' daily functioning and quality of life, outcomes that are not always captured by statistics like accident or arrest rates. The new findings highlight the need to regularly re-evaluate prescribing practices and guidelines as the patient population evolves. Both the Swedish study and Dr. Sultan's commentary are slated for publication in JAMA Psychiatry. About Integrative Psych is a Manhattan-based mental health practice and research clinic led by Dr. Ryan Sultan, MD, who is an Assistant Professor of Clinical Psychiatry at Columbia University Irving Medical Center and the New York State Psychiatric Institute. Integrative Psych provides a holistic, evidence-based approach to ADHD and other psychiatric conditions, combining psychopharmacology, cognitive-behavioral therapy, ketamine-assisted treatment, mindfulness, and personalized care to improve everyday functioning and well-being. Dr. Sultan's team is dedicated to advancing outcomes through both clinical innovation and real-world effectiveness research. About Ryan S. Sultan, MD Ryan S. Sultan, MD, Director of Integrative Psychiatry, an Assistant Professor of Clinical Psychiatry at Columbia University Irving Medical Center and a Research Scientist at the New York State Psychiatric Institute. An internationally recognized expert in ADHD, he specializes in the diagnosis and treatment of ADHD across the lifespan and focuses his research on ADHD medication outcomes and public health. Social Links Instagram | Facebook | YouTube | LinkedIn Media Contact Full Name: Yiting Huang Title: Research Coordinator Company Name: Integrative Psych Email: [email protected] Phone Number: +1(551) 263-8239 Website:
Medscape
27-06-2025
- Health
- Medscape
Diminishing Returns With Broader Use of ADHD Meds?
It's well known that medications used to treat attention-deficit hyperactivity disorder (ADHD) do more than address the core symptoms of inattention, hyperactivity, and impulsivity. They have also been associated with significant reductions in the risk for serious real-world outcomes such as self-harm, unintentional injury, car crashes, and crime. However, a large-scale Swedish study has found that the magnitude of associations between ADHD medication use and these real-world outcomes appears to have weakened, in parallel with rising prescription rates. 'The declining strength of the associations of ADHD medication and real-world outcomes could be attributed to the expansion of prescriptions to a broader group of individuals having fewer symptoms or impairments,' first author Lin Li, PhD, Karolinska Institutet, Stockholm, Sweden, and colleagues wrote. The findings were published online on June 25 in JAMA Psychiatry. Waning Real-World Impact? The rate of ADHD medication use has risen substantially in many countries over the past two decades. With treatment now reaching a broader population of individuals who may have less severe symptoms, an emerging question is whether there remains a meaningful reduction in real-world harm. To investigate, Li and colleagues analyzed health data from Swedish national registers for 247,420 individuals aged 4-64 years who were prescribed ADHD medications between 2006 and 2020. They employed a self-controlled case series design, which allowed individuals to serve as their own controls. Outcomes included rates of self-harm, unintentional injury, traffic crashes, and crime measured during medicated vs nonmedicated periods. Over the 14-year study period, ADHD medication use rose sharply in Sweden — from 0.6% to 2.8% in children and from 0.1% to 1.3% in adults. ADHD medication use was consistently linked to reduced risks for self-harm (incidence rate ratio [IRR] range, 0.77-0.85), unintentional injury (IRR range, 0.87-0.93), traffic crashes (IRR range, 0.71-0.87) and crime (IRR range, 0.73-0.84) across all analyzed time periods, age groups, and sexes. However, the magnitude of risk reduction for these real-world outcomes diminished significantly over time ( P < .01) and was not fully explained by the age and sex distribution of people taking ADHD medication. The study team noted that the strongest associations between ADHD medication and reduced risk for real-world outcomes were consistently observed in women during the earliest study period (2006-2010), a time when only the most severe ADHD cases in women were being diagnosed and treated. Over time, as more women were prescribed ADHD medication, the sex differences on the various real-world outcomes narrowed, investigators said. In an accompanying editorial in JAMA Psychiatry , Ryan S. Sultan, MD, Department of Psychiatry, College of Physicians and Surgeons, Columbia University and the New York State Psychiatric Institute, New York City, and colleagues said it's 'critically' important to remember that the purpose of ADHD treatment is not primarily to prevent arrests, car crashes, or self-harm crises but to improve patients' daily functioning and quality of life. 'The accumulation of evidence makes one thing clear: When used appropriately, ADHD medications can help affected people not just feel better but live safer, more productive lives. This message is important as many individuals with ADHD still do not receive medication as their first-line treatment, despite medications having the most robust evidence for ADHD,' the editorialists wrote.
