Slow, Supported Antidepressant Tapering Linked to Lower Relapse Risk
17 Dec 2025
Researchers found that a gradual, personalised approach works better than stopping medication suddenly or tapering too quickly.
The study, published in The Lancet Psychiatry, reviewed 76 randomised controlled trials involving more than 17,000 adults. It compared the main ways antidepressants are deprescribed and measured how often people experienced a relapse of depression or anxiety.
The strategies examined included:
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Abrupt stopping, where the antidepressant was replaced with a placebo
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Fast tapering, reducing the dose over four weeks or less
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Slow tapering, reducing the dose over more than four weeks
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Dose reduction, lowering to 50% or less of the minimum effective dose
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Continuing antidepressant treatment
Each approach was assessed both with and without psychological support, such as therapy.
The findings showed that for people who had recovered from depression while taking antidepressants, slow tapering combined with psychological support was the most effective option. Compared with sudden stopping or fast tapering, this approach prevented a relapse in around one in five people, which the authors described as a clinically meaningful benefit.
For anxiety disorders, the researchers said the evidence was less clear and more targeted studies are needed before firm conclusions can be drawn.
Antidepressants remain recommended for moderate to severe depression and anxiety, but the study highlights ongoing concerns about long-term use, overprescribing, and the lack of clear, evidence-based guidance on how to safely stop these medicines.
The researchers called for clinical guidelines to be updated to support individualised deprescribing, with gradual dose reductions and structured psychological support. This aligns with recent action by the Royal Australian College of General Practitioners (RACGP).
In November, the RACGP released its First Do No Harm resource to help GPs deprescribe antidepressants — including SSRIs and SNRIs — in a way that reduces withdrawal symptoms and relapse risk. The guidance encourages regular medication reviews and stresses that long-term prescribing should not continue without reassessing whether the treatment is still needed.
In 2023–24, antidepressants were supplied to 14% of Australians, with 92% prescribed by GPs. While most guidelines recommend using these medicines for 6–12 months for a single episode of depression or anxiety, the average duration of use in Australia is around four years.
Lead author Professor Giovanni Ostuzzi from the University of Verona said treatment often continues well beyond guideline recommendations.
“Many people don’t want to stay on medication forever, and some struggle with ongoing side effects,” he said.
Professor Ostuzzi hopes the research gives doctors clearer, stronger evidence on how to safely support patients who are ready to come off antidepressants after successful treatment.
Source: The Lancet Psychiatry; Royal Australian College of General Practitioners (RACGP) – First Do No Harm deprescribing resource.
