Grossly Flawed Paper Denies that Antidepressant Withdrawal Effects are “Clinically Meaningful”

Editor’s note: this post was first published on Mad in America on 19/07/25

After a long battle that finally succeeded in getting the UK’s medical policymakers to acknowledge these risks, pharma-funded researchers are endangering patient safety by minimising the incidence and severity of withdrawal.

Agroup of British researchers have just published a paper questioning whether withdrawal from antidepressants is ‘clinically meaningful’ and whether lengthy tapering is necessary when withdrawing. I’d like to provide some context and explain why these claims are false and dangerous.

There is no clearer example of the dominance of the drug companies’ simplistic, pessimistic and unevidenced ‘medical model’ than the millions upon millions of us around the world now taking antidepressants in an attempt to deal with our sadness or anxiety. The numbers have increased steadily for two decades. Women, older people and poor people are particularly likely to be on antidepressants. So, if you are a woman over 60 where I live (one of the poorest boroughs of London) you have a one in three chance of being on these drugs.

Global pharmaceutical revenue is about $1.6 trillion annually, of which antidepressants are an estimated 5% (i.e. about $80 billion). And this is all despite the drugs being no better than placebo for the vast majority of people who take them, and there being no empirical basis to the serotonin deficiency (‘chemical imbalance’) claim used to justify their usage proclaimed by the pharmaceutical industry and regurgitated for decades by psychiatry.

In 2019, Public Health England (PHE) conducted a comprehensive evidence review entitled Dependence and Withdrawal Associated with Some Prescribed Medicines. It found that 26% of the adult population (approximately 11.5 million people) had been prescribed antidepressants, opioids, benzodiazepines, Z-drugs, or gabapentinoids in the previous year, and raised concerns about inappropriate prescribing, long-term use, dependence and withdrawal.

To inform the PHE investigation, James Davies and I conducted and published our own review entitled “A Systematic Review into the Incidence, Severity and Duration of Antidepressant Withdrawal Effects: Are Guidelines Evidence-Based?”  We found that, on average, 56% of people will experience withdrawal effects when trying to stop or reduce and, of those, 46% describe those effects as ‘severe’.

The PHE report and our own review were instrumental in prolonged but ultimately successful attempts to have the National Institute for Health and Care Excellence (NICE) and the Royal College of Psychiatrists (RCP) amend their guidelines from the grossly minimising position promulgated by industry which they had parroted for years (and which the American Psychiatric Association still promotes today), to a more evidence-based description of the extent of the problem, along with sensible advice about how to slowly withdraw.

Since 2019, efforts have been underway to implement the vitally important PHE recommendations that there be dedicated support services within our National Health Service (NHS) to support people to safely withdraw form psychiatric drugs if they wish to. So far, just one clinic has been established, in London, under the leadership of Mark Horowitz, the lead author of another landmark sign of progress, The Maudsley Deprescribing Guidelines. Other services are in the planning stages, but progress is painfully slow, not only because of the perilous financial state of the NHS but resistance from some who prefer the status quo of millions being on psychiatric drugs for years or even life.

An example of that resistance was the publication on July 9^th of a paper called  “Incidence and Nature of Antidepressant Discontinuation Symptoms” by a group of 19 people, led by Michail Kalfas and including leading names in British psychiatry: David Nutt, David Baldwin, Carmine Pariante, Allan Young and Joseh Hayes. Many are from the renowned Institute of Psychiatry at King’s College London.

The minimising begins in the title, where they use the term Discontinuation Symptoms, invented by the pharmaceutical industry to create the impression that the phenomenon in question is somehow different from, and lesser than, withdrawal effects.

The day before publication, the Science Media Centre (SMC) promoted the paper in a tightly controlled media briefing for selected journalists. Several critics of the minimising efforts of this group of psychiatrists registered for the briefing, but were barred from entry at the last minute. These included the author of The Maudsley Deprescribing Guidelines (Horowitz), and both authors of the 2019 review (Davies and myself), which turned out be a major focus of the briefing (according to journalists who later corresponded with us).

Five of the SMC’s largest donors are drug companies (plus the British Association of the Pharmaceutical Industry).

Many of the paper’s authors receive money from drug companies. The paper lists more drug company payments to authors than references to scientific papers. For example, Allan Young, a co-author and a presenter at the SMC press briefing, is paid by at least six drug companies.

Among the many blatant methodological flaws of this new paper is the reliance on short-term drug company studies of just a few weeks, which contrasts with the millions of people worldwide who are on these drugs for many years. Such studies are bound to grossly underestimate the true incidence and severity of antidepressant withdrawal effects.

The attempts by the drug company-sponsored researchers to control the media via the SMC were not entirely successful.

Our own hastily constructed media release included the following comment from Stevie Lewis, ex-user of antidepressants:

‘I have experienced the prolonged agony of coming off these drugs and know that tens of thousands are going through the same thing now.  If policy makers and doctors take this flawed study seriously it could further reduce the very limited support available to us.’

And the following comment from Horowitz:

‘This paper from Kalkas about antidepressant withdrawal in JAMA Psychiatry will mislead the public, clinicians and policymakers because of methodological flaws in the study which has led them to under-estimate the risks of withdrawal effects to long term users. The main analysis in the paper relied on 11 randomised controlled trials that mostly went for 8-12 weeks. In the UK about 4 million people take antidepressants for more than 2 years, and 2 million people take them for more than 5 years. In the US at least 25 million people take antidepressants for more than 5 years. What happens to people in 8-12 week studies is a far cry from what happens to millions of people when they stop.’

I quote at length from another media release, from the Beyond Pills All Party Parliamentary Group:

The Beyond Pills All-Party Parliamentary Group (APPG) expresses serious concern over the publication and promotion of a recent study claiming that antidepressant withdrawal is largely mild, brief and overstated.

This paper, whose authors include several researchers with financial ties to the pharmaceutical industry, was promoted to the media through a tightly controlled press briefing organised by the Science Media Centre (SMC), an organisation that has attracted controversy for receiving considerable funding from the pharmaceutical industry.

The study draws its conclusions from mostly short-term clinical trials (most lasting only eight weeks). This approach fails to reflect the experiences of millions who take antidepressants for years (half of antidepressant users have been taking them for longer than two years). Evidence clearly shows that long-term use (two years and over) correlates with greater incidence of withdrawal effects, which can be more severe and prolonged. By excluding most of the real-world data on antidepressant use, the paper delivers a dangerously distorted picture, compounded by the accompanying campaign to the media.

The APPG is concerned that this misleads the public, denies the experiences of the many people harmed by poor prescribing practices, and stalls urgently needed policy reform, risking further harm to patients.

Commenting on the news, Dr Simon Opher MP, GP and Chair of the Beyond Pills APPG, said:

“As a GP I have personally helped many patients suffering withdrawal effects from antidepressants. The APPG has been campaigning on this issue for many years, calling for proper recognition, support and services for those harmed by severe and protracted antidepressant withdrawal. By minimising the scale and seriousness of withdrawal, this new study risks setting that work back significantly. It is disturbing that some of the authors receive funding from the pharmaceutical industry, as does the Science Media Centre. We view this as a serious public health concern, with real-world consequences for patient safety and informed care.”

Carrie Clark, formerly prescribed antidepressants:

“Antidepressant withdrawal is the single most terrifying and painful thing that has ever happened to me. I genuinely believed that I was going to die. Suicide has never seemed like such a rational choice. When I was prescribed these drugs as a troubled teenager, I was told they were safe and easy to stop. I did not give my informed consent to undertaking the risk of withdrawal and I feel completely betrayed by the psychiatric professionals I trusted to protect my best interests.”

The New York Times coverage included:

If you are looking at people on the drugs for eight weeks, you are not going to find withdrawal,” said James Davies, one of the authors of the 2019 study that found high rates of withdrawal symptoms. “It’s like saying cocaine isn’t addictive because we did a study on people who had only been taking it for eight weeks.”

Dr. Davies, of the University of Roehampton in England, said he worried that the findings, “if read uncritically,” would “cause considerable harm by significantly downplaying the effects of real-world antidepressant use.”

“According to their conclusions, the tens of thousands of people online who are struggling with severe and protracted withdrawal aren’t really in withdrawal,” he said. “There are real people out there on the ground that aren’t making up the fact that they are in a lot of pain coming off these drugs.”

Meanwhile in the UK, The Daily Telegraph, a popular daily paper, headlined its story: “Scientists Accused of Downplaying Dangers of Antidepressants: Row Breaks out Over Risk of Patients Experiencing Severe Withdrawals”.

It included:

Dr John Read, the chairman of the International Institute for Psychiatric Drug Withdrawal, who co-authored the original 2019 paper, said: “Minimising the incidence of the withdrawal effects of antidepressants endangers patients’ safety.

“It misinforms doctors, so they are less likely to recognise withdrawal effects and to provide proper support to the millions of people worldwide who are trying to come off their medication safely.’’

Dr Read said the new research relied on short-term drug company studies of just a few weeks, which bore little resemblance to patients who had been taking antidepressants for many years.

“What happens to people in eight to 12-week studies is a far cry from what happens to millions of people when they stop,” said Dr Mark Horowitz, who wrote describing guidelines for clinicians after suffering severe withdrawal effects when he came off antidepressants.

The New Scientist carefully emphasised that the study only covered ‘short-term use’ and ended its piece with:

John Read at the University of East London points out “There’s a strong relationship between how long you’re on these drugs and whether or not you end up with withdrawal, so short-term [use] studies aren’t going to tell you much about real-world effects.”

As such, you would need more studies involving long-term use to get a true answer, says Mark Horowitz at University College London. “It’s like crashing a car into a wall at 5 kilometres an hour, and saying it’s safe, but ignoring the fact that people are driving around on the roads at 60 kilometres an hour.”

This grossly flawed and dangerously misleading paper is co-authored by the cream of British academic psychiatry. One has to ask whether the flaws are intentional or unintentional. The latter interpretation implies extreme carelessness. The former implies something even more worrying.