The Truth About Antidepressant Withdrawal Symptoms

Does psychiatric medication withdrawal exist — or is it just a myth?For anyone who’s lived through it, the question alone can feel insulting.Psychiatric drug withdrawal is real. While the experience varies widely, for many, it’s not “brief and mild” as many guidelines state it is. It can be intense, destabilizing, and often misunderstood. One of the most painful challenges is trying to determine whether what you're experiencing is withdrawal or relapse.Unfortunately, current clinical guidelines don’t help. They often frame withdrawal as short-lived and minor, dismissing anything more severe as a return of illness. A potentially dangerous oversimplification that can leave patients feeling gaslit or unsupported.In this interview, Dr. Mark Horowitz, a psychiatrist and researcher who’s both studied and experienced withdrawal firsthand, unpacks a new JAMA study that exemplifies the problem: guidelines built on inadequate evidence.In this episode, you’ll hear:Why current drug withdrawal guidelines fall shortOverview of the new JAMA paper Incidence and Nature of Antidepressant Discontinuation SymptomsThe critical distinction between withdrawal and relapseThe truth about psychiatric drug withdrawalHow to design better research that reflects real-world experiencesWhy this information is often not reaching cliniciansHow we can conduct research that can better inform patient supportDr. Horowitz’s story is one of courage and insight. As a clinician, he had no idea how wrong the guidelines were, until he tried coming off medication himself. What he discovered was far more complex than anything he’d been taught.To those navigating psychiatric medication withdrawal — especially in the face of oversimplified headlines and a healthcare system not yet equipped to support you — our hearts go out to you. You deserve care that is informed, compassionate, and grounded in lived experience as well as science. We won’t stop until you have this.Expert Featured:Dr. Mark HorowitzX: @markhoroWebsite: https://markhorowitz.org/Resources Mentioned:Incidence and Nature of Antidepressant Discontinuation Symptoms A Systematic Review and Meta-Analysishttps://jamanetwork.com/journals/jamapsychiatry/article-abstract/28362623 Long-Term Psychiatric Medication Studieshttps://www.biologicalpsychiatryjournal.com/article/S0006-3223(98)00126-7/abstracthttps://journals.lww.com/intclinpsychopharm/abstract/2002/09000/discontinuation_symptoms__comparison_of_brief.2.aspxhttps://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/interruption-of-selective-serotonin-reuptake-inhibitor-treatment/F0241958CB073C51F366E2AABE636B5DOutro Clinichttps://www.outro.com/The Maudsley Desprescribing Guidelines: Antidepressants, Benzodiazepines, Gabapentinoids and Z-drugs