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A large network meta-analysis in The Lancet Psychiatry found that gradual antidepressant tapering with psychological support prevented depression relapse as well as continued medication, and was superior to abrupt or rapid discontinuation.
Why It Matters To Your Practice
▪ Addresses safe deprescribinga growing need as patients seek to minimize long-term medication use.
▪ Offers robust comparative evidence to inform individualized discontinuation plans.
▪ Reinforces guideline recommendations for regular treatment reviews and patient-centered care.
▪ Highlights need for scalable psychological support in primary settings.
Clinical Benefits
▪ Slow tapering plus psychological support reduces relapse risk comparably to ongoing antidepressants.
▪ Superior to abrupt or rapid discontinuation, even when psychological support is present.
▪ Standard or reduced-dose continuation also protects against relapse.
▪ Tolerability is similar across strategies, supporting deprescribing safety.
Managing Risks
▪ Relapse risk rises with abrupt or unsupported discontinuation.
▪ Evidence for anxiety disorders is less robustcaution needed for this population.
▪ Resource constraints may limit access to structured psychological interventions.
▪ Monitor closely for withdrawal symptoms and emerging relapse during taper.
The Bottom Line
▪ Gradual, supported tapering is a safe, effective alternative to indefinite antidepressant use for many remitted depression patients.
▪ Update clinical protocols to prioritize individualized deprescribing with psychological support.
▪ Advocate for accessible, scalable psychological interventions to support deprescribing.
▪ See the full study: The Lancet Psychiatry: https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(25)00330-X/abstract
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