Exposing the Lie That Antidepressant Withdrawal Symptoms Are Mild and Short-Lived

Exposing the Lie That Antidepressant Withdrawal Symptoms Are Mild and Short-Lived
by Peter C. Gøtzsche at Brownstone Institute

The house of cards of mainstream psychiatry is coming closer to falling. Increasingly, patients and their relatives, and even an atypical journalist, are becoming aware that the psychiatric leaders have systematically lied to them. 

One of the big and very harmful lies is that it is rarely a problem for patients to stop taking an antidepressant. On 9 July 2025, a systematic review was published in JAMA Psychiatry that claimed that antidepressant withdrawal is not a problem.¹ The authors even postulated that depression after discontinuation is indicative of depression relapse.

Psychiatrists virtually always mistake withdrawal symptoms for relapse. All the studies Maryanne Demasi and I included in our systematic review of interventions to help patients withdraw from depression drugs confounded withdrawal symptoms with relapse.² 

Abstinence Depressions

I invented the term “abstinence depression” for withdrawal symptoms that mimic a depression.³ It is a depression that occurs in a patient who is not currently depressed but whose drug is stopped abruptly or over a few weeks. Its hallmark is that the depression symptoms come quickly (depending on the half-life of the drug or its active metabolites) and disappear within hours when the full dose is resumed. Reintroducing the drug can therefore be regarded as a diagnostic test separating an abstinence depression from a true depression, which does not respond promptly to a depression pill.

A cold turkey trial showed the difference very clearly.⁴ Patients who were well suddenly had their maintenance therapy changed to a double-blind placebo for 5-8 days at a time unknown to them and their clinicians. The authors’ criteria for depression were fulfilled for 25 of those 122 patients who were on sertraline or paroxetine. I worked out,⁵ based on a study of 362 high school students who had experienced one or more episodes of depression,⁶ that the expected number of patients relapsing in such a short time interval was zero. 

Garbage in, Garbage out Review

The JAMA Psychiatry review was a dangerously misleading garbage in, garbage out review.⁷ The paper lists more drug company payments to the authors than their number of references to scientific papers,⁸ which was 47.¹ The authors mobilised a rapid media campaign to shape the public narrative, with the Science Media Centre issuing expert commentary to “reassure both patients and prescribers” that most withdrawal symptoms were “not clinically significant.”⁷

The Science Media Centre has a very bad reputation. It promotes corporate views of science and is partially funded by corporations and industry groups whose products the Centre often defends.^8,9

The review included 50 studies involving 17,828 patients. Among its many blatant methodological flaws, the review didn’t assess symptom severity and it followed patients for just two weeks even though many patients report that symptoms don’t emerge until after that timeframe.⁸

Furthermore, the review relied on short-term drug company studies of just some weeks, which contrasts with the millions of people worldwide who are on these drugs for many years.⁸ The median duration of antidepressant use in the United States is approximately 5 years.¹⁰

Such studies are bound to grossly underestimate the true incidence and severity of antidepressant withdrawal effects. Length of treatment is obligatory information in scientific papers, but nowhere in the article did the authors reveal that the studies they reviewed were short-term studies. 

An expert on drug withdrawal, psychiatrist Mark Horowitz from the UK, wrote that “Studying what happens to people after just eight to 12 weeks on antidepressants is like testing car safety by crashing a vehicle into a wall at 5km/h – ignoring the fact that real drivers are out on the roads doing 60km/h.”¹¹

Ask the Patients and not Psychiatrists on Industry Payroll

A 2019 systematic review by James Davies and John Read showed that half of the patients experience withdrawal symptoms; half of those with symptoms experience the most extreme severity rating on offer; and some patients experience withdrawal for months or even years.¹² A survey of 580 people included in their review reported that in 16% of the patients, the withdrawal symptoms lasted for over 3 years.

In 2025, these authors and colleagues reported that 38% of the participants in their survey had been unable to stop their antidepressant; 10% reported withdrawal symptoms lasting more than a year; and those who had used antidepressants for over 24 months prior to stopping were far more likely to experience a withdrawal syndrome, report severe withdrawal effects, report longer lasting symptoms, and be less likely to be able to stop than those using the drugs for less than six months.¹³

Awais Aftab, a Useful Figure for Mainstream Psychiatry 

Two days after the JAMA Psychiatry review came out, psychiatrist Awais Aftab tried to defend it and to cast doubt on a much better review¹² of what the patients experience in clinical practice that told a story of serious drug harm.

Aftab claimed that the symptom burden related to withdrawal for the average user of antidepressants is quite modest,¹⁴ which is clearly wrong. He furthermore called the review by Davies and Read¹² “very methodologically-problematic” and opined that their figures were “obviously highly-inflated,” but did not explain why. 

Aftab wrote that Henssler et al. demolished the estimates of Davies and Read in a meta-analytic review, which he considered provided “the most rigorous estimates currently available,” again without explaining why. 

Interestingly, in their 2025 survey,¹³ Davies and Read explained why the Henssler review¹⁵ is unreliable. Most of the included studies were not designed to assess withdrawal effects but relied on spontaneous reporting. Furthermore, the weighted average duration of drug use was only 25 weeks.

In an interview four months earlier, Aftab said that “antidepressants are not addictive, because people don’t get high.”¹⁶ If this were true, it would be great news for smokers. As they don’t get high by smoking, nicotine is not addictive and they could easily stop smoking, right?

Aftab noted in the interview that about half of depressed people who try one or several antidepressants ultimately respond well. It seems, also based on another article,¹⁷ that Aftab believes in the results from the STAR*D trial, where the patients tried several drugs if the first ones were not successful. This trial is fraudulent in the extreme,^3,18 and most or all the more than 100 publications about it should be retracted.

Aftab opined that the ANTLER withdrawal trial, which was published in the New England Journal of Medicine,¹⁹ the journal most favoured by the drug industry, was “rigorous and high-quality.”¹⁴ It isn’t. Demasi and I explained in our systematic review of withdrawal studies that the tapering regime was inappropriate.² The study reported increased risk of relapse, but this was after a short tapering regimen where the drug was discontinued at a dose corresponding to high receptor occupancy, introducing a high risk of confounding relapse with withdrawal symptoms. Moreover, the results were reported selectively, as only results after 12 weeks in the 52-week study were described in the text. These results favoured continuation with the drug, in contrast to the 52-week results. Thus, the trial report told a false story about patients still needing to take their drug. 

When psychiatry professor Joanna Moncrieff and colleagues recently exposed the hoax about depression being caused by a chemical imbalance in the brain, Aftab called her a “contrarian.”²⁰ Aftab, a biological psychiatrist, involuntarily revealed that biological psychiatry is a pseudoscience. He put forward unsubstantiated speculations and hid behind pompous mumbo jumbo with no meaning and no testable hypotheses. Moncrieff exposed this in her article, “Wishful thinking dressed up in scientific terminology: a reply to Awais Aftab.”²⁰ 

Robert Whitaker, the founder of the Mad in America website, has explained that Aftab has staked out a position as being open-minded to critiques of psychiatry, which is a public stance that makes him particularly valuable to his profession.¹⁷ He can serve as a defender of psychiatry against critiques that are truly threatening, and his criticisms will be seen as coming from someone who is open-minded about psychiatry’s flaws. Whitaker demonstrated that Aftab, “in his criticism of us, is seeking to protect psychiatry’s narrative of progress – a narrative that arises from psychiatry’s guild interests, and not a faithful record of its own research literature.”

Other Reactions to the JAMA Psychiatry Review

A BMJ news headline, “Most people have no severe withdrawal from antidepressants, large review finds,”²¹ is misleading. Its first sentence is equally misleading: “Most people do not experience severe withdrawal when discontinuing antidepressants, and clinical guidelines should be updated to reflect this, say the UK authors of the largest review of the evidence to date.”

Large is not synonymous with quality. Most often, a review of many trials reflects a garbage in, garbage out exercise. The rapid responses to the BMJ news item were more truthful. 

On the blog Sensible Medicine, John Mandrola wrote under the headline, “Good News in Psychiatry,” that “Concern over withdrawal of antidepressant is common. A new study suggests this concern is not supported by empirical data.”²² 

Mandrola finds it “remarkable that something that induces huge amounts of worry (antidepressant withdrawal) was not borne out when studied systematically.

This phenomenon – of things thought but not confirmed empirically – is one of the driving forces of Sensible Medicine. This study-of-the-week supports the clear benefits of empirical study, especially of commonly-held beliefs.”

Whether called empirical data or not, garbage is still garbage. And asking patients of their experiences is also empirical data. There is an abundance of data that tell us a totally different story of millions of patients in despair because they cannot come off their drug.

History is repeating itself. The psychiatrists denied for decades that benzodiazepines could cause dependence.²³ And now they have denied for over 50 years that antidepressants can cause dependence.

There were some interesting comments in The Canary.²⁴ Horowitz noted that if the JAMA Psychiatry review influenced guidelines, which its authors wanted, “psychiatrists will fail to spot withdrawal because they’ll be educated that it’s not something to look out for, they’ll think that everybody is relapsing, that they’re experiencing a return of their anxiety or depression, they won’t manage people carefully by taking them off the drugs, so they’ll cause a lot of harm…So, if people are already struggling, they end up having to rely on friends and family to support them. And the truth is, people take their own lives because they are so disabled by their symptoms and on top of it, they can’t get financial support.”

Horowitz pointed out the similarities to other areas. When people are defending a commercial status quo, such as cigarettes or fossil fuels, they start by denying that the issue exists. Then, when more data accumulate and the facts become harder to deny, they slow it down by introducing doubt. The idea is to complicate the issue to slow down action. A 

bunch of academics in the UK have made careers and millions of pounds off telling the public that the drugs are safe, effective, and easy to stop, so they’re trying very hard to save face and cover what makes them look culpable.

James Davies said that many academics, clinicians, and service users are deeply concerned about the implications of the review, which dangerously downplays the existence of antidepressant withdrawal. Worryingly, the review aligns with longstanding pharmaceutical industry narratives that minimise harms. 

The Bottom Line

The bottom line is that over 100 million people worldwide are on depression pills; about 50 million will experience withdrawal reactions when they try to stop, and in 25 million, the symptoms are severe. It is shameful that leading psychiatrists are still willing to turn a blind eye to the disaster they have created. I often wonder why these people became doctors when they are so unwilling to listen to their patients. 

References

1 Kalfas M, Tsapekos D, Butler M, et al. Incidence and nature of antidepressant discontinuation symptoms: a systematic review and meta-analysis. JAMA Psychiatry 2025;Jul 9:e251362.

2 Gøtzsche PC, Demasi M. Interventions to help patients withdraw from depression drugs: A systematic review. Int J Risk Saf Med 2024;35:103-16.

3 Gøtzsche PC. Is psychiatry a crime against humanity? Institute for Scientific Freedom 2024 (freely available).

4 Rosenbaum JF, Fava M, Hoog SL, et al. Selective serotonin reuptake inhibitor discontinuation syndrome: a randomised clinical trial. Biol Psychiatry 1998;44:77-87.

5 Gøtzsche PC. Critical psychiatry textbook. Copenhagen: Institute for Scientific Freedom; 2022: page 115 (freely available).

6 Lewinsohn PM, Clarke GN, Seeley, et al. Major depression in community adolescents: age at onset, episode duration, and time to recurrence. J Am Acad Child Adolesc Psychiatr 1994;33:809-18.

7 Demasi M. Antidepressant withdrawal—why do researchers keep downplaying it? Substack 2025;July 11.

8 Read J. Grossly flawed paper denies that antidepressant withdrawal effects are “clinically meaningful.” Mad in America 2025;July 19.

9 Malkan S. Science Media Centre promotes corporate views of science. US Right to Know 2023;Nov 2.  

10 Ward W, Haslam A, Prasad V. Antidepressant trial duration versus duration of real-world use: a systematic analysis. Am J Med 2025;May 3:S0002-9343(25)00286-4.

11 Horowitz MA. Review underestimates antidepressant withdrawal effects by relying on short-term studies. BMJ 2025;July 12. 

12 Davies J, Read J. A systematic review into the incidence, severity and duration of antidepressant withdrawal effects: Are guidelines evidence-based? Addict Behav 2019;97:111-21.

13 Horowitz MA, Buckman JEJ, Saunders R, et al. Antidepressants withdrawal effects and duration of use: a survey of patients enrolled in primary care psychotherapy services. Psychiatry Res 2025;350:116497.

14 Aftab A. Playing whack-a-mole with the uncertainties of antidepressant withdrawal. Psychiatry at the Margins 2025;July 11.

15 Henssler J, Schmidt Y, Schmidt U, et al. Incidence of antidepressant discontinuation symptoms: a systematic review and meta-analysis. Lancet Psychiatry 2024;11:526-35.

16 Rosen M, Sanders L. 6 things to know about antidepressants. Science News 2025;March 11. 

17 Whitaker R. Answering Awais Aftab: when it comes to misleading the public, who is the culprit? Mad in America 2023;April 6.

18 Pigott HE, Kim T, Xu C, et al. What are the treatment remission, response and extent of improvement rates after up to four trials of antidepressant therapies in real-world depressed patients? A reanalysis of the STAR*D study’s patient-level data with fidelity to the original research protocol. BMJ Open 2023;13:e063095.

19 Lewis G, Marston L, Duffy L et al. Maintenance or discontinuation of antidepressants in primary care. N Engl J Med 2021;385:1257–67.

20 Moncrieff J. Wishful thinking dressed up in scientific terminology: a reply to Awais Aftab. 

21 Wise J. Most people have no severe withdrawal from antidepressants, large review finds. BMJ 2025;390:r1432.

22 Mandrola J. Good news in psychiatry. Sensible Medicine 2025;July 14.

23 Nielsen M, Hansen EH, Gøtzsche PC. Dependence and withdrawal reactions to benzodiazepines and selective serotonin reuptake inhibitors. How did the health authorities react? Int J Risk Saf Med 2013;25:155-68.

24 HG. Big pharma-funded psychiatrists ‘cosplaying science’ in misleading antidepressant withdrawal study. The Canary 2025;July 13. 

Exposing the Lie That Antidepressant Withdrawal Symptoms Are Mild and Short-Lived
by Peter C. Gøtzsche at Brownstone Institute – Daily Economics, Policy, Public Health, Society