Clinical guidelines on antidepressant withdrawal urgently need updating

In February 2018 the international debate on antidepressant withdrawal was reignited.1-4 In response to a letter published in the Times by Davies et al on the benefits and harms of antidepressants,1 the Royal College of Psychiatrists publicly stated that, “[for] the vast majority of patients, any unpleasant symptoms experienced on discontinuing antidepressants have resolved within two weeks of stopping treatment.”2 To support this claim the college referred to guidelines from the National Institute for Health and Care Excellence (NICE), which state that “[withdrawal] symptoms are usually mild and self-limiting over about 1 week.”5 When Davies et al issued a freedom of information request to NICE asking for the evidence for its one week claim NICE was able to provide only two short review articles, neither of which supports the one week claim, although both cite numerous sources that contradict it.6 We think that NICE’s current position on antidepressant