Slow tapering with psychological support is just as effective as continuing antidepressants—and clearly safer than abrupt or rapid discontinuation—in preventing relapse among people whose depression is in remission. In this systematic review and network meta-analysis of 76 trials including 17,379 adults with remitted depression or anxiety, several strategies outperformed abrupt stopping: continuing antidepressants at a standard dose with psychological support, continuing at a standard dose alone, slow tapering with psychological support, and continuing at a reduced dose. These strategies also outperformed fast tapering. In contrast, fast tapering with psychological support, abrupt stopping with support, and slow tapering alone showed no clear benefit over abrupt discontinuation. Results were consistent across sensitivity and subgroup analyses, and tolerability was similar across approaches. Overall, the evidence supports gradual, supported tapering—rather than abrupt or rapid discontinuation—as a key component of safe, and individualized antidepressant deprescribing. Source: https://www.thelancet.com/
