Slow tapering plus psychological support as effective as antidepressant continuation and better than abrupt discontinuation
TUESDAY, Dec. 16, 2025 (HealthDay News) — Slow tapering plus psychological support seems as effective as antidepressant continuation for preventing relapse in remitted depression and is better than abrupt or rapid discontinuation, according to a study published online Dec. 10 in The Lancet Psychiatry.
Debora Zaccoletti, Psy.D., from the University of Verona in Italy, and colleagues conducted a systematic review and meta-analysis to compare the effectiveness of different deprescribing approaches in individuals with clinically remitted depression or anxiety. Randomized controlled trials comparing abrupt discontinuation, fast tapering (≤4 weeks), slow tapering (>4 weeks), dose reduction (≤50 percent of the minimal effective dose), or continuation, with or without psychological support, were included in the review. Overall, 76 trials (79 percent investigated depression and 21 percent investigated anxiety) with 17,379 participants were included.
The researchers found that continuation at the standard dose plus psychological support, continuation at the standard dose, slow tapering plus psychological support, and continuation at a reduced dose outperformed abrupt discontinuation for relapse prevention (relative risks, 0.40, 0.51, 0.52, and 0.62, respectively). These strategies also outperformed fast tapering (point estimates varied from 0.39 to 0.52). No difference in relapse prevention was seen for fast tapering plus psychological support, abrupt stopping plus psychological support, and slow tapering alone compared with abrupt discontinuation.
“These findings highlight the need for clinical guidelines to be updated to promote regular treatment reviews and individualized deprescribing with gradual tapering and structured psychological support for patients with depression who are feeling better and wish to come off their medication,” Zaccoletti said in a statement.
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