Antidepressant withdrawal effects and how to safely stop them: The Maudsley Deprescribing Guidelines approach

Antidepressant withdrawal effects and how to safely stop them: The Maudsley Deprescribing Guidelines approach

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In this TI Best Evidence webinar, Dr. Mark Horowitz presented the Maudsley Deprescribing Guidelines approach to deprescribing antidepressants and shared insights about distinguishing between the withdrawal effects resulting from stopping antidepressants and the relapse of underlying conditions. He also described the method of hyperbolic tapering to stopping antidepressants.

TITLE: Antidepressant withdrawal effects and how to safely stop them: The Maudsley Deprescribing Guidelines approach

SPEAKER: Dr. Mark Horowitz

WHEN: Wednesday, May 8th, 2024 at 12:00-01:00 PM PDT [convert to your local time]

WHERE: This is a free online event.

CME CREDITS: MainPro+/MOC Section 1 credits: 1.0Those who registered, attended the webinar and completed the evaluation will receive their certificate.


LEARNING OBJECTIVES

By the end of this presentation, participants will be able to:

  1. Identify when, why and in whom to stop antidepressants;
  2. Describe the risks of stopping these medications too quickly;
  3. Be able to distinguish between withdrawal effects from these drugs and relapse of an underlying condition;
  4. Be able to apply hyperbolic tapering to stopping these medications, adjusted to the individual patient.

About the speaker: Dr. Mark Horowitz MBBS, PhD is a Clinical Research Fellow in Psychiatry in the UK National Health Service, a Visiting Lecturer at King’s College London and a training psychiatrist. He has a PhD from the Institute of Psychiatry, Psychology and Neuroscience at King’s College London in the neurobiology of depression and antidepressant action. He is the lead author of the Maudsley Deprescribing Guidelines and an associate editor of the journal Therapeutic Advances in Psychopharmacology. Dr. Horowitz co-authored the recent Royal College of Psychiatry guidance on ‘Stopping Antidepressants’ in the UK, and his work informed the recent NICE guidelines on safe tapering of psychiatric medications, including antidepressants, benzodiazepines and z-drugs. He has been commissioned by Health Education England to prepare a teaching module on how to safely stop antidepressants. He is a collaborating investigator on the RELEASE clinical trial in Queensland examining hyperbolic tapering of antidepressants. Dr. Horowitz has written several papers about safe approaches to tapering psychiatric medications including publications in The Lancet Psychiatry, JAMA Psychiatry and Schizophrenia Bulletin. He has an interest in rational psychopharmacology and deprescribing psychiatric medication, having experienced the difficulty of coming off psychiatric medications first hand, which has informed much of his work.

1 Comment
  • Antony David Sangster
    Posted at 05:22h, 03 December Reply

    I have just seen your online discussion with other members of a panel in Adelaide today, 3/11/2024. As a retired doctor with now 58 years lived experience of Type One Diabetes and much of that time battling depression – my research and lived experience in withdrawing partially off anti-depressants (20 mg desvenalfaxine –> 1/2 x 50mg was eased by use of a a very low, ketogenic diet – this was over 4 weeks and no side-effects – I am biding my time to make the final step. There are now a number of nutritional or metabolic psychiatrists who whilst still prescribing medications will use a variety of low carb, paleo or very low ketogenic diets to manage patients initially with diet and if medication is already prescribed will attempt to use diet in conjunction with a graded withdrawal – de-prescription of medication. e.g. see video: presentations by Dr Georgia Ede or Dr Christopher Palmer. Dr David Unwin is a GP in northern England who pioneered a low carb diet in his practice for patients with T2D now reporting in its 9=th year (( e.g. video: 9 years in Norwood) His research has prompted RCGP to use low carb prescribing as part of CME. I am certain a discussion with David could provide you with much information and about how many of his patients also gained improvement in their mental health status and what de-prescription of anti-depressants may or may not have occurred.(Therapeutic Carb Reduction/Restriction is the Australian, NZ , Canadian and US acronym See Dr Phinney’s 2022; The Realities of Nutritional ketosis apprise 1 hr plus Q&A or video; 2018; Troubleshooting the ketogenic diet for optimal weight and health 59 mins and the chart at the end depicting what health con editions can also be improved by very low ketogenic diet,
    Another ‘straight-shooter’ is Dr Westman -video; 37m 16s: 2019: Keto-Medicine: the art of carbohydrate restriction. Best Wishes in your journey.

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