RELEASE: REdressing Long-tErm Antidepressant uSE

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$\scriptsize\textsf{Research Lead: Professor Katharine Wallis.}\\ \scriptsize\textsf{Commonwealth Department of Health, Medical Research Future Fund, Clinician Researchers Applied Research in Health - MRFAR000079.}\\ \scriptsize\textsf{National Health and Medical Research Council (NHMRC) 2021 Partnership Projects PRC3 - 2015744.}\\ \scriptsize\textsf{The University of Queensland Human Research Ethics Committee approval: 2022/HE001667. medical-school.uq.edu.au/release}$

This website contains information about antidepressants and how to stop antidepressants by slow hyperbolic tapering of dose over time (usually months) which helps to minimise antidepressant withdrawal symptoms.

The website includes the RELEASE resources which have been co-designed with people with lived experience of long-term antidepressant use and GPs. The resources include tapering plans for 15 of the most commonly prescribed antidepressants, including ‘slower’, ‘even slower’ and ‘faster’ versions.

The RELEASE resources have been officially recognised as an Accepted Clinical Resource by The Royal Australian College of General Practitioners.

For patients: We recommend that you share and discuss the RELEASE resources with your doctor. The information in the RELEASE resources is not medical advice. The RELEASE resources have been designed to help your doctor to help you.

RELEASE resources

The RELEASE 3As brief intervention

This brief intervention has been designed for GPs to use in practice to prompt and support a discussion with people who have been taking antidepressants for longer than 12 months, for example when these patients present requesting a repeat prescription.

Ask
- How long have you been taking antidepressants?
- Have you ever tried to stop antidepressants? How did this go?
Advise
- Long-term antidepressant use is not harmless. Adverse effects include emotional numbing, lethargy & fatigue, weight gain, low libido and difficulty reaching orgasm, and in older age increased risk of falls.
- Long-term antidepressant use is not recommended for most people.
- Depression is not a long-term condition caused by a chemical imbalance in the brain. The ‘serotonin deficiency’ theory is not grounded in science.
- Antidepressant withdrawal symptoms are common and can be severe, yet are readily mistaken as relapse or ongoing need for medication.
Assist
- Provide information brochures and the decision aid
- Provide a tapering plan that includes practical step-by-step guidance for slowly decreasing drug dose and accessing antidepressant mini doses
- Provide a prescription for compounded capsules of mini doses (if this option is chosen)

Documentaries and webinars

Deprescribing antidepressants and managing withdrawal – Prof Katharine Wallis
How to safely taper off antidepressants - developing resources for patient use – BJGP Life podcast (14:28)
Antidepressant long-term use and withdrawal – BJGP Open, Prof Katharine Wallis, YouTube (0:57)
Maudsley Deprescribing Guidelines - public lecture – Prof Katharine Wallis and Dr Mark Horowitz, YouTube (10:12-60:00)
The Antidepressant Story – ABC Four Corners (45:00)
Are too many of us taking antidepressants? - ABC Life Matters (20:00)
The difficulty of deprescribing antidepressants - ABC Health Report (09:00)
The myth of low-serotonin and antidepressants – YouTube (30:02)
Antidepressant withdrawal syndrome and its management – YouTube (54:08)
Why we need to talk about antidepressant withdrawal – Full Story podcast – The Guardian Australia (22:36)
LEAP for Prescribed Drug Dependence: Lived and professional Experience Advisory Panel – YouTube (5:15)
Antidepressant Withdrawal Australia 2025 - Lived Experience - YouTube (8:25)
Deprescribing psychotropics with Dr Mark Horowitz - Purple Pen Podcast (51:10)

RELEASE Instructional videos

eLearning module (login required)
Follow a RELEASE antidepressant tapering plan – Vimeo (2:04)
RELEASE 3As brief intervention: Ask, Advise, Assist – Vimeo (2:51)
Distinguishing withdrawal from relapse – Vimeo (2:27)

Clinical guidelines

Stopping antidepressants: At lower, go slower: Slowly decreasing drug dose can help to minimise withdrawal symptoms to enable people to successfully stop antidepressants.
Antidepressant therapy: non-drug interventions are recommended as first line, and only 6-12 months therapy for a single episode of major depression.

Supporting evidence

1 in 7 Australians are taking antidepressants. GPs prescribe 92% antidepressants.
Depression is not a long-standing condition caused by a chemical imbalance in the brain. The ‘serotonin deficiency’ theory is not grounded in science.
Long-term antidepressant use is not harmless.
Antidepressant withdrawal symptoms are common and can be severe.
Antidepressant withdrawal symptoms are frequently misconstrued as relapse but can be distinguished from relapse.

RELEASE team publications

Many people get withdrawal symptoms when they try to stop antidepressants. So how can you safely stop? – Prof Katharine Wallis, The Conversation, 2024
Acceptability and optimisation of resources to support antidepressant cessation: a qualitative think-aloud study with patients in Australian primary care – BJGP, 2023
Wallis KA, Donald M, Horowitz M, et al. RELEASE (REdressing Long-tErm Antidepressant uSE): protocol for a 3-arm pragmatic cluster randomised controlled trial effectiveness-implementation hybrid type-1 in general practice. Trials. 2023;24(1):615.
Horowitz M, Moncrieff J, Wallis KA. Antidepressant withdrawal should be taken seriously - we're investigating ways to help people come off the pills. The Conversation. 2023 March 16.
Lessons from the Netherlands for Australia: cross-country comparison of trends in antidepressant dispensing 2013–2021 and contextual factors influencing prescribing – Australian Journal of Primary Health, 2023
Antidepressants can cause withdrawal symptoms – here’s what you need to know – Dr Mark Horowitz, The Conversation, 2023
Horowitz MA, Taylor D. Tapering of SSRI treatment to mitigate withdrawal symptoms. Lancet Psychiatry. 2019;6(6):538-46.
How to help patients safely taper and withdraw from antidepressants– BJGP Life, 2023