We thank Hayes and Jauhar for blogging about our recently published systematic review about withdrawal from antidepressants thereby keeping the spotlight on a vitally important issue impacting millions of people around the world.
After decades of silence and minimisation any discussion that maintains public attention is invaluable.
We now invite them to do what is customary in any serious academic debate and submit their blog critique to the journal in which we published, Addictive Behaviors. This way their critique can be properly peer-reviewed, and we can respond to each of their points in the appropriate place and manner, especially because we take serious issue with many of the arguments they raise.
While we disagree with many of their arguments, we do accept, as we did in the review, that some of the 24 studies reviewed had important limitations, as did our best efforts to integrate studies using such varied methodologies.
The fact that there was not more and better research for us to review speaks volumes about whether the prescribing professions have taken the issues seriously. In particular, many of RCT studies employed treatment durations and follow-up protocols that may significantly underestimate withdrawal incidence and duration.
Hayes and Jauhar seem particularly concerned about whether our inclusion of surveys may have biased our estimates that 56% experience withdrawal symptoms when coming off and 46% of those describe them as severe.
We readily concede, as we did in the review, that our estimates are indeed estimates, based on the best available evidence. They may be off by 5% or even perhaps as much as 10%, lower or higher.
Nevertheless, even the most conservative estimate of 46% experiencing withdrawal, and 36% of those at the severe level, would represent a public health issue of significant proportions.
While waiting for the prescribing professions to conduct better studies we hope that all concerned, including those guilty of denial and minimisation in the past, can now work together to acknowledge what thousands of people with direct experience have been trying to tell their doctors for years, to provide full information to people contemplating starting antidepressants, and to lobby for support for the millions trying to withdraw from them.
Dr James Davies & Professor John Read