Overview
- The network meta-analysis pooled 76 randomized trials involving 17,379 adults in remission and followed participants for about 10–11 months.
- Gradual dose reduction paired with psychological support prevented relapse to a similar extent as continuing standard-dose medication and could avert one relapse in five compared with abrupt or fast stopping.
- Abrupt discontinuation or rapid tapering produced the highest relapse risk, with relapse approaching 40% after stopping suddenly.
- Across strategies, adjunct psychological support improved outcomes, while reporting on withdrawal symptoms, quality of life and longer-term effects was limited.
- Authors urge updated clinical guidance and scalable brief therapies, noting weaker evidence for anxiety disorders and widespread antidepressant use such as nearly nine million users in England last year.