There is much about antidepressant withdrawal that requires on-going scientific investigation (it has been a neglected area of research at all), but there is little doubt in my mind that it is a serious problem that requires to be acknowledged & addressed without evasion. /1 https://twitter.com/christophlane/status/1321512059121651716

As an early-career psychiatrist in the US, what is striking to me is the disconnect between what I learned abt AD withdrawal during my training & what I learned abt AD withdrawal from the literature being shared & discussed on social media, often by patients & critics. /2

I am reminded of the 2018 New York Times story on AD withdrawal which prompted replies from several psychiatrists as letters to the editor. Some of these replies have not aged well, to say the least. /3 https://www.nytimes.com/2018/04/09/opinion/antidepressants.html

A letter signed by nearly 40 psychiatrists reads: "To practicing psychiatrists & the vast majority of patients, withdrawal is low on the list of priorities... although withdrawal has not been well studied, the clinical consensus is that it is real, rare and always treatable." /4

A question often does the rounds on social media, "what radicalized you?" I think repeated responses such as above are enough to radicalize patients experiencing several AD withdrawal, their families, and clinicians working with patients experiencing AD withdrawal. /5

Dr Pies noted in his letter that based on his experience "fewer than 10% will experience severe withdrawal symptoms when the AD dose is tapered over 3-6 months." I think that matches the experience of a lot of psychiatrists, but even 10% is A LOT considering that... /6

...14% of the US population is on ADs! IMO that makes it a matter of public health importance, something that should be prioritized by funders of psychiatric research. The new guidance by RCPsych in this regard is a very welcome development, and the continued silence from... /7

... professional organizations in the US is concerning. As clinicians it is our responsibility to take harm & suffering seriously. That we as a profession have been party to a decades-long neglect of this issue should prompt some serious self-reflection. /8