Deprescribing antidepressants for depression – what is the evidence for and against?

Objective: Recent guidelines suggest that the overall quantity and duration of antidepressant prescriptions should be reduced. In this paper, we comment on the evidence both for and against this view. 

Methods: We critically review the arguments proposed by proponents of antidepressant deprescribing in the context of the evidence-base for the treatment of depression. 

Results: Proponents of deprescribing do not address the substantive issues of whether inappropriate prescribing has been demonstrated, and when prescribing is needed. Their arguments for deprescribing are rebutted in this context. 

Conclusions: Whether or not to deprescribe antidepressant medication needs to take into consideration the risk-benefit profile of the decision, the responsibility for which needs to be shared and based on the context of the patient’s depression, their preferences, experiences and perspectives.