Depression is one of the most prevalent illnesses in France, with one in five people experiencing a depressive episode in their lifetime, according to the French National Authority for Health. For those who improve after treatment, a critical question arises: how to safely stop antidepressant medication? A major new study provides crucial guidance.
Navigating the End of Treatment
While doctors have decades of experience in prescribing antidepressants, the process of discontinuing them has been fraught with uncertainty. Should treatment continue indefinitely? Should it be stopped suddenly or gradually? These questions represent a significant medical challenge for patients in remission.
A comprehensive review, published in The Lancet Psychiatry on December 11, 2025, analyzed 76 clinical trials involving 17,379 participants to compare these options. Led by researchers Giovanni Ostuzzi and Debora Zaccoletti, the study offers evidence-based answers affecting thousands.
The Winning Combination: Gradual Tapering and Psychological Support
The central finding is clear: a patient whose antidepressant is gradually tapered does not have a higher risk of relapse than one who continues treatment, provided they have concurrent psychological support. This approach is as effective as ongoing medication for preventing relapse and is superior to a sudden or rapid discontinuation.
“In depression in remission, a progressive reduction of antidepressants associated with psychological support is as effective as continuing treatment to prevent relapses and superior to a sudden or rapid stop,” the study states.
The worst option, researchers emphasize, remains an abrupt halt to medication. The study also notes that for anxiety in remission, despite similar findings, a lack of robust data calls for caution against broad generalization.
The Emerging Concept of “Deprescribing”
This research bolsters the growing concept of “deprescribing”—a deliberate, clinical process of reducing or stopping medication. However, awareness of this practice remains inconsistent.
“Throughout my residency, which I completed very recently, this subject was never addressed in teaching,” French psychiatrist Maeva Musso, president of the Association of Young Psychiatrists and Young Addictologists, told AFP.
Christine Villelongue, co-president of the association France Dépression, highlighted a systemic gap. “As soon as you change or reduce an antidepressant, it’s a source of anxiety for the person concerned, and there is no framework: very often, when you stop, there is no follow-up,” she said.
A Gap Between Evidence and Practice
The study’s recommendations advocate for individualized deprescribing with structured support. Yet, experts point to a stark reality in France’s healthcare landscape.
Villelongue noted that other countries, like Norway and the Netherlands, are more advanced, offering dedicated deprescribing consultations or authorizing micro-doses for very gradual reduction. In France, she insists, a “shortage” of caregivers makes such psychological support an unrealistic option for many patients.
“The conclusions of The Lancet Psychiatry are in an ideal world, but the reality on the ground is not that,” she judged.
The Broader Context of Mental Health in France
Mental health has been declared a national priority. Recent data from Santé Publique France indicates 16% of adults experienced a major depressive episode in 2024, and one in twenty had suicidal thoughts. Significant inequalities persist, with higher rates among women, young people, and those in financial difficulty.
Study author Debora Zaccoletti concluded, “Even if antidepressants are effective in preventing depressive relapses, nothing obliges us to make it a long-term treatment for everyone.”
The research underscores that the path to stopping medication is not merely pharmacological. As German psychiatrist Jonathan Henssler noted in an accompanying commentary, the findings highlight “the additional benefit provided by psychotherapy”—a component that remains out of reach for too many within the current system.
