Stopping antidepressants can lead to withdrawal complaints. Tapering strips are a tool to prevent these complaints. Researchers Prof. Jim van Os & Dr. Peter Groot investigated how a client can gradually and safely taper antidepressants using tapering strips.
More than a million people in the Netherlands use antidepressants, medicines that are sometimes prescribed for depression and anxiety disorders. Stopping antidepressants can be a problem because reducing dosage too quickly can lead to withdrawal complaints. To prevent these problems, it is important to taper gradually. Until now, this has been almost impossible to achieve. Tapering strips offer a solution. Researchers from the UMC Utrecht have now investigated for the first time how many steps and how gradually a patient should taper using tapering strips.
Tapering strips are a series of connected bags, each containing the medication dose for one day. As a result, the strips make it possible to reduce the dose in daily steps. Jim van Os, professor of psychiatry, explains: “The taper is hyperbolic. This means that the steps by which the dose is reduced become smaller and smaller as the dose is lowered. It’s like a playground slide: it becomes less and less steep towards the end, so that people can come down safely without shocks.”
Tapering strips make it possible to reduce the dose in daily steps.
Jim: “In the context of ‘deciding together’, the prescriber and patient can decide in consultation at what rate they will reduce the medication with the help of tapering strips. Tapering strips allow for a tailor-made tapering schedule.”
For the study, the researchers followed more than 600 patients for 1 to 6 months. They saw that the ‘hyperbolic’ and tailor-made tapering led to fewer withdrawal complaints over the entire tapering period (see Results box). Jim explains: “The more gradual the reduction was, the fewer complaints we saw.” Some other factors also appeared to influence withdrawal difficulty. Women and young people were more likely to suffer from withdrawal symptoms. Jim: “Prescribers can respond to this by offering even better tailor-made tapering schedules in consultation with the patient.”
The results of the study are in line with previous tapering strip studies. These studies showed that tapering strips are effective, even in patients who had previously attempted tapering and failed. People who stopped taking antidepressants after using tapering strips in the majority of cases did not start using them again. Jim is optimistic about the future: “Our research suggests that tapering can help a majority of clients to successfully stop using an antidepressant. Even after years of use and after one or more previous failed attempts to quit.”
