The murky perils of quitting antidepressants

Victoria Toline would hunch over the kitchen table, steady her hands and draw a bead of liquid from a vial with a small dropper. It was a delicate operation that had become a daily routine — extracting ever tinier doses of the antidepressant she had taken for three years, on and off, and was desperately trying to quit.

“Basically that’s all I have been doing — dealing with the dizziness, the confusion, the fatigue, all the symptoms of withdrawal,” said Toline, 27, of Tacoma, Washington. It took nine months to wean herself from the drug, Zoloft, by taking increasingly smaller doses.

“I couldn’t finish my college degree,” she said. “Only now am I feeling well enough to try to re-enter society and go back to work.”

Long-term use of antidepressants is surging in the United States, according to a new analysis of federal data by The New York Times. Some 15.5 million Americans have been taking the medications for at least five years. The rate has almost doubled since 2010, and more than tripled since 2000.

Nearly 25 million adults, like Toline, have been on antidepressants for at least two years, a 60 percent increase since 2010.

The drugs have helped millions of people ease depression and anxiety, and are widely regarded as milestones in psychiatric treatment. Many, perhaps most, people stop the medications without significant trouble. But the rise in longtime use is also the result of an unanticipated and growing problem: Many who try to quit say they cannot because of withdrawal symptoms they were never warned about.

Some scientists long ago anticipated that a few patients might experience withdrawal symptoms if they tried to stop — they called it “discontinuation syndrome.” Yet withdrawal has never been a focus of drugmakers or government regulators, who felt antidepressants could not be addictive and did far more good than harm.

The drugs initially were approved for short-term use, following studies typically lasting about two months. Even today, there is little data about their effects on people taking them for

RUTH FREMSON / THE NEW YORK TIMES Victoria Toline needed nine months in 2014 to taper off the drug Zoloft. Many people on antidepressants quit without much trouble, but withdrawal reactions are a common problem and have contributed to soaring rates of long-term antidepressant use. “I...