Should I stop my antidepressant after reading this?

No. Stopping an antidepressant abruptly — or tapering too quickly — carries real risks: discontinuation syndrome (flu-like symptoms, dizziness, worsening mood) and, for people with recurrent major depression, a risk of relapse that can be more severe than the original episode. What this research raises is not 'should everyone stop' — it is 'should everyone on long-term antidepressants have a regular structured review of whether ongoing treatment is still appropriate?' The answer to that second question, per the AJGP evidence, is yes. If you want to review your antidepressant, the right place for that conversation is with your GP.

Are antidepressants prescribed too freely in Australia?

This is the question the AJGP June 2026 systematic review is directly addressing. The evidence suggests that the threshold for long-term continuation has drifted lower than clinical guidelines intend. Australian guidelines recommend antidepressants for six to twelve months in severe depression, then reassessment. In practice, about a third of long-term users continue without a clearly documented clinical indication — which suggests the reassessment step is frequently being skipped. Whether that constitutes overprescribing depends on individual cases. The systematic concern is the absence of review, not individual clinical judgment in specific circumstances.

AJGP June 2026: a third of long-term antidepressant users lack clear indication

What just happened

The AJGP June 2026 issue — the Royal Australian College of General Practitioners’ peer-reviewed journal, released this month under the theme When less is more — includes a systematic review titled “Continuing antidepressants or not: Evaluating the potential benefits and harms”. The finding: there is little evidence of benefit in continuing antidepressants beyond twelve months, and there is documented evidence of harm.

The harms are not rare side effects in a small subset. They include lethargy or fatigue, weight gain, emotional numbing, and sexual dysfunction — effects that, in a population of long-term users, occur at frequencies that matter clinically.

About one in seven Australians is currently taking an antidepressant. Of those, approximately a third continue for more than a year. And of that long-term group, a third have no clearly documented clinical indication for ongoing treatment — what researchers describe as a “set-and-forget” prescribing pattern.

If that description sounds like your situation — or someone you care for — this piece is worth reading carefully.

The both-and

Antidepressants are genuinely useful medicines with a clear evidence base in severe depression. The concern is not with the medicines themselves. The concern is with the systematic absence of the review step that guidelines specify.

When antidepressants make sense

The clinical evidence for antidepressants in acute, moderate-to-severe major depressive disorder is solid. The AJGP review acknowledges clinically meaningful response rates above placebo in this population. For the person in the middle of a severe depressive episode — unable to function, unable to sleep, unable to see forward — antidepressants are a legitimate and sometimes lifesaving intervention.

The clinical guidelines are clear: Australian-aligned guidance recommends antidepressant treatment for six to twelve months in severe depression after the acute episode resolves, to consolidate remission and reduce relapse risk. That is the evidence base. That is the timeline the evidence supports.

Off-label use in anxiety, chronic pain, and sleep has expanded the prescribing landscape further — some of it justified, some of it with limited high-quality efficacy data. Low-dose tricyclic use in pain pathways, for example, persists despite limited evidence and cumulative adverse effect burden in older adults. These are the populations where the “set-and-forget” pattern is most entrenched, and where the harm burden is highest.

Where the evidence runs out

Beyond twelve months, the evidence thins considerably. Continuation studies show lower relapse rates in people who stay on antidepressants versus those who stop — but these studies have a persistent methodological problem. Most compare abrupt discontinuation against continuation, rather than structured tapering against continuation. Abrupt discontinuation carries its own relapse risk from withdrawal effects, which inflates the apparent benefit of continuation. The design is not neutral.

What is better characterised than the benefit is the harm profile of long-term use. Lethargy and fatigue in people who have already been through a depressive episode — which is itself exhausting — represent a compounded burden. Weight gain in a population where metabolic risk is already elevated adds another layer. Emotional numbing — the sense of being blunted, neither low nor fully present — is frequently reported and rarely documented in clinical notes as a reason to review the prescription.

Sexual dysfunction affects an estimated 30–40% of antidepressant users, varies significantly by drug class, and is systematically underreported because patients often do not raise it and clinicians often do not ask.

The prescribing pattern the data reveals

The MJA analysis of antidepressant prescribing in Australian general practice found that apparent dose reductions occurred in only 35% of long-term users, with little change over time — suggesting systematic absence of deprescribing activity at a population level. A cross-sectional analysis found that approximately a third of long-term users continue without a clearly documented clinical indication.

The AJGP June issue frames this as a “when less is more” problem. It is an important framing because the counter-narrative — antidepressants are underprescribed, not overprescribed — is also partially true, and in this space both things are simultaneously real.

The antidepressant that saves someone’s life in an acute depressive episode is not the same prescription, in the same clinical context, two years later. The question is not whether antidepressants have value. It is whether the reassessment step that guidelines specify is actually happening. The data says: frequently not.

2 cents

If you have been on an antidepressant for more than a year and cannot remember having a specific conversation with your GP about whether ongoing treatment is still the right fit — that is the conversation to have.

Not “should I stop” — the answer to that is with careful medical guidance, not abruptly, not alone. But “should I review”: yes. The AJGP evidence says yes.

If you are worried about raising it, bring this piece. “I read that the AJGP looked at this and found that a third of long-term users don’t have a current clinical indication. I’d like to talk about where I sit.” That is a legitimate clinical conversation that your GP should welcome.

This is general health information and does not constitute individual clinical advice.

Verdict

Verdict: yes — worth knowing about.

The AJGP systematic review is the clearest, most recent Australian primary-tier statement on the long-term antidepressant evidence base. It does not say stop. It says review. For a medicine that one in seven Australians is currently taking — in a country where the review step is demonstrably absent in roughly a third of long-term users — that is a clinically meaningful call.