SynthesisEpidemiology and psychiatric sciences2025
Post-acute withdrawal syndrome (PAWS) after stopping antidepressants: a systematic review with meta-narrative synthesis.
Synthesis in Epidemiology and psychiatric sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- Dismantling the Diagnostic Construct of Borderline Personality Disorder: A Critical Discourse Analysis.International journal of mental health nursing · 2026Article
- The dual functions of Ziziphi spinosae semen as medicine and food: origins, cross-domain applications, antidepressant metabolites, and pharmacological mechanisms.Frontiers in pharmacology · 2026Review
Corrections and comments
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Authors and funding
2 authors.
Funding
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Abstract
aimsThe literature on persistent antidepressant withdrawal symptoms is sparse. This systematic review is the first to examine the prevalence, duration, severity, risk/protective factors and treatment strategies for post-acute withdrawal syndrome (PAWS) following the discontinuation of antidepressant medications.
methodsWe searched PubMed, Web of Science and PsycInfo, focusing on newer-generation antidepressants. The electronic database search was complemented with handsearching reference lists of pivotal studies. We included original studies in adults reporting on PAWS and providing data about epidemiology and clinical management of withdrawal symptoms persisting for at least 6 weeks.
resultsThe literature search yielded 1286 results, with 26 records assessed for eligibility, and seven studies fulfilled our selection criteria. Prevalence data were sparse, with one small cohort study reporting a 15% prevalence rate for PAWS in patients with panic disorder and agoraphobia. The duration of PAWS varied considerably across studies, ranging from 1.5 to 166 months. Long-term paroxetine use emerged as a potential risk factor for the development of PAWS. There was no reliable evidence to support the effectiveness of various treatment strategies, including the reinstatement of antidepressant medication, the use of benzodiazepines and the provision of cognitive-behavioral therapy.
conclusionsThe current evidence on PAWS is sparse and predominantly of low certainty. The presence of withdrawal symptoms, lasting several months and possibly even years in some patients, underscores the need for further research with rigorous methodology. Large prospective cohort studies are needed to assess the epidemiology of PAWS, while randomized controlled trials are quired to test the efficacy of clinical interventions to treat PAWS. PROSPERO REGISTRATION: CRD42023461793.
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