There's a disconnect between what the meta-analysed randomized clinical trials are saying about antidepressants (that they are at best minimally effective relative to placebo) and what relapse rates suggest (that people relapse when withdrawn from antidepressants because the antidepressant was effectively treating the underlying depression).<p>This conflict is resolved when antidepressants are acknowledged as addictive. Long-term use of antidepressants creates a biochemical dependency that is only removed with long, slow tapering.<p>I've experienced this fact personally. When I first attempted to go off antidepressants, I did so at what I thought was a slow pace, but in fact turned out to be far too fast. My life completely fell apart. I was depressed, anxious, obsessive, worse than I had been in many years. I thought this proved that I really "had depression" (as a discrete illness) and needed the drugs, so I increased my dose back up to more or less the original level. Soon after doing this, my depression/anxiety/OCD went away, and I felt normal again.<p>But a few years later I tried getting off the drugs again, going much more slowly. And now I'm at the same point I was last time when things fell apart, and I'm doing fine. Overall this withdrawal (from 200mg Zoloft) will probably take me 3 or 4 years. (I'm down to 25mg now.)<p>I'm convinced that I'm succeeding now where I failed before simply because my previous approach was triggering horrible withdrawal effects, whereas my current slower approach does not.<p>One secret to successful antidepressant withdrawal: the rate of dose reductions needs to decrease as the overall dose decreases. So when I'm at 200mg maybe I decrease by 20mg in a month. But now that I'm at 25mg maybe I decrease by 2.5mg in a month. The rate of decrease should be proportional to the current dose.<p>Before I was decreasing in constant increments all the way down (200->150->100->50) but then I started going crazy.<p>Sorry this is so long. It's a favorite subject of mine ;-)