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How Long Should You Stay on Antidepressants?
- Dr Titilayo Akinsola
- Nov 3
- 5 min read
Introduction
One of the most common questions clients raise is: “Once I start an antidepressant, how long do I have to stay on it?” It’s a valid concern—and there’s no one-size-fits-all answer. At Favor Mental Health we believe in tailored, evidence-based plans rather than arbitrary timelines. In this blog post, we’ll explore what research and guidelines say, how individual factors influence treatment duration, and how we at Favor support you through this process.
What the Guidelines and Research Say
Here are key insights gathered from the latest clinical guidance and research.
For a first episode of major depression, many guidelines recommend continuing treatment for 4 to 12 months after remission of symptoms.
For individuals who have had multiple episodes or recurrent depression, longer durations—or even indefinite maintenance—may be recommended because relapse risk is much higher. (Perelman School of Medicine)
One large population-based study found that discontinuing antidepressants before 10-12 months of treatment (after remission) was associated with higher risk of restarting treatment (which proxies relapse) compared to those who stayed on the medication for at least 10–12 months.
According to the National Institute for Health and Care Excellence (NICE) and other UK sources: for first episode: at least 6 months after improvement; for those at high risk of relapse (residual symptoms, multiple previous episodes): at least 2 years of maintenance.
So in summary:
Minimum duration: commonly ~6 months after remission for first episode.
Extended duration: 1-2 years (or longer) when risk of relapse is higher.
Indefinite maintenance: might be advised when there are many prior episodes, high severity, or incomplete recovery.
Which Factors Influence How Long You Should Stay On Antidepressants?
Your individual treatment-duration decision depends on multiple variables. At Favor we carefully review each of these:
Number of past depressive episodes: More prior episodes → higher relapse risk → longer treatment recommended. (e.g., 50% chance of recurrence after one episode; ~70% after two; ~90% after three).
Severity of the episode: Severe depression (hospitalisation, suicidal behaviour, psychosis) often warrants longer maintenance.
Presence of residual symptoms: If after remission you still have low-level symptoms (sleep problems, anxiety, concentration issues) the risk of relapse is higher → longer treatment.
Co-morbid conditions: e.g., anxiety disorders, substance use, medical illnesses, hormonal imbalances—all these complicate recovery and may support longer antidepressant use.
Life context & stability: Major life stressors, unstable environment, or inability to access therapy may justify more cautious tapering and longer duration.
Response to treatment: If your response is poor, partial or unstable, the clinician may decide to extend treatment duration and use strategic monitoring.
Your preferences and goals: Cultural, personal, and contextual factors matter: work, family, stigma, access issues—all speak into personalized treatment-length decisions.
What Favour Mental Health’s Approach Looks Like
Here’s how we work with you to decide when and how to stay on or come off antidepressants.
1. Baseline & ongoing evaluation
At the outset we take a full history: episodes, severity, comorbidity, life context.
Once you’ve been on the antidepressant and achieved remission, we schedule review checkpoints: 3-4 weeks (for response), 6-8 weeks, then monthly or bi-monthly to assess stability, side-effects, functional recovery.
We evaluate your readiness for tapering only after you’ve met criteria: stable remission, low residual symptoms, stable life context, understanding of relapse risk.
2. Collaborative decision-making on duration
We discuss the evidence: “Based on your history, you might stay on the medication for 12 months vs 2 years vs longer.”
We set milestones: e.g., “If you remain well for 12 months with no relapse, we will revisit whether to reduce gradually.”
We commit to transparent monitoring: side-effects, wellbeing, functional metrics (work, social life, sleep, mood).
3. Safe tapering when appropriate
When criteria are met (and you both decide to taper), we design a gradual reduction plan, mindful of withdrawal risks, recurrence risk, and monitoring.
We stress that stopping is not abrupt. We regularly review: “How are you feeling? Any early signs of relapse? How’s your support network? Are lifestyle/therapy supports in place?”
If the original episode was severe or you have high relapse risk, we may recommend maintenance use rather than tapering.
4. Emphasis on functional outcomes
Staying on medication is not just about “not getting depressed again” — it’s about sustaining function: work, relationships, daily life, life purpose.
We integrate therapy, lifestyle change, sleep hygiene, social support — so medication doesn’t become the only pillar. If other pillars are weak, longer medication may be needed until the other pieces are strong.
Practical Guidance: What To Ask & Expect
Here are questions to take to your appointment, and what you can expect:
Questions you can ask your clinician:
“Based on my history, how long would you recommend I stay on this antidepressant?”
“What are my relapse risks if I stop after 6 months vs 12 vs 24 months?”
“What will we use as the criteria to decide when it’s safe to taper?”
“What plan do you have for monitoring if/when we taper?”
“What side-effects or long-term risks should I be mindful of if I stay on longer?”
What you should expect:
Your clinician should review your progress regularly, not just “set and forget”.
A clear plan: one that covers “how long we will stay”, “when we will review”, “how we will decide to stop or continue”.
Transparent discussion of relapse risk and side-effect risk of extended use.
Support for lifestyle, therapy and non-medication supports as part of the plan.
If you choose to taper: a structured plan, monitoring for withdrawal symptoms, plan for rapid response if symptoms return.
Call to Action — How Favor Mental Health Can Assist You
If you’re on an antidepressant (or considering one) and are unsure how long you should stay on it, let’s help clarify: Schedule a paid consultation with Favor Mental Health. In that session we will:
Review your full history, treatment response and risk factors.
Map out a personalised duration plan for your antidepressant: how long, when to reassess, when to consider tapering.
Integrate your medication plan with therapy/lifestyle supports — so your recovery is robust and not dependent solely on medication.
Provide you with monitoring tools and follow-up strategy to ensure you stay safe and supported.
Your recovery journey deserves clarity. Your medication strategy deserves purpose. Let’s work together to make your plan tailored, transparent and aligned with your life context.
Closing
There is no fixed “one-size” answer to how long you should stay on antidepressants. The best answer comes from a personalised evaluation of your history, response, risk and environment. At Favor Mental Health we believe you deserve more than arbitrary timelines — you deserve a strategic, evidence-informed treatment path that reflects your story. Let’s chart that path together.
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