A recent report highlights a growing concern: many older adults are remaining on antidepressants for decades without regular review. In the UK, more than one in five adults over 65 now take these medications—double the rate from 20 years ago. Experts warn that prolonged use in older age can increase risks, including falls, memory problems, sexual dysfunction, and agitation. The report also describes withdrawal symptoms such as restlessness and insomnia.

What is not mentioned is withdrawal akathisia. Akathisia is a medication-induced disorder marked by intense inner restlessness and agitation. It can emerge when stopping, starting or changing drug dose or type. During withdrawal, akathisia is often mistaken for relapse or “worsening depression,” leading some patients to remain on medication indefinitely.

Most SSRIs were studied in short-to-medium term clinical trials, not long term use. Regular reassessment, informed consent, and gradual tapering when appropriate are especially important for older adults, who may be more vulnerable to adverse effects.

MISSD offers free educational resources to help clinicians, patients, and families better recognize and prevent medication-induced akathisia. Take our courses at MISSD.LearnUpon.com.