Belgium has a high prevalence of antidepressant use, and a significant group of patients uses this medication for several years. At the same time, there is growing evidence that discontinuation for some patients requires a slow and individualized tapering process, particularly when severe withdrawal symptoms occur.
BFAP is therefore in consultation with the General Pharmaceutical Association (APB) regarding a practical tapering model for antidepressants, in line with the ambition for rational drug use outlined in the federal coalition agreement.
We aim to build upon the Belgian tapering program for benzodiazepines, in which GPs, pharmacists, and patients collaborate, and compounded preparations enable smaller dosage increments.
A similar approach could make antidepressant tapering more accessible for both GPs and psychiatrists. Particularly for venlafaxine and duloxetine, available dosages are not always suitable for patients requiring a very gradual tapering process. Tailored compounded preparations could potentially play a significant role here.
The pharmacist can also offer more than just dispensing medication. When patients experience withdrawal symptoms during tapering, the pharmacy can serve as an accessible location to discuss and monitor these issues, and where necessary, re-coordinate with the prescribing physician.
The goal is not a faster tapering process, but a feasible, patient-tailored tapering approach, supported by effective collaboration between the patient, physician, and pharmacist.