Practical issues

When reducing antidepressant doses hyperbolically, very small doses may be needed towards the end of the withdrawal period. For such small doses there may not necessarily be tablet or capsule formulations available. NICE acknowledges these practical concerns and recommends using liquid preparations when these are available. When licensed liquid products are not available unlicensed products may need to be considered. 

Antidepressant tapering is not recommended at periods of major change, whether the change is positive or negative (e.g. moving house, starting university, getting divorced, the birth of a child). It is recommended to wait until things have subsided to increase the likelihood of a successful withdrawal. There is some evidence that mindfulness based Cognitive Behavioural Therapy (CBT) can support antidepressant withdrawal.