Gidan kati na magungunan hauka na yau da kullun yana zuwa kusa da faɗuwa. Da yawa, marasa lafiya da danginsu, har ma da ɗan jarida na yau da kullun, suna sane da cewa shugabannin masu tabin hankali sun yi musu ƙarya a tsanake.
Ɗayan ƙarairayi babba kuma mai cutarwa ita ce cewa ba kasafai ake samun matsala ga marasa lafiya su daina shan maganin bacin rai ba. A ranar 9 ga Yuli, 2025, an buga bita na tsari a cikin JAMA Psychiatry wanda ya yi iƙirarin cewa janyewar antidepressant ba shi da matsala.1 Marubutan har ma sun buga cewa bacin rai bayan katsewa yana nuni da komawar bakin ciki.
Likitoci masu tabin hankali a koyaushe suna kuskuren alamun cirewa don komawa. Duk Karatun ni da Maryanne Demasi sun haɗa a cikin bitar mu na tsare-tsare don taimaka wa marasa lafiya su janye daga magungunan bacin rai sun ruɗe alamun janyewar tare da komawa.2
Rashin Ciwon Zuciya
Na ƙirƙira kalmar “ƙauracewa bakin ciki” don alamun ja da baya waɗanda ke kwaikwayi baƙin ciki.3 Bacin rai ne da ke faruwa ga majiyyaci wanda a halin yanzu ba ya cikin damuwa amma an daina maganin sa kwatsam ko kuma a cikin ƴan makonni. Alamarsa ita ce alamun baƙin ciki suna zuwa da sauri (dangane da rabin rayuwar miyagun ƙwayoyi ko metabolites masu aiki) kuma suna ɓacewa cikin sa'o'i lokacin da aka dawo da cikakken kashi. Sake dawo da maganin don haka ana iya ɗaukarsa azaman gwajin ganowa wanda ke raba baƙin ciki daga baƙin ciki na gaske, wanda ba ya amsa da sauri ga ƙwayar baƙin ciki.
Gwajin turkey mai sanyi ya nuna bambanci sosai.4 Marasa lafiya da ke da lafiya ba zato ba tsammani an canza maganin kulawa zuwa wuribo mai makafi sau biyu na kwanaki 5-8 a lokacin da ba a san su da likitocin su ba. Marubutan marubutan don bakin ciki sun cika 25 daga cikin waɗancan marasa lafiya 122 waɗanda ke kan sertraline ko paroxetine. Na yi aiki,5 bisa binciken da aka yi na daliban makarantar sakandare 362 da suka fuskanci matsala guda ko fiye da haka,6 cewa adadin majinyatan da ake sa ran zai sake komawa cikin ɗan gajeren lokaci bai zama sifili ba.
Sharar gida, Sharar waje Review
The JAMA Psychiatry bita ya kasance datti mai ɓarna mai haɗari a ciki, datti daga bita.7 Takardar ta lissafa ƙarin biyan kuɗin kamfanonin magunguna ga marubuta fiye da adadin nassoshi ga takaddun kimiyya,8 wanda shine 47.1 Marubutan sun tattara kamfen na kafofin watsa labarai cikin sauri don tsara labarin jama'a, tare da Cibiyar Watsa Labarai ta Kimiyya ta ba da sharhin ƙwararru don "tabbatar da duka marasa lafiya da masu rubutawa" cewa yawancin alamun janyewar ba su da "mahimmancin asibiti."7
Cibiyar Media Media tana da mummunan suna. Yana haɓaka ra'ayoyin kamfanoni game da kimiyya kuma ana samun wani bangare na tallafi daga hukumomi da ƙungiyoyin masana'antu waɗanda samfuransu galibi ke karewa.8,9
Binciken ya haɗa da nazarin 50 wanda ya shafi marasa lafiya 17,828. Daga cikin manyan kurakuran hanyoyin sa, bitar ba ta tantance tsananin alamun ba kuma ya bi marasa lafiya na makonni biyu kacal duk da cewa yawancin marasa lafiya sun ba da rahoton cewa alamun ba sa fitowa har sai bayan wancan lokacin.8
Bugu da ƙari, bitar ta dogara ne da nazarin kamfanonin magunguna na ɗan gajeren lokaci na wasu makonni, wanda ya bambanta da miliyoyin mutane a duk duniya waɗanda ke shan waɗannan magungunan shekaru da yawa.8 Tsawon tsaka-tsakin lokacin amfani da maganin bacin rai a cikin Amurka shine kusan shekaru 5.10
Irin waɗannan karatun suna daure su raina ainihin abin da ya faru da tsananin tasirin cirewar antidepressant. Tsawon magani shine bayanin wajibi a cikin takardun kimiyya, amma babu wani wuri a cikin labarin da marubutan suka bayyana cewa binciken da suka yi nazari shine nazarin gajeren lokaci.
Wani kwararre kan cire muggan kwayoyi, likitan hauka Mark Horowitz daga Burtaniya, ya rubuta cewa "Nazarin abin da ke faruwa da mutane bayan makonni takwas zuwa 12 kawai kan maganin rage damuwa kamar gwada lafiyar mota ne ta hanyar fada da wata katanga a cikin 5km / h - yin watsi da gaskiyar cewa direbobi na gaske suna kan tituna suna yin 60km / h."11
Tambayi Marasa lafiya ba Likitan tabin hankali akan Biyan Ma'aikata ba
Wani bita na 2019 na James Davies da John Read ya nuna cewa rabin marasa lafiya suna fuskantar alamun janyewa; Rabin waɗanda ke da alamun bayyanar sun sami mafi girman ƙimar ƙima akan tayin; kuma wasu marasa lafiya suna fuskantar janyewar watanni ko ma shekaru.12 Wani bincike na mutane 580 da aka haɗa a cikin bita ya ruwaito cewa a cikin 16% na marasa lafiya, alamun janyewar sun kasance fiye da shekaru 3.
A cikin 2025, waɗannan marubuta da abokan aiki sun ba da rahoton cewa 38% na mahalarta a cikin binciken su ba su iya dakatar da maganin su ba; 10% sun ruwaito alamun janyewar da ke da fiye da shekara guda; da waɗanda suka yi amfani da maganin rage damuwa fiye da watanni 24 kafin su tsaya sun fi dacewa su fuskanci ciwo na janyewa, suna ba da rahoton sakamako mai tsanani, bayar da rahoton bayyanar cututtuka masu tsayi, kuma suna da wuya su iya tsayawa fiye da waɗanda ke amfani da kwayoyi na kasa da watanni shida.13
Awais Aftab, Hoto Mai Fa'ida don Babban Masanin tabin hankali
Bayan kwana biyu JAMA Psychiatry bita ya fito, likitan hauka Awais Aftab yayi ƙoƙarin kare shi kuma ya sanya shakku akan ingantaccen bita12 na abin da marasa lafiya ke fuskanta a cikin aikin asibiti wanda ya ba da labari game da mummunar cutar da miyagun ƙwayoyi.
Aftab ya yi iƙirarin cewa nauyin alamun da ke da alaƙa da cirewa ga matsakaita masu amfani da maganin rashin jin daɗi yana da ƙanƙanta.14 wanda a fili yake kuskure. Ya kuma kira bita ta Davies da Karanta12 "Matsala-matsala ce sosai" kuma sun yanke shawarar cewa alkalumman nasu "a zahiri sun yi yawa," amma ba su bayyana dalilin ba.
Aftab ya rubuta cewa Henssler et al. ya rushe kimar Davies kuma Karanta a cikin bita-bita-nazari, wanda ya yi la'akari da bayar da "mafi tsananin ƙididdiga a halin yanzu," kuma ba tare da bayyana dalilin ba.
Abin sha'awa, a cikin binciken su na 2025.13 Davies da Read sun bayyana dalilin da yasa bitar Henssler15 ba abin dogaro ba ne. Yawancin binciken da aka haɗa ba a tsara su don tantance tasirin cirewa ba amma sun dogara da rahoton kai tsaye. Bugu da ƙari, matsakaicin matsakaicin lokacin amfani da miyagun ƙwayoyi ya kasance makonni 25 kawai.
A cikin wata hira da aka yi da shi watanni hudu da suka gabata, Aftab ya ce "magungunan hana shan inna ba sa jaraba, saboda mutane ba sa karuwa."16 Idan wannan gaskiya ne, zai zama babban labari ga masu shan taba. Kamar yadda ba su girma ta shan taba, nicotine ba jaraba ba ne kuma suna iya daina shan taba cikin sauƙi, daidai?
Aftab ya lura a cikin hirar cewa kusan rabin mutanen da ke fama da baƙin ciki waɗanda ke gwada magungunan rage damuwa ɗaya ko da yawa a ƙarshe sun amsa da kyau. Ga alama, kuma bisa wani labarin,17 cewa Aftab ya yi imani da sakamakon daga gwajin STAR * D, inda marasa lafiya suka gwada kwayoyi da yawa idan na farko ba su yi nasara ba. Wannan shari'ar yaudara ce a cikin matsanancin hali.3,18 kuma ya kamata a janye yawancin ko duk fiye da 100 wallafe-wallafe game da shi.
Aftab ya yanke shawarar cewa gwajin janyewar ANTLER, wanda aka buga a cikin New England Journal of Medicine,19 Mujallar da masana'antun magunguna suka fi so, "ta kasance mai tsauri kuma mai inganci."14 Ba haka ba. Ni da Demasi mun yi bayani a cikin tsarin nazarin binciken mu na janyewa cewa tsarin tapering bai dace ba.2 Binciken ya ba da rahoton ƙarin haɗarin sake dawowa, amma wannan ya kasance bayan ɗan gajeren tsari na tapering inda aka dakatar da miyagun ƙwayoyi a wani adadin da ya dace da babban wurin mai karɓa, yana gabatar da babban haɗari na sake dawowa tare da alamun cirewa. Bugu da ƙari, an ba da rahoton sakamakon da aka zaɓa, kamar yadda kawai sakamakon bayan makonni 12 a cikin binciken 52-mako da aka kwatanta a cikin rubutun. Waɗannan sakamakon sun fi son ci gaba da maganin, sabanin sakamakon makonni 52. Don haka, rahoton gwaji ya ba da labarin ƙarya game da marasa lafiya har yanzu suna buƙatar shan magungunan su.
Lokacin da farfesa a fannin tabin hankali Joanna Moncrieff tare da abokan aikinta kwanan nan suka fallasa labarin bacin rai da rashin daidaituwar sinadarai ke haifarwa a cikin kwakwalwa, Aftab ya kira ta da “mai saba wa juna.”20 Aftab, masanin ilimin hauka, ba da son rai ba ya bayyana cewa ilimin tabin hankali ilimin kimiyya ne. Ya gabatar da hasashe marasa tushe kuma ya buya a bayan mumbo jumbo mara ma'ana kuma babu wani hasashe da za a iya gwadawa. Moncrieff ta fallasa hakan a cikin labarinta, "Tunani mai ban sha'awa da aka yi ado cikin kalmomin kimiyya: amsawa ga Awais Aftab."20
Robert Whitaker, wanda ya kafa gidan yanar gizon Mad in America, ya bayyana cewa, Aftab ya fito da matsayinsa na mai da hankali kan sukar ilimin tabin hankali, wanda wani matsayi ne na jama'a wanda ke ba shi daraja musamman ga sana'arsa.17 Zai iya zama mai kare ilimin tabin hankali kan sukar da ke da barazana da gaske, kuma za a ga sukar sa sun fito ne daga wani mai budaddiyar ra'ayi game da kurakuran masu tabin hankali. Whitaker ya nuna cewa Aftab, "a cikin sukar da ya yi a kanmu, yana neman kare labarin ci gaba na masu tabin hankali - labarin da ya taso daga muradun masu tabin hankali, kuma ba rikodi mai aminci na littattafan binciken kansa ba."
Sauran Ra'ayoyin ga JAMA Psychiatry review
A BMJ labarai kanun labarai, "Mafi yawan mutane ba su da matsananciyar janyewa daga antidepressants, babban bita ya gano,"21 yana yaudara. Jumlarta ta farko daidai take da yaudara: "Mafi yawan mutane ba sa fuskantar janyewa mai tsanani lokacin da suke daina maganin damuwa, kuma ya kamata a sabunta ƙa'idodin asibiti don yin la'akari da hakan, in ji marubutan Burtaniya na mafi girman bitar shaidar zuwa yau."
Babban ba daidai yake da inganci ba. Mafi sau da yawa, bita na gwaji da yawa yana nuna sharar da ke cikin, motsa jiki. The saurin amsawa zuwa BMJ labarai sun fi gaskiya.
A kan blog Maganin Hankali, John Mandrola ya rubuta a karkashin kanun labarai, "da gaske a cikin tabin hankali," da cewa "damuwa kan janye wannan damuwa yana goyan bayan wannan damuwa."22
Mandrola ya gano cewa "abin mamaki ne cewa wani abu da ke haifar da damuwa mai yawa (cirewar maganin damuwa) ba a haifar da shi ba lokacin da aka yi nazari akai-akai.
Wannan lamari - abubuwan da ake tunani amma ba a tabbatar da su a zahiri ba - yana daya daga cikin abubuwan da ke haifar da Magungunan Hankali. Wannan binciken-na-mako yana goyan bayan fa'idodin ingantaccen bincike, musamman na imani da aka saba amfani da shi. ”
Ko ana kiransa da empirical data ko a'a, datti har yanzu datti ne. Kuma tambayar majiyyata abubuwan da suka faru shima bayanai ne mai ma'ana. Akwai ɗimbin bayanai da ke ba mu labari daban-daban na miliyoyin marasa lafiya da ke cikin firgita saboda ba za su iya fita daga miyagun ƙwayoyi ba.
Tarihi yana maimaita kansa. Likitocin masu tabin hankali sun musanta shekaru da yawa cewa benzodiazepines na iya haifar da dogaro.23 Kuma a yanzu sun yi musun fiye da shekaru 50 cewa magungunan rage damuwa na iya haifar da dogara.
Akwai wasu maganganu masu ban sha'awa a ciki Canary.24 Horowitz ya lura cewa idan JAMA Psychiatry nazarin jagororin tasiri, wanda marubutansa ke so, "masu ilimin hauka za su kasa gano janyewar saboda za a koya musu cewa ba abu ne da za a duba ba, za su yi tunanin cewa kowa yana sake dawowa, cewa suna fuskantar dawowar damuwa ko damuwa, ba za su kula da mutane a hankali ta hanyar cire su daga kwayoyi ba, don haka za su haifar da cutar da mutane da yawa, kuma idan sun kasance abokantaka. don tallafa musu kuma gaskiyar ita ce, mutane suna kashe kansu saboda suna da nakasu saboda alamun su kuma a kan hakan, ba za su iya samun tallafin kuɗi ba.
Horowitz ya nuna kamanceceniya da sauran yankuna. Lokacin da mutane ke kare matsayin kasuwanci, kamar taba sigari ko mai, sun fara da musanta cewa akwai batun. Sa'an nan, lokacin da ƙarin bayanai suka taru kuma gaskiyar ta zama da wuya a ƙaryata su, suna rage shi ta hanyar gabatar da shakku. Manufar ita ce a dagula lamarin don rage aiki. A
gungun malamai a Burtaniya sun yi sana'o'i da miliyoyin fam suna gaya wa jama'a cewa magungunan suna da lafiya, masu inganci, kuma suna da sauƙin dakatarwa, don haka suna ƙoƙari sosai don ceton fuska da rufe abin da ke sa su zama masu laifi.
James Davies ya ce yawancin malaman ilimi, likitoci, da masu amfani da sabis sun damu sosai game da abubuwan da ke tattare da bita, wanda ke da haɗari ga kasancewar janyewar antidepressant. Abin damuwa, bita ya yi daidai da dogon tarihin masana'antar harhada magunguna waɗanda ke rage lahani.
Kwayar
Maganar ƙasa ita ce, fiye da mutane miliyan 100 a duk duniya suna shan maganin damuwa; kimanin miliyan 50 za su fuskanci halayen janyewa lokacin da suke ƙoƙari su daina, kuma a cikin miliyan 25, alamun suna da tsanani. Abin kunya ne cewa manyan likitocin kwakwalwa har yanzu suna shirye su rufe ido ga bala'in da suka haifar. Sau da yawa ina mamakin dalilin da ya sa waɗannan mutane suka zama likitoci sa'ad da ba sa son sauraron marasa lafiya.
References
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2 Gøtzsche PC, Demasi M. Hanyoyin da za a taimaka wa marasa lafiya su janye daga magungunan damuwa: nazari na yau da kullum. Int J Risk Saf Med 2024; 35: 103-16.
3 Gøtzsche PC. Shin ilimin hauka laifi ne ga bil'adama? Cibiyar 'Yancin Kimiyyar Kimiyya 2024 (akwai kyauta).
4 Rosenbaum JF, Fava M, Hoog SL, et al. Zaɓaɓɓen serotonin reuptake inhibitor decontinuation syndrome: gwaji na asibiti bazuwar. Biol Babban ilimin zuciya 1998; 44: 77-87.
5 Gøtzsche PC. Littafin koyarwa mai mahimmanci. Copenhagen: Cibiyar 'Yancin Kimiyya; 2022: shafi na 115 (akwai kyauta).
6 Lewinsohn PM, Clarke GN, Seeley, et al. Babban bakin ciki a cikin samari na al'umma: shekaru a farkon, tsawon lokaci, da lokacin dawowa. J Am Acad Child Adolesc Psychiatr 1994; 33: 809-18.
7 Demasi M. Janyewar antidepressant-me yasa masu bincike ke ci gaba da rage shi? Substack 2025; Yuli 11.
8 Karanta J. Takarda mai cike da kuskure ta musanta cewa tasirin janyewar antidepressant yana da "ma'ana a asibiti." mahaukaci a Amurka 2025; Yuli 19.
9 Malkan S. Cibiyar Media Media tana haɓaka ra'ayoyin kamfanoni na kimiyya. Haƙƙin sanin Amurka 2023; Nuwamba 2.
10 Ward W, Haslam A, Prasad V. Tsawon lokacin gwaji na antidepressant tare da tsawon lokacin amfani da ainihin duniya: nazari na tsari. Am J Med 2025;May 3:S0002-9343(25)00286-4.
11 Horowitz MA. Yin bita yana ƙididdige tasirin janyewar antidepressant ta hanyar dogaro da karatun ɗan gajeren lokaci. BMJ 2025; Yuli 12.
12 Davies J, Karanta J. Bita na yau da kullun a cikin abin da ya faru, tsanani da tsawon lokacin tasirin cirewar antidepressant: Shin jagororin tushen shaida ne? Addict Behav 2019; 97: 111-21.
13 Horowitz MA, Buckman JEJ, Saunders R, et al. Sakamakon janyewar antidepressants da tsawon lokacin amfani: binciken marasa lafiya da suka shiga cikin ayyukan kulawa na farko. Ciwon magunguna Res 2025; 350: 116497.
14 Aftab A. Yin wasa whack-a-mole tare da rashin tabbas na cirewar antidepressant. Ilimin halin kwakwalwa a Margins 2025; Yuli 11.
15 Henssler J, Schmidt Y, Schmidt U, et al. Abubuwan da ke faruwa na katsewar bayyanar cututtuka na antidepressant: nazari na yau da kullum da meta-bincike. Lancet Lafiya 2024; 11: 526-35.
16 Rosen M, Sanders L. Abubuwa 6 da ya kamata ku sani game da maganin rage damuwa. Science News 2025; Maris 11.
17 Whitaker R. Amsa Awais Aftab: Idan ana maganar bata jama'a wanene mai laifi? mahaukaci a Amurka 2023; Afrilu 6.
18 Pigott HE, Kim T, Xu C, et al. Menene gafarar jiyya, amsawa da girman haɓakar haɓakawa bayan har zuwa gwaje-gwaje guda huɗu na hanyoyin kwantar da hankali a cikin marasa lafiya masu tawayar zuciya? Sake nazarin bayanan matakin haƙuri na STAR*D tare da aminci ga ƙa'idar bincike ta asali.. BMJ Bude 2023; 13: e063095.
19 Lewis G, Marston L, Duffy L et al. Kulawa ko dakatar da maganin rashin jin daɗi a cikin kulawa na farko. N Engl J Med 2021; 385: 1257-67.
20 Moncrieff J. Tunani mai ban sha'awa sanye da kalmomin kimiyya: amsa ga Awais Aftab.
21 Mai hikima J. Yawancin mutane ba su da janyewa mai tsanani daga magungunan antidepressants, babban bita ya gano. BMJ 2025;390:r1432.
22 Mandrola J. Labari mai dadi a likitan hauka. Maganin Hankali 2025; Yuli 14.
23 Nielsen M, Hansen EH, Gøtzsche PC. Dogaro da halayen janyewa ga benzodiazepines da masu hana masu hana sake sakewa na serotonin. Yaya hukumomin lafiya suka yi? Int J Risk Saf Med 2013; 25: 155-68.
24 HG. Manyan likitocin masu tabin hankali da ke samun tallafin kantin magani 'suna yin amfani da ilimin kimiyya' a cikin yaudarar binciken janyewar maganin bacin rai.. Canary 2025; Yuli 13.
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