Six Months on an Antidepressant: What to Discuss at Your Review

Six months is a milestone in long-term antidepressant treatment. NICE NG222 and RANZCP both describe six to twelve months of continued treatment after symptom remission as the standard recommendation to reduce relapse risk. The six-month review is when prescribers and patients begin discussing the longer arc of treatment — including how well the medication has been working and what comes next.

What the six-month review typically covers

Sustained response. Whether the improvement has been maintained since the medication started working, and whether any symptoms have crept back.

Long-term tolerability. Whether the current side-effect profile is something you can manage for the foreseeable future.

Health changes. Any new health developments since starting treatment that might affect the medication choice going forward.

Continuation plan. What the plan for the next phase of treatment looks like, including duration and any future tapering discussion.

What major guidelines recommend

NICE NG222 explicitly recommends continuing antidepressant treatment for at least six months after remission, with some patients benefiting from longer treatment based on relapse-risk factors. RANZCP guidelines similarly recommend continuation, with longer treatment for those with multiple previous episodes or risk factors. The six-month review is typically when these decisions begin being made formally.

What you can bring to make the review productive

A written summary of the last six months is the most useful thing you can bring — what improved, what plateaued, what side effects remain, and any significant life events. Specific questions about the planned duration of treatment, any concerns about long-term effects, and a clear sense of your own priorities for the next phase will help make the conversation concrete and useful.

What to flag to your prescriber

Raise these at your six-month review or sooner

Return of symptoms during the past six months, even if brief.
Side effects affecting wellbeing that have not resolved.
Major life events that may affect the treatment plan.
Questions about eventually stopping the medication.

Frequently asked questions

Do I need to keep taking my antidepressant after six months?

Major guidelines recommend at least six to twelve months of continued treatment after symptom remission. Talk to your prescriber about the right duration for your situation — it depends on your history and individual relapse-risk factors.

What if I want to stop after six months?

Discuss with your prescriber. Stopping should be planned and gradual, particularly if you have had recurrent episodes. A prescriber-guided taper is safer and more comfortable than stopping abruptly.

Will I be on this antidepressant forever?

Not necessarily. Many patients eventually taper off successfully. Some patients with recurrent depression do benefit from longer-term treatment. Your prescriber can help assess your individual risk profile and what the right approach looks like for you.

Evidence and sources referenced

NICE Guideline NG222 — Depression in adults: treatment and management (United Kingdom).
Royal Australian and New Zealand College of Psychiatrists (RANZCP) — Clinical Practice Guidelines for Mood Disorders.
NPS MedicineWise — prescriber and patient resources on antidepressant treatment (Australia).
Royal College of Psychiatrists — patient information on antidepressants.
TGA and FDA — product information for SSRI and SNRI medication classes.
Maudsley Prescribing Guidelines in Psychiatry — prescribing patterns and side-effect timelines.