Thirty two studies (n=8,972) were included in the review: 19 RCTs and 13 prospective observational studies. There was a discrepancy in the number of patients reported in the text and tables (we used the number reported in the text). Sample sizes ranged from 15 to 6,291 patients; most studies included 300 or fewer participants. The authors reported that few studies were of high quality, but no further details were reported.
Diuretics (four RCTs): Between 87% and 100% of patients treated with thiazides were successfully withdrawn from medication over a period of six to 52 weeks compared to between 51% and 100% of controls. Serious adverse effects (such as heart failure) were reported to be rare.
Antihypertensives (10 observational studies): Between 20% and 85% of patients were successfully withdrawn over a four-week to five-year period. The main reason for recommencing antihypertensive therapy was a gradual increase in blood pressure, and sometimes heart failure.
Psychotropics (11 RCTs): The studies showed inconsistent results between patients who withdrew from psychotropics compared to those who did not; most studies reported no significant differences in withdrawal symptoms between the two groups.
Outcomes for miscellaneous medication withdrawal (seven studies) were inconsistent and were reported in the review.