Narrative reviewindependent cross-checkabstract checked I-PPI-105 standard review
Are acid blockers addictive?
Rebound Acid Hypersecretion after Withdrawal of Long-Term Proton Pump Inhibitor (PPI) Treatment-Are PPIs Addictive?
Overview
Namikawa K et al.. Int J Mol Sci 2024 · PMID 38791497 · DOI 10.3390/ijms25105459
Stopping PPIs can cause a temporary acid surge that people mistake for their old illness; warning patients helps them stop.
Does the study support the specific claim? Partly · Methodological quality: low
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Review rebound after PPI withdrawal.
- How was the study done?
Narrative review.
- How many people, animals or samples were studied?
Published studies.
- What was actually found?
Rebound is well established; may cause unnecessary restarts.
- How large was the observed effect?
40-50% symptomatic in volunteers.
- What do the results mean in everyday life?
Knowing about rebound makes stopping easier.
- What are the study's limitations?
Not systematic.
- What does it say about Elawady's specific claim?
Partly supports the 'trap' idea but not 'cannot stop'.
- Do the results apply to Germany and Europe?
Applicable.
- What can explicitly not be concluded from this study?
Cannot quantify long-term dependence.
Scientific in-depth review
1. Full reference
- Authors
- Namikawa K et al.
- Journal
- Int J Mol Sci
- Year
- 2024
- Identifier
- PMID 38791497 DOI 10.3390/ijms25105459
- Verification
- verified – PubMed efetch 2026-10-26 + Crossref 2026-10-26
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
Authors declare no conflict of interest
2. Research question
What is known about rebound acid hypersecretion after PPI withdrawal and are PPIs 'addictive'?
3. Study design and population
- Study design
- Narrative review – Narrative review
- Population
Studies of PPI withdrawal
- Country
Iceland (author affiliation); international literature
- Period
Published 2024
- Sample size
Not applicable
- Inclusion and exclusion criteria
Not stated
4. Methods and endpoints
- Exposure / intervention
PPI withdrawal
- Comparator
Placebo withdrawal
- Endpoints
Acid secretion; symptoms
- Statistical methods
Narrative
5. Actual results
- Results
Pentagastrin-stimulated acid secretion increases after stopping PPIs; in healthy volunteers 40-50% had symptoms after stopping PPIs; rebound may lead patients to restart PPIs because symptoms are mistaken for relapse; clinical risk factors not well understood.
- Absolute risks
Not applicable
- Authors' conclusion
Physicians should inform patients about rebound to avoid unnecessary continuation; more research is needed.
6. Strengths
- Expert authors (Bjornsson led withdrawal RCTs)
7. Weaknesses
- Narrative; no systematic search
8. Risk of bias
- Orienting tool
- none applicable
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- not assessable
- Rationale
Narrative review.
9. Assessment of the statistical interpretation
Not applicable
10. Relevance to the specific claim
Supports the kernel of C-PPI-07 (rebound can drive unnecessary continuation) while describing it as a manageable, informable effect, not addiction.
11. Independent contrary findings
Deprescribing trials show most people can stop (I-PPI-106).
12. Transferability to Germany and Europe
Applicable.
13. Overall methodological judgement
Balanced expert view on the 'addiction' framing.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | low |
| Risk of bias | not assessable |
| Precision of results | not applicable |
| Directness | direct |
| Reproducibility | replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
Risk factors for clinically relevant rebound.
15. Linked fact checks
- PPIs create dependency: the drug 'manufactures the disease it claims to treat', so that a short course for a passing complaint turns into chronic dependence and one 'cannot stop'. – Studies with mixed or unclear results
- After stopping a PPI, rebound acid hypersecretion can cause new heartburn and reflux symptoms, even in people who had none before. – Studies supporting the claim