Antidepressant discontinuation syndrome, also called antidepressant withdrawal syndrome, is a condition that can occur following the interruption, reduction, or discontinuation of antidepressant medication following its continuous use of at least a month.[5] The symptoms may include flu-like symptoms, trouble sleeping, nausea, poor balance, sensory changes, akathisia, intrusive thoughts, depersonalization and derealization, mania, anxiety, and depression.[2][3][4] The problem usually begins within three days[2] and may last for several weeks or months.[4] Rarely psychosis may occur.[2]
A discontinuation syndrome can occur after stopping any antidepressant including selective serotonin reuptake inhibitors (SSRIs), serotonin–norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants (TCAs).[2][3] The risk is greater among those who have taken the medication for longer and when the medication in question has a short half-life.[2] The underlying reason for its occurrence is unclear.[2] The diagnosis is based on the symptoms.[2]
Methods of prevention include gradually decreasing the dose among those who wish to stop, though it is possible for symptoms to occur with tapering.[2][6][4] Treatment may include restarting the medication and slowly decreasing the dose.[2] People may also be switched to the long acting antidepressant fluoxetine which can then be gradually decreased.[6]
Approximately 20–50% of people who suddenly stop an antidepressant develop an antidepressant discontinuation syndrome.[2][3][4] The condition is generally not serious,[2] though about half of people with symptoms describe them as severe.[4] Many restart antidepressants due to the severity of the symptoms.[4]
Antidepressant discontinuation syndrome is a relatively new phenomenon, with its discovery in the 1950s. There is still little research on this syndrome; most of the research is conflicting or consists only of clinical trials. There has been a class action lawsuit in 2013, but the motion was dismissed.[7]
^Cite error: The named reference TI2018 was invoked but never defined (see the help page).
^ abcdefghijklmnopqWarner CH, Bobo W, Warner C, Reid S, Rachal J (1 August 2006). "Antidepressant discontinuation syndrome". American Family Physician. 74 (3): 449–56. PMID 16913164.
^ abcdefGabriel M, Sharma V (29 May 2017). "Antidepressant discontinuation syndrome". Canadian Medical Association Journal. 189 (21): E747. doi:10.1503/cmaj.160991. PMC 5449237. PMID 28554948.
^ abcdefghDavies J, Read J (4 September 2018). "A systematic review into the incidence, severity and duration of antidepressant withdrawal effects: Are guidelines evidence-based?". Addictive Behaviors. 97: 111–121. doi:10.1016/j.addbeh.2018.08.027. PMID 30292574.
^Diagnostic and statistical manual of mental disorders : DSM-5 (5th ed.). American Psychiatric Association. 2013. pp. 712–714. ISBN 9780890425541.
^ abWilson E, Lader M (December 2015). "A review of the management of antidepressant discontinuation symptoms". Therapeutic Advances in Psychopharmacology. 5 (6): 357–68. doi:10.1177/2045125315612334. PMC 4722507. PMID 26834969.
^Johnston JA, Nelson DR, Bhatnagar P, Curtis SE, Chen Y, MacKrell JG (2021-02-23). "Prevalence and cardiometabolic correlates of ketohexokinase gene variants among UK Biobank participants". PLOS ONE. 16 (2): e0247683. Bibcode:2021PLoSO..1647683J. doi:10.1371/journal.pone.0247683. ISSN 1932-6203. PMC 7901775.
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