Antidepressant discontinuation syndrome | |
---|---|
Other names | Antidepressant withdrawal syndrome[1] |
Specialty | Psychiatry |
Symptoms | Flu-like symptoms, trouble sleeping, nausea, poor balance, sensory changes[2] |
Usual onset | Within 3 days[2] |
Duration | Few weeks to months[3][4] |
Causes | Stopping of an antidepressant medication[2][3] |
Diagnostic method | Based on symptoms[2] |
Differential diagnosis | Anxiety, mania, stroke[2] |
Prevention | Gradual dose reduction[2] |
Frequency | 15–50% (with sudden stopping)[3][4] |
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] Psychosis may rarely 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 15–50% of people who suddenly stop an antidepressant develop an antidepressant discontinuation syndrome.[7][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.[8]
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