The DOI matches its Crossref record; 72 of the 72 references it cites were found in a registry or an index; 21 of the 144 sources its claims cite were checked for support.
Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review
Open accessAbstract
Background: Selective serotonin reuptake inhibitors (SSRI) are widely used in medical practice. They have been associated with a broad range of symptoms, whose clinical meaning has not been fully appreciated. Methods: The PRISMA guidelines were followed to conduct a systematic review of the literature. Titles, abstracts, and topics were searched using the following terms: ‘withdrawal symptoms' OR ‘withdrawal syndrome' OR ‘discontinuation syndrome' OR ‘discontinuation symptoms', AND ‘SSRI' OR ‘serotonin' OR ‘antidepressant' OR ‘paroxetine' OR ‘fluoxetine' OR ‘sertraline' OR ‘fluvoxamine' OR ‘citalopram' OR ‘escitalopram'. The electronic research literature databases included CINAHL, the Cochrane Library, PubMed and Web-of-Science from inception of each database to July 2014. Results: There were 15 randomized controlled studies, 4 open trials, 4 retrospective investigations, and 38 case reports. The prevalence of the syndrome was variable, and its estimation was hindered by a lack of case identification in many studies. Symptoms typically occur within a few days from drug discontinuation and last a few weeks, also with gradual tapering. However, many variations are possible, including late onset and/or longer persistence of disturbances. Symptoms may be easily misidentified as signs of impending relapse. Conclusions: Clinicians need to add SSRI to the list of drugs potentially inducing withdrawal symptoms upon discontinuation, together with benzodiazepines, barbiturates, and other psychotropic drugs. The term ‘discontinuation syndrome' that is currently used minimizes the potential vulnerabilities induced by SSRI and should be replaced by ‘withdrawal syndrome'.
Overview
Integrity signals
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Claims the paper makes
40 No full text of the sources · 26 Sources not found · 12 No basis given · 8 Not checked yet · 8 Own result · 7 Partly supported · 6 Own interpretation · 5 Couldn’t confirm · 4 Own method · 1 Supported so far · 1 Not supported · accuracy not yet measured
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“Results showed that, 1 and 2 weeks after randomization, the total DESS score was significantly higher in those who discontinued escitalopram than in the continuation group (p < 0.01).”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Discontinuation Symptoms in RCT Single Drug and Placebo Comparisons
What the sources say
- Could not verifycites [36] sourceExperimental — accuracy not yet measured
The Withdrawal reactions section reports spontaneous adverse-reaction reports for paroxetine, sertraline, fluoxetine and fluvoxamine. Our copy does not address escitalopram, social anxiety disorder, DESS scores or a randomized discontinuation-versus-continuation comparison; searches for those terms and the stated time points found no supporting passage. Page numbers were unavailable for the indexed passages. (LLM, conf=0.78)
plaincorrelationaln = 371 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Could not verify
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“However, only a few studies used either a definition of withdrawal reaction based on specific criteria [23,47] or a cutoff score of the DESS [36,40,43,46] to determine the occurrence of withdrawal symptoms.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Multiple Drug Comparisons
What the sources say
- Not checked — no full text of the sourcecites [23] source
- Not checked — no full text of the sourcecites [47] source
- Could not verifycites [36] sourceExperimental — accuracy not yet measured
The Methods describe scrutinising spontaneous reports of withdrawal reactions and following up paroxetine reports with a standardised questionnaire, but the passages found do not state specific criteria for defining a withdrawal reaction. I searched the Methods for a definition and inclusion criteria; the paper also does not assess how many studies used such criteria. (LLM, conf=0.70)
- Not checked — no full text of the sourcecites [40] source
- Not checked — no full text of the sourcecites [43] source
- Not checked — no full text of the sourcecites [46] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Discontinuation syndromes subsided within a month in all but 3 patients (27%).”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Withdrawal Symptoms in Open Trials
What the sources say
- Partly supportedcites [50] sourceExperimental — accuracy not yet measured
In the letter “Citalopram withdrawal symptoms” (page not provided), Benazzi reports that one patient’s symptoms disappeared after a week, supporting only the general point that symptoms can subside within a month. The letter does not report a Fava et al. study or the claim that three patients (27%) still had symptoms after a month. (LLM, conf=0.85)
plainn = 3- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Nine of 20 patients (45%) experienced a discontinuation syndrome according to specific criteria based on the DESS.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Withdrawal Symptoms in Open Trials
What the sources say
- Partly supportedcites [50] sourceExperimental — accuracy not yet measured
The letter “Citalopram withdrawal symptoms” (page not provided) describes one patient who developed symptoms suggestive of a discontinuation syndrome despite slow tapering. It does not report a group of 20 patients, nine cases (45%), behavioral treatment, or DESS-based criteria. (LLM, conf=0.88)
plaindirectn = 20- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“Animal studies concerned with the longterm use of AD have limited implications, since clear discontinuation-like behaviors in animal models are not available [28] .”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Discussion
What the sources say
- Could not verifycites [28] sourceExperimental — accuracy not yet measured
The Tolerability assessments and Discussion passages describe discontinuation symptoms in human patients after stopping SSRIs. Searches for animal studies and discontinuation-like behaviors in animal models found no passage addressing whether such behaviors are available or what that means for interpreting long-term antidepressant studies. Page numbers were not provided in our copy. (LLM, conf=0.76)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Could not verify
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Bhanji et al. [59] and Fava et al. [50] documented the persistence of symptoms up to 1 year following paroxetine discontinuation.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Discussion
What the sources say
- Partly supportedcites [59] sourceExperimental — accuracy not yet measured
The Withdrawal Reactions section (page not specified in our copy) reports that discontinuation symptoms can persist for months or even years. The References section (p. 204) cites a report of persistent post-withdrawal disorders induced by paroxetine. The paper does not give a specific duration of up to one year for paroxetine symptoms, so that detail is not established by this source. (LLM, conf=0.82)
- Could not verifycites [50] sourceExperimental — accuracy not yet measured
The letter ‘Citalopram withdrawal symptoms’ (page unavailable) mentions that paroxetine can cause discontinuation symptoms, but does not discuss symptoms persisting for a year or findings by Bhanji et al. or Fava et al. Its reported case concerns citalopram, with symptoms disappearing after one week. Searches for paroxetine, the named authors, and year-long persistence found no passage addressing the attributed finding. (LLM, conf=0.76)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“However, when symptoms persist and are distressing, the reinstitution of the same AD that triggered the problem or its substitution with a long-acting SSRI such as fluoxetine [26] may only postpone and aggravate the issue [86] .”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Discussion
What the sources say
- Could not verifycites [26] sourceExperimental — accuracy not yet measured
The Interventions section describes tapering sertraline and venlafaxine XR, and Signs and Symptoms of Discontinuation reports symptoms during that taper. The copy does not address substituting fluoxetine for a withdrawn antidepressant or reinstituting the same drug to manage persistent symptoms (searched: fluoxetine substitution, reinstitution, and postponing taper). The sentence attaches a separate citation, [86], to the claim that these approaches may postpone and aggravate the issue. (LLM, conf=0.75)
- Not matchedcites [86]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Could not verify
In the paper
“The study showed that placebo substitution, but not continued active medication, was associated with statistically significant increases in total numbers of solicited adverse events for patients treated with paroxetine by the end of the fourth day (p < 0.001).”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Multiple Drug Comparisons
What the sources say
- Not checked — no full text of the sourcecites [37] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Results, obtained according to the patients' relapse status, showed no differences in neurological and psychiatric symptoms between individuals switched to placebo and those who continued with the active treatment.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Discontinuation Symptoms in RCT Single Drug and Placebo Comparisons
What the sources say
- Not checked — no full text of the sourcecites [33] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“After 2 weeks, somnolence was found to be significantly more frequently present in patients who abruptly discontinued the medication (4%) than in those who continued to receive fluoxetine (0%, p < 0.01).”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Discontinuation Symptoms in RCT Single Drug and Placebo Comparisons
What the sources say
- Not checked — no full text of the sourcecites [17] source
plaincorrelationaln = 395 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Probably not a substantial claim. 29
- It may state two separate claims as one. 40
- The quote only partly states this claim. 3
At least one cited source doesn’t support this claim or points to a different paper, and none confirmed it — see the verdicts below.
In the paper
“The authors did not report information on the duration of the withdrawal syndromes, probably because symptoms were treated reintroducing fluoxetine [10,57,58] or administering other drugs [1,5] .”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Withdrawal Symptoms in Case Reports
What the sources say
- Not checked — no full text of the sourcecites [10] source
- Not checked — no full text of the sourcecites [57] source
- Not checked — no full text of the sourcecites [58] source
- Could not verifycites [1] sourceExperimental — accuracy not yet measured
The case report (Abstract and Additional information; page unavailable) concerns withdrawal from fluvoxamine, not fluoxetine. It describes when symptoms appeared and says the patient continued fluvoxamine, but does not address the duration or treatment of the claimed fluoxetine withdrawal cases. Searches for fluoxetine withdrawal, symptom duration, reintroduction, and other drugs found no supporting passage. (LLM, conf=0.76)
- Disputedcites [5] sourceExperimental — accuracy not yet measured
The Abstract (page unavailable) explicitly reports that withdrawal symptoms persisted for approximately seven days in all five cases, contrary to the claim that duration was not reported. It also says two patients received lorazepam, but these were paroxetine—not fluoxetine—withdrawal cases. (LLM, conf=0.88)
Checked by a reasoning model — may be wrong.
hedgedconditionaln = 6- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“and to differ in prevalence according to the pharmacological profile of SSRI [20,21]”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Introduction
What the sources say
- Not checked — no full text of the sourcecites [20] source
- Supportedcites [21] source
The Conclusions state that the incidence of discontinuation symptoms varies among SSRIs in a way that appears related to plasma elimination characteristics. The Potential mechanisms section identifies differences in pharmacokinetic half-life as the most apparent explanation, supporting the claim’s reference to pharmacological profile. (LLM, conf=0.93)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Less common reactions were 'electric-shock' sensation [9,59,61,62] , visual and auditory hallucination [63] , nocturnal enuresis [64] , pruritus [65] , and emesis [6] .”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Paroxetine
What the sources say
- Not checked — no full text of the sourcecites [9] source
- Partly supportedcites [59] sourceExperimental — accuracy not yet measured
The Withdrawal Reactions section lists vomiting among symptoms of antidepressant withdrawal, supporting the emesis portion to which this citation is attached. It does not identify vomiting as a less common reaction or specifically link it to paroxetine; its separate list of less common physical symptoms does not include vomiting. (LLM, conf=0.88)
- Not checked — no full text of the sourcecites [61] source
- Could not verifycites [62] sourceExperimental — accuracy not yet measured
Citation [6] is attached specifically to emesis. Section 2.1 discusses withdrawal reactions generally, and section 4.1 describes withdrawal after citalopram, but neither identifies emesis as a paroxetine withdrawal reaction. Searches for emesis, vomiting, and paroxetine found no passage addressing that point. (LLM, conf=0.76)
- Not checked — no full text of the sourcecites [63] source
- Could not verifycites [64] sourceExperimental — accuracy not yet measured
Citation [6] is attached specifically to emesis. The Study population section says only four participants used paroxetine, and Tolerability and safety reports increased depressive or neuropsychiatric symptoms after antidepressant discontinuation; neither identifies emesis as a reaction. Searches for emesis, vomiting, nausea, and paroxetine withdrawal found no passage addressing it. (LLM, conf=0.72)
plainn = 18- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In all reports, withdrawal reactions appeared within 1-5 days following either abrupt [68,69] or tapered [9,14,13,16,70,71] discontinuation and lasted from 1-2 weeks [13,14,69,70] to 6 weeks [16] or even longer (13-14 weeks) [9,68] .”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Paroxetine
What the sources say
- Not checked — no full text of the sourcecites [68] source
- Not matchedcites [69]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites [9] source
- Could not verifycites [14] sourceExperimental — accuracy not yet measured
The PRISMA Statement’s sections on reporting biases and review protocols address systematic-review reporting, not sertraline withdrawal. Searches for sertraline, discontinuation, and the claimed onset and duration found no passage addressing those points in our copy. (LLM, conf=0.78)
- Partly supportedcites [13] sourceExperimental — accuracy not yet measured
The Clinical Evidence of SSRI Discontinuation Syndrome section reports sertraline discontinuation symptoms and describes diagnostic criteria for SSRI symptoms developing within 1–7 days after stopping or reducing a dose. It does not establish that all sertraline case reports had onset within 1–5 days, or give the claimed durations of 1–2, 6, or 13–14 weeks. (LLM, conf=0.82)
- Not checked — no full text of the sourcecites [16] source
- Not matchedcites [70]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [71]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirectn = 8- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“Belaise et al. [62] described 3 cases of what they defined as 'persistent post-withdrawal disorders induced by paroxetine'.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Discussion
What the sources say
- Could not verifycites [62] sourceExperimental — accuracy not yet measured
Section 2.2 discusses persistent symptoms after SSRI withdrawal, and §4.1 describes one case involving citalopram. Searches for Belaise, paroxetine, and three paroxetine cases found no passage in our copy addressing the specific claim. Page numbers were not available in the indexed passages. (LLM, conf=0.76)
plaindirectn = 3- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Could not verify
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Third, discontinuation of SSRI may trigger complex phenomena, which may or may not be related to the onset of withdrawal symptomatology, such as hypomania or mania [85,88] and persistent postwithdrawal disorders [62] .”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Discussion
What the sources say
- Not matchedcites [85]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [88]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Supportedcites [62] source
The citation to this source is attached to “persistent postwithdrawal disorders,” not to hypomania or mania. Section 2.2 explicitly lists persistent post-withdrawal symptoms after SSRI discontinuation, and §4.3 says post-withdrawal syndromes may ensue despite slow tapering. (LLM, conf=0.92)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“There are anecdotal reports on the use of clonazepam and other benzodiazepines or mood stabilizers, which, however, need to be properly tested [15,50,59,62,72] .”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Discussion
What the sources say
- Not checked — no full text of the sourcecites [15] source
- Partly supportedcites [50] sourceExperimental — accuracy not yet measured
In “Citalopram withdrawal symptoms” (page unavailable), the case report describes a patient taking alprazolam and valproate when citalopram was discontinued and withdrawal symptoms appeared. It does not describe those drugs as treatments for withdrawal, mention clonazepam, or assess whether such treatments need testing. (LLM, conf=0.82)
- Partly supportedcites [59] sourceExperimental — accuracy not yet measured
The Withdrawal Reactions section says antidepressant discontinuation can trigger hypomania or mania that may require specific antimanic treatment. It does not report anecdotal use of clonazepam, other benzodiazepines, or mood stabilizers to treat SSRI withdrawal; the clonazepam discussion in AD in Anxiety Disorders concerns social-anxiety treatment instead. The cited copy provides no page number for these passages. (LLM, conf=0.79)
- Could not verifycites [62] sourceExperimental — accuracy not yet measured
Section 4.1 describes alprazolam being prescribed alongside citalopram, then tapered before citalopram; it does not describe its use to treat SSRI withdrawal. Section 4.3 discusses withdrawal from both antidepressants and benzodiazepines, but the passages found for clonazepam, mood stabilizers, and withdrawal treatment do not report anecdotal use of those drugs for SSRI withdrawal. Page numbers were not available in our copy. (LLM, conf=0.76)
- Not matchedcites [72]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“During discontinuation, the paroxetine treatment group also reported significant increases in depressive symptoms and clinical global severity scores as well as difficulty in social functioning.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Multiple Drug Comparisons
What the sources say
- Not checked — no full text of the sourcecites [38] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“After treatment interruption, discontinuation symptoms, as measured through the DESS, were more frequently reported by patients treated with paroxetine (p < 0.001) and sertraline (p < 0.001) than by those receiving fluoxetine.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Multiple Drug Comparisons
What the sources say
- Not checked — no full text of the sourcecites [22] source
plaincorrelationaln = 231 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“At weeks 4 and 6, subjects in the placebo group reported dizziness more frequently than patients in the continuation group (7 vs. 4%, p < 0.05 and 5 vs. 1%, p < 0.05, respectively).”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Discontinuation Symptoms in RCT Single Drug and Placebo Comparisons
What the sources say
- Not checked — no full text of the sourcecites [17] source
plaincorrelationaln = 395 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Symptoms typically occur within a few days from drug discontinuation and last a few weeks, also with gradual tapering.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Abstract
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The literature search identified 437 potentially relevant papers about SSRI withdrawal/discontinuation syndrome; 275 were left after the removal of duplicates.”
- Also stated in: § Characteristics of Included Studies · plain
“A total of 61 investigations met the criteria for inclusion in the study”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Characteristics of Included Studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one. The quote only partly states this claim.
- Also stated in: § Characteristics of Included Studies · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Other studies included 4 open trials and 4 retrospective investigations (online suppl.table 2).A total of 38 clinical reports were also examined (online suppl.table 3).”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Characteristics of Included Studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“When treatments were compared, individuals treated with paroxetine reported the greatest number of DESS symptoms compared to those treated with sertraline (p < 0.05) and fluoxetine (p < 0.001).”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Multiple Drug Comparisons
What the sources say
- Not checked — no full text of the sourcecites [22] source
plaincorrelationaln = 231 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Increased dreaming, trouble sleeping, nervousness or anxiety, irritability, and sudden worsening of mood occurred with an incidence >10% in the escitalopram group.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Multiple Drug Comparisons
What the sources say
- Not checked — no full text of the sourcecites [41] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Results showed that 46% of subjects reported discontinuation symptoms and that the incidence was similar in both conditions (47 vs. 46% in the short vs. long taper groups).”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Multiple Drug Comparisons
What the sources say
- Not checked — no full text of the sourcecites [46] source
plainn = 28- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Symptoms occurred significantly more frequently in patients who were treated either with one of the shorter half-life SSRI, fluvoxamine or paroxetine (17.2%), or with clomipramine (30.8%) than in patients taking SSRI with longer half-life metabolites such as sertraline or fluoxetine (1.5%).”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Withdrawal Symptoms in Retrospective Studies
What the sources say
- Not checked — no full text of the sourcecites [52] source
plaincorrelationaln = 171- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In all cases, subjects abruptly discontinued their medications, and withdrawal symptoms mostly appeared within 2 days, except for 1 patient who reported symptoms 2 weeks after discontinuation.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Withdrawal Symptoms in Case Reports
What the sources say
- Not matchedcites [1,5,10,[56][57][58]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plainn = 6- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“After a tapered discontinuation, 34.3% of patients treated with sertraline experienced a discontinuation syndrome from moderate to severe; 23.9% of them experienced a mild discontinuation reaction, while 23.9% reported a minimal one.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Multiple Drug Comparisons
What the sources say
- Not checked — no full text of the sourcecites [42] source
plainn = 163- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Common symptoms were dizziness, light-headedness, and sleep disturbances.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Withdrawal Symptoms in Case Reports
What the sources say
- Not matchedcites [1,5,10,[56][57][58]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plainn = 6- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“Rates of withdrawal symptoms were significantly greater in patients who discontinued paroxetine than in those continuing on medication (p < 0.001), while no significant differences were found in the agomelatine patient group (3.0 ± 4.2 and 4.4 ± 5.7).”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Multiple Drug Comparisons
What the sources say
- Not checked — no full text of the sourcecites [39] source
plainn = 192 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“At discontinuation, while patients treated with escitalopram did not differ in terms of adverse events from placebo controls, those who discontinued paroxetine showed a significantly higher mean DESS score compared to controls (p < 0.001).”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Multiple Drug Comparisons
What the sources say
- Not checked — no full text of the sourcecites [44] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Interestingly, an association between the occurrence of discontinuation syndrome and age emerged, although such an associa-tion seemed to be moderated by the fact that younger patients were more inclined to abruptly stop the medication.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Withdrawal Symptoms in Retrospective Studies
What the sources say
- Not checked — no full text of the sourcecites [54] source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“In conclusion, among patients with MDD, the average mean DESS score was 5.7 (SD = 7.36) for those who discontinued treatment with paroxetine [22,38,39,45] , whereas for escitalopram [41,45] it ranged from 2.4 to 3.2, and in both studies investigating fluoxetine discontinuation [22,38] , it was 0.2 (SD = 3.86).”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Multiple Drug Comparisons
What the sources say
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Discontinuation symptoms were reported independently of treatment duration (from few weeks to years) and type of discontinuation (abrupt vs. tapered).”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Paroxetine
plainn = 18- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“These 3 patients all received paroxetine and displayed alternation of worsened mood, fatigue, and emotional instability with trouble sleeping, irritability, and hyperactivity, meeting the DSM-IV criteria [51] for cyclothymic disorder except for duration.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Withdrawal Symptoms in Open Trials
What the sources say
- Not checked — no full text of the sourcecites [51] source
plainn = 3- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Twenty-three percent of obsessive-compulsive disorder patients [48] and 85.7% of PD patients [3] experienced dizziness, nausea, headache, confusion, low energy, and weakness that abated in about 2-3 weeks.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Withdrawal Symptoms in Open Trials
What the sources say
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Authors pointed out that withdrawal reactions with paroxetine constituted a greater proportion of the reports than with the other SSRI.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Withdrawal Symptoms in Retrospective Studies
What the sources say
- Not checked — no full text of the sourcecites [53] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“Case reports of escitalopram discontinuation syndrome involved 2 patients [77,78] .”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Paroxetine
What the sources say
- Not matchedcites [77]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [78]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plainn = 2- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“Both experienced electric-shock sensations a few days after drug stoppage, which lasted from 5 days [77] to 4 weeks [78] .”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Paroxetine
What the sources say
- Not matchedcites [77]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [78]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirectn = 2- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“Furthermore, 1 patient experienced orthostatic hypotension [71] .”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Paroxetine
What the sources say
- Not matchedcites [71]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plainSingle case- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
None of the sources cited for this claim have been checked yet.
In the paper
“Three case reports of fluvoxamine discontinuation syndrome were also published [2,72,73] .”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Paroxetine
What the sources say
- Not checked — no full text of the sourcecites [2] source
- Not matchedcites [72]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [73]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plainn = 3- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“Symptoms appeared within 1-5 days after the last dose and lasted from 1 week [74] to 2 months [76] .”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Paroxetine
What the sources say
- Not matchedcites [74]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [76]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirectn = 3- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
None of the sources cited for this claim have been checked yet.
In the paper
“Symptoms were managed with fluvoxamine resumption [2,73] or treated with clonazepam [72] .”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Paroxetine
What the sources say
- Not checked — no full text of the sourcecites [2] source
- Not matchedcites [73]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [72]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirectn = 3- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“An editorial published in the late 1990s claimed that AD discontinuation reactions were preventable and simple to treat [47] .The evidence that we have just collected indicates the contrary.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Discussion
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one. The quote only partly states this claim.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Withdrawal symptoms are likely to have an early onset, while recurrent symptoms generally present with a gradual return.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Discussion
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Fatigue, instability, vertigo, and flu-like symptoms were the more frequently reported adverse reactions.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Paroxetine
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“All subjects showing withdrawal syndromes gradually discontinued citalopram.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Paroxetine
What the sources say
- Not matchedcites [74][75][76]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plainn = 3- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
In the paper
“One subject also experienced hypersensitivity of the genitals and premature ejaculation [76] .”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Paroxetine
What the sources say
- Not matchedcites [76]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plainSingle case- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
None of the sources cited for this claim have been checked yet.
In the paper
“Extrapyramidal symptoms and electric-shock sensations were also reported [9,70] .”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Paroxetine
What the sources say
- Not checked — no full text of the sourcecites [9] source
- Not matchedcites [70]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Common symptoms were dizziness, anxiety, and irritability.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Paroxetine
What the sources say
- Not matchedcites [74][75][76]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plainn = 3- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
- Not matched
None of the sources cited for this claim have been checked yet.
In the paper
“Gradual tapering does not eliminate the risk of withdrawal reactions.”
- Also stated in: § Discussion · hedged
“First, gradual tapering of SSRI appears to be a reasonable clinical strategy but does not prevent the onset of withdrawal phenomena.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § Discussion · hedged
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“Even though one patient gradually discontinued fluvoxamine [72] and another missed only few doses [73] , they both experienced withdrawal symptoms such as dizziness, nausea, paresthesia, loss of concentration, restless feelings, and agitation.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Paroxetine
What the sources say
- Not matchedcites [72]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [73]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirectn = 2- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The term 'discontinuation syndrome' has progressively replaced 'withdrawal syndrome' in the SSRI literature.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Discussion
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“The clinical data suggested that the syndrome could last up to 3 weeks and could be improved by restarting the same or a similar antidepressant drug (AD).”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Introduction
What the sources say
- Not checked — no full text of the sourcecites [17] source
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Data were independently extracted by both reviewers with the use of a precoded form.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Data Extraction
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“However, the duration of treatment was brief, and the assessment methods were not geared to detecting withdrawal symptoms.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Discontinuation Symptoms in RCT Single Drug and Placebo Comparisons
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Search was carried out independently by two investigators (A.G. and C.B.); disagreements were resolved by consensus among these primary raters and the other investigators (G.A.F., J.G., and E.O.).”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Study Selection
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The pathophysiological mechanisms of withdrawal phenomena are still hypothetical and in need of proper neurobiological investigations.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Discussion
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The appearance of withdrawal symptoms after SSRI discontinuation may thus be potentially related to a number of important clinical phenomena [86] .”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Discussion
What the sources say
- Not matchedcites [86]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
- Not matched
In the paper
“However, this is only a general tendency with mood disorders and not a rule, which in any event does not apply to the widespread use of SSRI in anxiety disorders [87] .”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Discussion
What the sources say
- Not matchedcites [87]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“Such disturbances appear to be quite common on patients' websites [30] but await adequate exploration in clinical studies.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Discussion
What the sources say
- Not checked — no full text of the sourcecites [30] source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Continued drug treatment may recruit processes that oppose the initial acute effects of a drug and may lead to a loss of efficacy and/or to a treatment-unresponsive course.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Discussion
What the sources say
- Not matchedcites [85]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Not matched
In the paper
“When drug treatment ends, oppositional processes may operate for some time, resulting in the appearance of withdrawal symptoms and/or an increased vulnerability to relapse and/or resistance to treatment (if it is reinstituted) and/or switching to a bipolar course [85] .”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Discussion
What the sources say
- Not matchedcites [85]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Not matched
None of the sources cited for this claim have been checked yet.
In the paper
“This shift was heavily supported by the pharmaceutical industry [27,88] and was aimed at emphasizing that SSRI do not cause addiction or dependence, and symptoms are substantially different from the phenomena that take place with benzodiazepines [24] .”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Discussion
What the sources say
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Fourth, even when withdrawal symptoms are properly recognized, their clinical management is hindered by the complexity of the involved variables and the lack of appropriate research.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Discussion
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“Clinicians are familiar with the withdrawal phenomena that may occur from alcohol, benzodiazepines, barbiturates, opioids, and stimulants [96] .”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Discussion
What the sources say
- Not matchedcites [96]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“Indeed, the use of this latter term has minimized the potential vulnerabilities induced by SSRI and has provided the ground for misleading in-dications (e.g., AD are to be preferred to benzodiazepines in anxiety disorders due to a lack of dependence) [94,95] .”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Discussion
What the sources say
- Not matchedcites [94]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [95]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The term 'discontinuation syndrome' minimizes the vulnerabilities induced by SSRI and should be replaced by 'withdrawal syndrome'.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Discussion
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“Another neglected area of research is concerned with the role of withdrawal symptoms in assessing switching strategies that are increasingly utilized in the treatment resistance of mood and anxiety disorders [86,91] .”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Discussion
What the sources say
- Not matchedcites [86]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [91]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Drug effects are attributed without adequate consideration of the confounding role of withdrawal symptoms.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Discussion
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
The paper relies on this without support.
The withdrawal symptoms reported in the included studies are attributable to SSRI discontinuation rather than to relapse or other causes.
“Symptoms may be easily misidentified as signs of impending relapse.”
The paper relies on this without support.
Knowledge about the clinical aspects of SSRI discontinuation is important because of the widespread use of SSRI in medical practice.
“Yet, such knowledge is important because of the widespread use of SSRI in medical practice.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Antidepressants have been associated with withdrawal symptoms since 1960 for TCAs and MAOs (Nilsen 2012), and since the 1990s for SSRIs and SNRIs (Fava 2015; Fava 2018b).”
From Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (2021) · cites this paper as Fava 2015
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“However, this scale has been criticised because of its problems in differentiating between withdrawal and depressive symptoms (Fava 2015: Haddad 2007).”
From Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (2021) · cites this paper as Fava 2015
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Withdrawal symptoms may be misdiagnosed as relapse when relapse is assessed with the HAM-D scale (see above, Overall completeness and applicability of evidence) (Fava 2015: Haddad 2007).”
From Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (2021) · cites this paper as Fava 2015
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The incidence and severity appears to be influenced by half-life and receptor affinities, duration and dose of usage, as well as method of tapering, and individual patient characteristics 3,9 .”
From Tapering of SSRI treatment to mitigate withdrawal symptoms (2019) · cites this paper as [9]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Although the details remain to be elucidated, SSRI withdrawal has been attributed to a relative deficiency of serotonin in the context of widespread adaptation of serotonergic receptors 9,49,64 .”
From Tapering of SSRI treatment to mitigate withdrawal symptoms (2019) · cites this paper as [9]
Experimental — accuracy not yet measured
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Thus far, we can extrapolate from our review that antidepressant withdrawal symptoms may last for many months and even years in some patients, as previously noted in the literature (Davies and Read, 2019; Fava et al., 2015; Hengartner et al., 2019).”
From Post-acute withdrawal syndrome (PAWS) after stopping antidepressants: a systematic review with meta-narrative synthesis (2025) · cites this paper as Fava et al., 2015
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The most common symptoms include dizziness, vertigo, tremor, nausea, insomnia, fatigue, mood dysregulation, anxiety, panic, irritability and agitation (Fava et al., 2015; Haddad and Anderson, 2007; Jha et al., 2018).”
From Post-acute withdrawal syndrome (PAWS) after stopping antidepressants: a systematic review with meta-narrative synthesis (2025) · cites this paper as Fava et al., 2015
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“However, the withdrawal syndrome can be distinguished from a relapse or recurrence of the underlying disorder by its quickness of onset (days rather than weeks) 3,7,8 , rapid response to re-introduction of the antidepressant (generally within hours, certainly within days) 3,7,9 , and the presence of somatic and psychological symptoms quite distinct from the original illness (including, dizziness,”
From Tapering of SSRI treatment to mitigate withdrawal symptoms (2019) · cites this paper as [9]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“However, withdrawal effect from other medications do not observe threshold effects 47,50 , and withdrawal effects have been observed at many doses during tapering of SSRIs 9,36 , suggesting withdrawal is likely to be continuous entity.”
From Tapering of SSRI treatment to mitigate withdrawal symptoms (2019) · cites this paper as [9]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Severity varies according to the SSRI, paroxetine being the most likely to be associated with severe depressive and somatic symptoms, and fluoxetine being the least likely to be associated with severe depressive and somatic symptoms [5, 111].”
From Acute and Persistent Withdrawal Syndromes Following Discontinuation of Psychotropic Medications (2020) · cites this paper as [5]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Peaks of onset occur 36 h to 10 days after dose decrease or discontinuation,”
From Acute and Persistent Withdrawal Syndromes Following Discontinuation of Psychotropic Medications (2020) · cites this paper as [5]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“They occur irrespective of whether gradual or abrupt discontinuation is implemented and are similar to those observed after discontinuation of SSRIs [5].”
From Acute and Persistent Withdrawal Syndromes Following Discontinuation of Psychotropic Medications (2020) · cites this paper as [5]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“they are usually reversible and last from a few hours to 6 weeks [5, 16, 97].”
From Acute and Persistent Withdrawal Syndromes Following Discontinuation of Psychotropic Medications (2020) · cites this paper as [5]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Their frequency and duration depend on the drug discontinued [5, 16, 97].”
From Acute and Persistent Withdrawal Syndromes Following Discontinuation of Psychotropic Medications (2020) · cites this paper as [5]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Withdrawal syndromes after decrease or discontinuation of antidepressants may be associated with additional clinical manifestations. They include modifications of the illness course, such as switching to mania or other forms of excessive behavioral activations [24], but also loss of clinical effects and refractoriness to treatment; they have been reported with SSRI and SNRI [5, 6, 27].”
From Acute and Persistent Withdrawal Syndromes Following Discontinuation of Psychotropic Medications (2020) · cites this paper as [5]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Fluoxetine should take 35-75 days to reach steady state 49 , a fact that is likely responsible for observations that its withdrawal symptoms can arise weeks after cessation 9,20 .”
From Tapering of SSRI treatment to mitigate withdrawal symptoms (2019) · cites this paper as [9]
The cited source says what the claim attributes to it.
In the citing paper
“Withdrawal symptoms are reported to last for several weeks (or longer) after medication discontinuation in a significant proportion of patients 9,13 .”
From Tapering of SSRI treatment to mitigate withdrawal symptoms (2019) · cites this paper as [9]
The cited source says what the claim attributes to it.
In the citing paper
“Discontinuation of antidepressant medications such as selective serotonin reuptake inhibitors, duloxetine and venlafaxine represents a major clinical challenge 99,100 .”
From The pursuit of euthymia (2020) · cites this paper as [99]
The cited source says what the claim attributes to it.
In the citing paper
“New withdrawal symptoms following decrease or discontinuation of SSRIs have been widely documented and include a wide range of symptoms [5] which are listed in detail in Table 4.”
From Acute and Persistent Withdrawal Syndromes Following Discontinuation of Psychotropic Medications (2020) · cites this paper as [5]
The cited source says what the claim attributes to it.
In the citing paper
“Even though discontinuation symptoms were mostly reported after abrupt discontinuation, they were found to occur after gradual tapering [5, 6]”
From Acute and Persistent Withdrawal Syndromes Following Discontinuation of Psychotropic Medications (2020) · cites this paper as [5]
The cited source says what the claim attributes to it.
In the citing paper
“The first systematic review of SSRIs withdrawal reactions was published in 2015 [5]”
From Acute and Persistent Withdrawal Syndromes Following Discontinuation of Psychotropic Medications (2020) · cites this paper as [5]
In the citing paper
“Risk-factors such as sexual trauma and bullying are common to a wide range of mental health problems, 495,496”
From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [495]
In the citing paper
“Recent systematic reviews of withdrawal symptoms from antidepressants have drawn attention to the fact that withdrawal symptoms are more common, more severe and longer-lasting than previously supposed,5,7,8”
In the citing paper
“Common symptoms following SSRI withdrawal include dizziness, nausea, fatigue, anxiety, headache, electric shock-like symptoms, sweating, insomnia and nightmares [6].”
From SSRI and SNRI withdrawal symptoms reported on an internet forum (2018) · cites this paper as [6]
In the citing paper
“However, psychiatric literature has started to report cases with longer durations of symptoms [6,8].”
From SSRI and SNRI withdrawal symptoms reported on an internet forum (2018) · cites this paper as [6]
In the citing paper
“Three recent systematic reviews have, however, indicated that these are gross underestimates.21–23”
From A survey of UK general practitioners about depression, antidepressants and withdrawal: implementing the 2019 Public Health England report (2020) · cites this paper as [22]
In the citing paper
“A possible driver of unnecessary long-term medication could be the propensity of antidepressants to cause physical dependence (i.e., pharmacodynamic neurophysiological adaptations) and withdrawal symptoms upon dose reduction or cessation discouraging discontinuation.11–18”
From Protracted withdrawal syndrome after stopping antidepressants: a descriptive quantitative analysis of consumer narratives from a large internet forum (2020) · cites this paper as [13]
In the citing paper
“It is now suspected that antidepressant withdrawal syndrome is more common and severe than earlier presumed, affecting roughly 30–50% of those who attempt to stop their treatment.12,13,23,24”
From Protracted withdrawal syndrome after stopping antidepressants: a descriptive quantitative analysis of consumer narratives from a large internet forum (2020) · cites this paper as [13]
In the citing paper
“When withdrawal symptoms emerge in the acute phase of antidepressant withdrawal, reinstatement of the drug to treat them is recommended throughout the scientific literature and in many new-generation antidepressant package inserts.11,13,23,28,44”
From Protracted withdrawal syndrome after stopping antidepressants: a descriptive quantitative analysis of consumer narratives from a large internet forum (2020) · cites this paper as [13]
In the citing paper
“Moreover, these symptoms are also frequent acute withdrawal symptoms,11,13,14,28”
From Protracted withdrawal syndrome after stopping antidepressants: a descriptive quantitative analysis of consumer narratives from a large internet forum (2020) · cites this paper as [13]
In the citing paper
“However, this position is no longer tenable in view of current evidence that indicates that the clinical phenomena pertain to withdrawal syndromes and do not differ from those that occur with other psychotropic drugs.”
From May antidepressant drugs worsen the conditions they are supposed to treat? The clinical foundations of the oppositional model of tolerance (2020) · cites this paper as [40]
In the citing paper
“Psychological symptoms may occur as well: agitation, anxiety, panic attacks, dysphoria, irritability, confusion, and worsening of mood.”
From May antidepressant drugs worsen the conditions they are supposed to treat? The clinical foundations of the oppositional model of tolerance (2020) · cites this paper as [40]
In the citing paper
“The withdrawal syndrome encompasses a broad range of somatic symptoms (e.g. headache, dizziness, flu-like symptoms, nausea).”
From May antidepressant drugs worsen the conditions they are supposed to treat? The clinical foundations of the oppositional model of tolerance (2020) · cites this paper as [40]
In the citing paper
“Untreated symptoms may be mild and resolve spontaneously in 1–3 weeks; in other cases they may persist for months or even years,40–45 leading to what has been defined as persistent post-withdrawal disorder.”
From May antidepressant drugs worsen the conditions they are supposed to treat? The clinical foundations of the oppositional model of tolerance (2020) · cites this paper as [40]
In the citing paper
“They have been described with any type of AD, but particularly with SSRI, venlafaxine, and duloxetine.”
From May antidepressant drugs worsen the conditions they are supposed to treat? The clinical foundations of the oppositional model of tolerance (2020) · cites this paper as [40]
In the citing paper
“However, in due course after their introduction, more pronounced problems occurred with most of the newer antidepressants.40–46”
From May antidepressant drugs worsen the conditions they are supposed to treat? The clinical foundations of the oppositional model of tolerance (2020) · cites this paper as [40]
In the citing paper
“It would seem that, with both types of drugs, that withdrawal reactions and post-withdrawal syndromes may ensue, despite slow tapering.”
From May antidepressant drugs worsen the conditions they are supposed to treat? The clinical foundations of the oppositional model of tolerance (2020) · cites this paper as [40]
In the citing paper
“Moreover, withdrawal symptoms can occur after abrupt or gradual discontinuation of major psychiatric drugs (6,(11)(12)(13).”
From Discontinuing Psychiatric Medications: A Survey of Long-Term Users (2017) · cites this paper as [12]
In the citing paper
“Other times, behavioral toxicity may entail subtle manifestations, which may be detected only with specific assessment strategies, such as with cognitive impairment associated with all psychotropic drugs [34] or with apathy related to the use of antidepressant drugs [35].”
From Iatrogenic Factors in Psychopathology (2019) · cites this paper as [34]
In the citing paper
“An understanding of users’ own experiences of antidepressant use is increasingly important in the context of growing doubts about the effectiveness of antidepressant treatment [5, 26], concerns about side effects [27] and withdrawal effects [28].”
From ‘In my life antidepressants have been…’: a qualitative analysis of users’ diverse experiences with antidepressants (2016) · cites this paper as [28]
In the citing paper
“Indeed, several papers have identified the occurrence of withdrawal signs/symptoms relating to a range of ADs, and especially SSRIs (Addictionblog.org, 2012; Harvey and Slabbert, 2014; Fava et al., 2015).”
From Is There a Potential of Misuse for Venlafaxine and Bupropion? (2018) · cites this paper as Fava et al., 2015
In the citing paper
“Although, similar to what described with the SSRIs, the occurrence of a withdrawal syndrome may be interpreted as being associated with a “dependence” condition (Fava et al., 2015), this may not necessarily be an indication, per se, of an index drug possessing a misuse/recreational value (Shang et al., 2007).”
From Is There a Potential of Misuse for Venlafaxine and Bupropion? (2018) · cites this paper as Fava et al., 2015
In the citing paper
“and may be easily misidentified as signs of impending relapse.52”
From Should antidepressants be used for major depressive disorder? (2020) · cites this paper as [52]
In the citing paper
“Withdrawal symptoms may be alleviated by reinstating treatment with the antidepressant that triggered the symptoms”
From Should antidepressants be used for major depressive disorder? (2020) · cites this paper as [52]
In the citing paper
“and it may for this, and many other reasons, be difficult for some patients to stop taking antidepressants once the treatment has started.52”
From Should antidepressants be used for major depressive disorder? (2020) · cites this paper as [52]
In the citing paper
“Withdrawal symptoms after SSRIs typically occur within a few days from drug discontinuation and last a few weeks, also with gradual tapering”
From Should antidepressants be used for major depressive disorder? (2020) · cites this paper as [52]
In the citing paper
“but the withdrawal symptoms might include late onset and longer persistence of disturbances”
From Should antidepressants be used for major depressive disorder? (2020) · cites this paper as [52]
In the citing paper
“There are many similarities between the withdrawal symptoms associated with SSRIs and the withdrawal symptoms associated with antidepressants such as venlafaxine and duloxetine.52”
From Should antidepressants be used for major depressive disorder? (2020) · cites this paper as [52]
In the citing paper
“New SSRI withdrawal symptoms have been found to occur after drug discontinuation with variable frequency and duration, depending on the SSRI which is discontinued [1,12,22] .”
From New Classification of Selective Serotonin Reuptake Inhibitor Withdrawal (2015) · cites this paper as [1]
In the citing paper
“New withdrawal symptoms reported with SSRIs include a wide range of symptoms, both physical and psychological [1] , and are found throughout different systems in the body ( table 2 ).”
From New Classification of Selective Serotonin Reuptake Inhibitor Withdrawal (2015) · cites this paper as [1]
In the citing paper
“New withdrawal symptoms described in the literature include flu-like symptoms, headaches, nausea, diarrhea, dizziness, decreased concentration, sleep disturbances, dysphoria, irritability, and restlessness [1,12,22] .”
From New Classification of Selective Serotonin Reuptake Inhibitor Withdrawal (2015) · cites this paper as [1]
In the citing paper
“They usually reach a peak of onset between 36 and 96 h after SSRI reduction or discontinuation, and are reversible, lasting from a few hours up to 6 weeks [1,12,22] .”
From New Classification of Selective Serotonin Reuptake Inhibitor Withdrawal (2015) · cites this paper as [1]
In the citing paper
“A recurrent disabling withdrawal symptom described in the literature and online by patients is a sensory symptom of electric shock sensations and electric-like waves [1,12,22,26] .”
From New Classification of Selective Serotonin Reuptake Inhibitor Withdrawal (2015) · cites this paper as [1]
In the citing paper
“Withdrawal from SSRIs and other CNS drugs produces psychiatric symptoms that can be confounded with true relapse or recurrence of the original illness [1,2,7] .”
From New Classification of Selective Serotonin Reuptake Inhibitor Withdrawal (2015) · cites this paper as [1]
In the citing paper
“Severity may also vary mainly according to the SSRI used [1,20] .”
From New Classification of Selective Serotonin Reuptake Inhibitor Withdrawal (2015) · cites this paper as [1]
In the citing paper
“According to most studies [1,15,16,20,29] , even with gradual tapering, withdrawal symptoms still occur.”
From New Classification of Selective Serotonin Reuptake Inhibitor Withdrawal (2015) · cites this paper as [1]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Multiple Drug Comparisons
“The authors reported only ADDS symptoms that occurred in more than 10% of patients, showing no differences between those who received sertraline compared to venlafaxine XR.”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Multiple Drug Comparisons
“Dizziness (33.3%), vivid dreams (26.4%), fatigue (22.2%), vertigo (5.6%), rapid changing mood (6.9%), and tachycardia (4.2%) were the most frequently reported symptoms [42] .”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
“Nine of 20 patients (45%) experienced a discontinuation syndrome according to specific criteria based on the DESS.Discontinuation syndromes subsided within a month in all but 3 patients (27%).”
§ Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review > Withdrawal Symptoms in Open Trials
Reported 27 · recomputed 33.333333
Citations
Cites
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement
Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2009.06.005 · Cited by 19,575
Lingjærde, O., Ahlfors, U. G., Bech, P., Dencker, S. J., & Elgen, K. (1987) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1987.tb10566.x · Cited by 1,705
Selective serotonin reuptake inhibitor discontinuation syndrome: a randomized clinical trial
Rosenbaum, J. F., Fava, M., Hoog, S. L., Ascroft, R. C., & Krebs, W. B. (1998) · Biological Psychiatry · doi:10.1016/s0006-3223(98)00126-7 · Cited by 574
Management of Drug and Alcohol Withdrawal
Kosten, T. R., & O'Connor, P. G. (2003) · New England Journal of Medicine · doi:10.1056/nejmra020617 · Cited by 563
Serotonin Reuptake Inhibitor Withdrawal
Coupland, N. J., Bell, C. J., & Potokar, J. P. (1996) · Journal of Clinical Psychopharmacology · doi:10.1097/00004714-199610000-00003 · Cited by 303
Antidepressant discontinuation reactions: Are preventable and simple to treat
Haddad, P., Lejoyeux, M., & Young, A. (1998) · BMJ · doi:10.1136/bmj.316.7138.1105 · Cited by 286
Paroxetine in the Treatment of Panic Disorder a Randomised, Double-Blind, Placebo-Controlled Study
Oehrberg, S., Christiansen, P. E., Behnke, K., Borup, A. L., Severin, B., Soegaard, J., Calberg, H., Judge, R., Ohrstrom, J. K., & Manniche, P. M. (1995) · British Journal of Psychiatry · doi:10.1192/bjp.167.3.374 · Cited by 261
Montgomery, S. A., Kennedy, S. H., Burrows, G. D., Lejoyeux, M., & Hindmarch, I. (2004) · International Clinical Psychopharmacology · doi:10.1097/01.yic.0000137184.64610.c8 · Cited by 196
Michelson, D., Fava, M., Amsterdam, J., Apter, J., Londborg, P., Tamura, R., & Tepner, R. G. (2000) · British Journal of Psychiatry · doi:10.1192/bjp.176.4.363 · Cited by 181
PRICE, J. S., WALLER, P. C., WOOD, S. M., & MACKAY, A. V. P. (1996) · British Journal of Clinical Pharmacology · doi:10.1046/j.1365-2125.1996.00498.x · Cited by 171
Cited by
Sorted by citations
Kennedy, S. H., Lam, R. W., McIntyre, R. S., Tourjman, S. V., Bhat, V., Blier, P., Hasnain, M., Jollant, F., Levitt, A. J., MacQueen, G. M., et al. (2016) · The Canadian Journal of Psychiatry · doi:10.1177/0706743716659417 · Cited by 1,181
“Discontinuation symptoms, described by the FINISH mnemonic (flu-like symptoms, insomnia, nausea, imbalance, sensory disturbances, hyperarousal), may be experienced by up to 40% of patients when antidepressants are stopped abruptly.(87,88) These are generally mild and transient, but more severe symptoms have been descr…”
BackgroundTime for united action on depression: a Lancet–World Psychiatric Association Commission
Herrman, H., Patel, V., Kieling, C., Berk, M., Buchweitz, C., Cuijpers, P., Furukawa, T. A., Kessler, R. C., Kohrt, B. A., Maj, M., et al. (2022) · The Lancet · doi:10.1016/s0140-6736(21)02141-3 · Cited by 1,104
Carvalho, A. F., Sharma, M. S., Brunoni, A. R., Vieta, E., & Fava, G. A. (2016) · Psychotherapy and Psychosomatics · doi:10.1159/000447034 · Cited by 650
Self-citationDavies, J., & Read, J. (2019) · Addictive Behaviors · doi:10.1016/j.addbeh.2018.08.027 · Cited by 387
“…withdrawal can occur without discontinuation (e.g. between two doses of rapid-onset and short-acting drugs and with a decrease in medication) (Fava et al., 2015), while the term ‘syndrome’ subtly medicalises withdrawal by associating it with a disorder endogenous to the person than with a…”
BackgroundResultInfluentialCurrent Psychosomatic Practice
Fava, G. A., Cosci, F., & Sonino, N. (2017) · Psychotherapy and Psychosomatics · doi:10.1159/000448856 · Cited by 302
Self-citationHow addictive are gabapentin and pregabalin? A systematic review
Bonnet, U., & Scherbaum, N. (2017) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2017.08.430 · Cited by 294
“The described withdrawal symptoms resembled those of benzodiazepines (including withdrawal seizures and delirium) (Tyrer et al., 1990) or SSRIs (Fava et al., 2015) and appeared to respond poorly to benzodiazepines but improved after reinstating a gabapentinoid taper (Smith et al., 2016; Mersfelder and Nichols; 2016, S…”
BackgroundTapering of SSRI treatment to mitigate withdrawal symptoms
Horowitz, M. A., & Taylor, D. (2019) · The Lancet Psychiatry · doi:10.1016/s2215-0366(19)30032-x · Cited by 280
Antipsychotic-Induced Dopamine Supersensitivity Psychosis: Pharmacology, Criteria, and Therapy
Chouinard, G., Samaha, A.-N., Chouinard, V.-A., Peretti, C.-S., Kanahara, N., Takase, M., & Iyo, M. (2017) · Psychotherapy and Psychosomatics · doi:10.1159/000477313 · Cited by 270
Acute and Persistent Withdrawal Syndromes Following Discontinuation of Psychotropic Medications
Cosci, F., & Chouinard, G. (2020) · Psychotherapy and Psychosomatics · doi:10.1159/000506868 · Cited by 265
ACOG Committee on Clinical Practice Guidelines–Obstetrics (2023) · Obstetrics & Gynecology · doi:10.1097/aog.0000000000005202 · Cited by 252
“Abrupt discontinuation of SSRIs or SNRIs is associated with symptoms including gastrointestinal upset, dizziness, fatigue, headache, sleep disruption, agitation or anxiety, myalgias, tremors, headaches, and electric-like shocks (62).”
BackgroundManagement of Depression in Adults: A Review
Simon, G. E., Moise, N., & Mohr, D. C. (2024) · JAMA · doi:10.1001/jama.2024.5756 · Cited by 234
More treatment but no less depression: The treatment-prevalence paradox
Ormel, J., Hollon, S. D., Kessler, R. C., Cuijpers, P., & Monroe, S. M. (2022) · Clinical Psychology Review · doi:10.1016/j.cpr.2021.102111 · Cited by 213
Adverse Effects of Antidepressant Medications and their Management in Children and Adolescents
Strawn, J. R., Mills, J. A., Poweleit, E. A., Ramsey, L. B., & Croarkin, P. E. (2023) · Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy · doi:10.1002/phar.2767 · Cited by 211
Read, J., & Williams, J. (2018) · Current Drug Safety · doi:10.2174/1574886313666180605095130 · Cited by 175
“A recent review [54] found that they typically ‘last a few weeks’ but identified ‘many variations.”
BackgroundFeduccia, A. A., Jerome, L., Yazar-Klosinski, B., Emerson, A., Mithoefer, M. C., & Doblin, R. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00650 · Cited by 172
“Discontinuation of paroxetine and sertraline may be accompanied by adverse effects (55), likely caused by neuroadaptations of decreased levels of serotonin transporters in neuronal membranes after use of SSRIs (56).”
BackgroundGuidi, J., Tomba, E., & Fava, G. A. (2016) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2015.15040476 · Cited by 167
Self-citationNew Classification of Selective Serotonin Reuptake Inhibitor Withdrawal
Chouinard, G., & Chouinard, V.-A. (2015) · Psychotherapy and Psychosomatics · doi:10.1159/000371865 · Cited by 164
Should antidepressants be used for major depressive disorder?
Jakobsen, J. C., Gluud, C., & Kirsch, I. (2020) · BMJ Evidence-Based Medicine · doi:10.1136/bmjebm-2019-111238 · Cited by 162
“52 There are many similarities between the withdrawal symptoms associated with SSRIs and the withdrawal symptoms associated with antidepressants such as venlafaxine and duloxetine.”
InfluentialGuidi, J., & Fava, G. A. (2021) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2020.3650 · Cited by 155
Self-citationMunkholm, K., Paludan-Müller, A. S., & Boesen, K. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-024886 · Cited by 151
“symptoms during the placebo run-in that are alleviated by the study drug.(44) It could be misinterpreted as an improvement of the depression (increased benefits in the drug group).”
BackgroundFava, G. A., & Guidi, J. (2020) · World Psychiatry · doi:10.1002/wps.20698 · Cited by 148
Self-citationBockting, C. L. H., Klein, N. S., Elgersma, H. J., van Rijsbergen, G. D., Slofstra, C., Ormel, J., Buskens, E., Dekker, J., de Jong, P. J., Nolen, W. A., et al. (2018) · The Lancet Psychiatry · doi:10.1016/s2215-0366(18)30100-7 · Cited by 130
Complementary therapies for clinical depression: an overview of systematic reviews
Haller, H., Anheyer, D., Cramer, H., & Dobos, G. J. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-028527 · Cited by 134
Evidence-based pharmacotherapy of treatment-resistant unipolar depression
Dold, M., & Kasper, S. F. (2016) · International Journal of Psychiatry in Clinical Practice · doi:10.1080/13651501.2016.1248852 · Cited by 126
“It should be considered that the termination of the medication with an antidepressant compound can provoke withdrawal symptoms (Fava et al. 2015) and these are often misinterpreted as adverse effects of the newly dispensed antidepressant drug hampering the possibility to assess the effectiveness of…”
BackgroundAntidepressant Withdrawal and Rebound Phenomena
Henssler, J. F., Heinz, A., Brandt, L., & Bschor, T. (2019) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.2019.0355 · Cited by 124
Ouzir, M., & Errami, M. (2016) · Pharmacology Biochemistry and Behavior · doi:10.1016/j.pbb.2016.06.005 · Cited by 122
Psychiatrization of Society: A Conceptual Framework and Call for Transdisciplinary Research
Beeker, T., Mills, C., Bhugra, D., Meerman, S. T., Thoma, S., Heinze, M., & von Peter, S. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.645556 · Cited by 146
Ormel (2019) · doi:10.1097/yco.0000000000000505 · Cited by 102
Incidence of antidepressant discontinuation symptoms: a systematic review and meta-analysis
Henssler, J., Schmidt, Y., Schmidt, U., Schwarzer, G., Bschor, T., & Baethge, C. (2024) · The Lancet Psychiatry · doi:10.1016/s2215-0366(24)00133-0 · Cited by 106
Strategies to reduce use of antidepressants
Kendrick, T. (2020) · British Journal of Clinical Pharmacology · doi:10.1111/bcp.14475 · Cited by 97
“Anxiety, mood swings and sleep disturbance may appear to be a recurrence of the original problem requiring treatment.(20) Restarting medication, before withdrawal”
BackgroundSelective serotonin reuptake inhibitors for fibromyalgia syndrome
Walitt, B. T., Urrútia, G., Nishishinya, M. B., Cantrell, S. E., & Häuser, W. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011735 · Cited by 108
Van Leeuwen, E., van Driel, M. L., Horowitz, M. A., Kendrick, T., Donald, M., De Sutter, A. I., Robertson, L., & Christiaens, T. (2021) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013495.pub2 · Cited by 90
Fava, G. A., Cosci, F., Guidi, J., & Tomba, E. (2017) · Depression and Anxiety · doi:10.1002/da.22629 · Cited by 95
Self-citationAntidepressants in inflammatory bowel disease
Mikocka-Walus, A., Ford, A. C., & Drossman, D. A. (2020) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-019-0259-y · Cited by 93
Hengartner, M. P., & Plöderl, M. (2018) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2018.00517 · Cited by 99
Lerner, A., & Klein, M. (2019) · Brain Communications · doi:10.1093/braincomms/fcz025 · Cited by 89
“These in- clude drugs both scheduled and non-scheduled in the Controlled Substances Act, which categorizes drugs in five schedules based on their relative abuse potentials and dependence liabilities and for regulatory purposes.”
BackgroundInfluentialSwitching and stopping antidepressants
Keks, N. A., Hope, J., & Keogh, S. (2016) · Australian Prescriber · doi:10.18773/austprescr.2016.039 · Cited by 90
Managing antidepressant discontinuation: a systematic review
Maund, E., Stuart, B., Moore, M., Dowrick, C., Geraghty, A. W. A., Dawson, S., & Kendrick, T. (2019) · The Annals of Family Medicine · doi:10.1370/afm.2336 · Cited by 82
Fava, G. A. (2020) · Therapeutic Advances in Psychopharmacology · doi:10.1177/2045125320970325 · Cited by 84
Self-citationIatrogenic Factors in Psychopathology
Fava, G. A., & Rafanelli, C. (2019) · Psychotherapy and Psychosomatics · doi:10.1159/000500151 · Cited by 82
Self-citationPharmacological treatment for generalized anxiety disorder in adults: an update
Reinhold, J. A., & Rickels, K. (2015) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.2015.1059424 · Cited by 88
“The risk and extent of weight gain varies within this class, as some compounds promote weight gain and some are considered weight-neutral [43].”
BackgroundZagorscak, P., Heinrich, M., Sommer, D., Wagner, B., & Knaevelsrud, C. (2018) · Psychotherapy and Psychosomatics · doi:10.1159/000481515 · Cited by 85
Moreton, S. G., Szalla, L., Menzies, R. E., & Arena, A. F. A. (2019) · Psychopharmacology · doi:10.1007/s00213-019-05391-0 · Cited by 85
Huijbregts, K. M. L., Hoogendoorn, A. W., Slottje, P., van Balkom, A. J. L. M., & Batelaan, N. M. (2017) · Psychotherapy and Psychosomatics · doi:10.1159/000480456 · Cited by 67
Drug dependence is not addiction—and it matters
Szalavitz, M., Rigg, K. K., & Wakeman, S. E. (2021) · Annals of Medicine · doi:10.1080/07853890.2021.1995623 · Cited by 78
Guy, A., Brown, M., Lewis, S., & Horowitz, M. (2020) · Therapeutic Advances in Psychopharmacology · doi:10.1177/2045125320967183 · Cited by 77
Framer, A. (2021) · Therapeutic Advances in Psychopharmacology · doi:10.1177/2045125321991274 · Cited by 73
Estimating Risk of Antidepressant Withdrawal from a Review of Published Data
Horowitz, M. A., Framer, A., Hengartner, M. P., Sørensen, A., & Taylor, D. (2023) · CNS Drugs · doi:10.1007/s40263-022-00960-y · Cited by 76
“However, withdrawal symptoms following the cessation of fluoxetine, the SSRI with the longest half-life (7–15 days for its active metabolite, nor-fluoxetine), has been observed to occur with a delay of onset of 4–6 weeks after discontinuation in one study [45], and 2 weeks after discontinuation in another [69].”
BackgroundHengartner, M. P., Schulthess, L., Sorensen, A., & Framer, A. (2020) · Therapeutic Advances in Psychopharmacology · doi:10.1177/2045125320980573 · Cited by 74
Prodromal Symptoms in Depression: A Systematic Review
Benasi, G., Fava, G. A., & Guidi, J. (2021) · Psychotherapy and Psychosomatics · doi:10.1159/000517953 · Cited by 85
Self-citationAntidepressant discontinuation syndrome
Gabriel, M., & Sharma, V. (2017) · Canadian Medical Association Journal · doi:10.1503/cmaj.160991 · Cited by 77
Evidence-based medicine was bound to fail: a report to Alvan Feinstein
Fava, G. A. (2017) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2017.01.012 · Cited by 74
Self-citationDunlop, B. W., LoParo, D., Kinkead, B. L., Mletzko, T., Cole, S. P., Nemeroff, C. B., Mayberg, H. S., & Craighead, W. E. (2019) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2018.18091075 · Cited by 69
“In that study, patients requiring an SSRI+IPT to achieve remission experienced a 50% recurrence rate after tapering the SSRI, roughly double the 26% rate among those patients who remitted with IPT alone (45).”
InfluentialWhen Discontinuing SSRI Antidepressants Is a Challenge: Management Tips
Jha, M. K., Rush, A. J., & Trivedi, M. H. (2018) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2018.18060692 · Cited by 73
Horowitz, M. A., & Taylor, D. M. (2022) · BJPsych Advances · doi:10.1192/bja.2021.62 · Cited by 79
“1 (Rosenbaum 1998; Fava 2015; Cosci 2020).”
Hengartner, M. P. (2020) · Therapeutic Advances in Psychopharmacology · doi:10.1177/2045125320921694 · Cited by 72
Breedvelt, J., Warren, F. C., Segal, Z. V., Kuyken, W., & Bockting, C. (2021) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2021.0823 · Cited by 69
Role of Benzodiazepines in Anxiety Disorders
Balon, R., & Starčević, V. (2020) · Advances in experimental medicine and biology · doi:10.1007/978-981-32-9705-0_20 · Cited by 72
Latendresse, G., Elmore, C., & Deneris, A. (2017) · Journal of Midwifery & Women s Health · doi:10.1111/jmwh.12607 · Cited by 68
Sørensen, A., Ruhé, H. G., & Munkholm, K. (2022) · Molecular Psychiatry · doi:10.1038/s41380-021-01285-w · Cited by 65
White, E., Read, J., & Julo, S. (2021) · Therapeutic Advances in Psychopharmacology · doi:10.1177/2045125320981174 · Cited by 63
Harrison, S. L., Cations, M., Jessop, T., Hilmer, S. N., Sawan, M. J., & Brodaty, H. (2018) · Drugs & Aging · doi:10.1007/s40266-018-0623-6 · Cited by 63
Nordahl, H., Vogel, P. A., Morken, G., Stiles, T., Sandvik, P., & Wells, A. (2016) · Psychotherapy and Psychosomatics · doi:10.1159/000447013 · Cited by 60
Gastaldon, C., Schoretsanitis, G., Arzenton, E., Raschi, E., Papola, D., Ostuzzi, G., Moretti, U., Seifritz, E., Kane, J. M., Trifirò, G., et al. (2022) · Drug Safety · doi:10.1007/s40264-022-01246-4 · Cited by 68
“These estimates provide the first large body of real-world evidence, suggesting that SNRIs and SSRIs and also TCAs could be associated with a higher risk of withdrawal syndrome, compared to all other drugs [4, 5, 10, 14].”
BackgroundResultInfluentialDiscontinuing Psychiatric Medications: A Survey of Long-Term Users
Ostrow, L., Jessell, L., Hurd, M., Darrow, S. M., & Cohen, D. (2017) · Psychiatric Services · doi:10.1176/appi.ps.201700070 · Cited by 62
“Initial studies have documented the withdrawal effects of various classes of drugs (5,6,13,34).”
BackgroundYoshinaga, N., Matsuki, S., Niitsu, T., Sato, Y., Tanaka, M., Ibuki, H., Takanashi, R., Ohshiro, K., Oshima, F., Asano, K., et al. (2016) · Psychotherapy and Psychosomatics · doi:10.1159/000444221 · Cited by 61
Schramm, E., Zobel, I., Schoepf, D., Fangmeier, T., Schnell, K., Walter, H., Drost, S., Schmidt, P. J., Brakemeier, E., Berger, T., et al. (2015) · Psychotherapy and Psychosomatics · doi:10.1159/000381957 · Cited by 65
Antidepressant tapering strips to help people come off medication more safely
Groot, P. C., & van Os, J. (2018) · Psychosis · doi:10.1080/17522439.2018.1469163 · Cited by 55
The Isoxazole Ring and Its N‐Oxide: A Privileged Core Structure in Neuropsychiatric Therapeutics
Pairas, G., Perperopoulou, F., Tsoungas, P. G., & Varvounis, G. (2017) · ChemMedChem · doi:10.1002/cmdc.201700023 · Cited by 57
Behavioral Toxicity Revisited: Iatrogenic Comorbidity in Psychiatric Evaluation and Treatment
Fava, G. A., Cosci, F., Offidani, E., & Guidi, J. (2016) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000000570 · Cited by 55
“The following psychological symptoms may ensue as well: agitation, anxiety, panic attacks, dysphoria, confusion, and worsening of mood.(16,17) Symptoms typically appear within 3 days of stopping antidepressant medication or initiating a medication taper.”
BackgroundSelf-citationSSRI and SNRI withdrawal symptoms reported on an internet forum
Stockmann, T., Odegbaro, D., Timimi, S., & Moncrieff, J. (2018) · International Journal of Risk & Safety in Medicine · doi:10.3233/jrs-180018 · Cited by 54
“Common symptoms following SSRI withdrawal include dizziness, nausea, fatigue, anxiety, headache, electric shock-like symptoms, sweating, insomnia and nightmares [6].”
InfluentialHengartner, M. P. (2017) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2017.00275 · Cited by 53
“Research has shown that antidepressants may cause severe withdrawal symptoms after discontinuation (61, 62), which in some cases persist for months and therefore are easily misdiagnosed as depression relapse (63).”
BackgroundEffects of Treatment Discontinuation in Clinical Psychopharmacology
Baldessarini, R. J., & Tondo, L. (2019) · Psychotherapy and Psychosomatics · doi:10.1159/000497334 · Cited by 52
Sørensen, A., Juhl Jørgensen, K., & Munkholm, K. (2022) · Therapeutic Advances in Psychopharmacology · doi:10.1177/20451253211067656 · Cited by 52
Kuhlmann, S. L., Arolt, V., Haverkamp, W., Martus, P., Ströhle, A., Waltenberger, J. L., Rieckmann, N., & Müller‐Nordhorn, J. (2019) · Psychotherapy and Psychosomatics · doi:10.1159/000501502 · Cited by 52
Clinical Pharmacopsychology: Conceptual Foundations and Emerging Tasks
Fava, G. A., Tomba, E., & Bech, P. (2017) · Psychotherapy and Psychosomatics · doi:10.1159/000458458 · Cited by 52
Self-citationDiscontinuation of psychotropic medication: a synthesis of evidence across medication classes.
Vinkers, C. H., Kupka, R. W., Penninx, B. W., Ruhé, H. G., van Gaalen, J. M., van Haaren, P. C. F., Schellekens, A. F. A., Jauhar, S., Ramos-Quiroga, J. A., Vieta, E., et al. (2024) · Molecular Psychiatry · doi:10.1038/s41380-024-02445-4 · Cited by 51
“It is hypothesized that most DS coincide with the largest reductions in serotonin transporter (SERT) occupancy, which particularly occur at lower doses [8, 23, 24].”
BackgroundAntidepressant withdrawal – the tide is finally turning
Hengartner, M. P., Davies, J., & Read, J. (2020) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796019000465 · Cited by 48
“…Fava and colleagues maintained that even the common gradual tapers over a few weeks could not substantially reduce the risk of withdrawal reactions (Fava et al., 2015; Fava and Cosci, 2019), a view also supported by recent work published in Lancet Psychiatry, where withdrawal can span over…”
BackgroundResultInfluentialGroot, P. C., & van Os, J. (2020) · Therapeutic Advances in Psychopharmacology · doi:10.1177/2045125320932452 · Cited by 49
Prady, S. L., Pickett, K. E., Gilbody, S. M., Petherick, E., Mason, D., Sheldon, T., & Wright, J. (2016) · BMC Psychiatry · doi:10.1186/s12888-016-0805-x · Cited by 42
“Both gradual and abrupt discontinuation from antidepressants and benzodiazepines in general populations can result in a variety of temporary distressing withdrawal symptoms, although absolute rates have proven difficult to establish, and there are few studies in pregnancy [13–15].”
BackgroundWang, J., & Cosci, F. (2021) · Psychotherapy and Psychosomatics · doi:10.1159/000516031 · Cited by 47
Gibson, K., Cartwright, C., & Read, J. (2016) · BMC Psychiatry · doi:10.1186/s12888-016-0844-3 · Cited by 43
Mechanisms of SSRI Therapy and Discontinuation
Sharp, T., & Collins, H. (2023) · Current Topics in Behavioral Neurosciences · doi:10.1007/7854_2023_452 · Cited by 55
Addiction theory matters—Why there is no dependence on caffeine or antidepressant medication
Heinz, A., Daedelow, L. S., Wackerhagen, C., & Di Chiara, G. (2020) · Addiction Biology · doi:10.1111/adb.12735 · Cited by 45
“There is a growing concern among users of psychiatric services that psychopharmacological drugs including antidepressant medication can cause drug dependence akin to benzodiazepines and other drugs of abuse.(1) Some authors claim that “clinicians are familiar with the withdrawal phenomena that may occur from alcohol,…”
BackgroundClinical guidelines on antidepressant withdrawal urgently need updating
Davies, J., Read, J., Hengartner, M. P., Cosci, F., Fava, G. A., Chouinard, G., van Os, J., Nardi, A. E., Gøtzsche, P. C., Groot, P. C., et al. (2019) · BMJ · doi:10.1136/bmj.l2238 · Cited by 47
Self-citationChiappini, S., & Schifano, F. (2018) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000000814 · Cited by 44
Read, J., Renton, J., Harrop, C., Geekie, J., & Dowrick, C. (2020) · Therapeutic Advances in Psychopharmacology · doi:10.1177/2045125320950124 · Cited by 43
Quilichini, J.-B., Revet, A., Garcia, P., Bouquié, R., Hamard, J., Yrondi, A., & Montastruc, F. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.10.041 · Cited by 42
António, J., Newmire, D. E., Stout, J. R., Antonio, B. B., Gibbons, M., Lowery, L. M., Harper, J., Willoughby, D. S., Evans, C., Anderson, D., et al. (2024) · Journal of the International Society of Sports Nutrition · doi:10.1080/15502783.2024.2323919 · Cited by 57
“This is also the case with certain anti-depressants [194].”
BackgroundThe emerging role of euthymia in psychotherapy research and practice
Guidi, J., & Fava, G. A. (2020) · Clinical Psychology Review · doi:10.1016/j.cpr.2020.101941 · Cited by 40
Self-citationAdamo, D., Pecoraro, G., Coppola, N., Calabria, E., Aria, M., & Mignogna, M. D. (2020) · Oral Diseases · doi:10.1111/odi.13602 · Cited by 43
Overprescribed Medications for US Adults: Four Major Examples
Safer, D. J. (2019) · Journal of Clinical Medicine Research · doi:10.14740/jocmr3906 · Cited by 41
Moncrieff, J. (2018) · BJPsych Bulletin · doi:10.1192/bjb.2017.11 · Cited by 40
Dold, M., Bartova, L., Rupprecht, R., & Kasper, S. (2017) · Psychotherapy and Psychosomatics · doi:10.1159/000477770 · Cited by 38
Is There a Potential of Misuse for Venlafaxine and Bupropion?
Schifano, F., & Chiappini, S. (2018) · Frontiers in Pharmacology · doi:10.3389/fphar.2018.00239 · Cited by 38
“Indeed, several papers have identified the occurrence of withdrawal signs/symptoms relating to a range of ADs, and especially SSRIs (Addictionblog.org, 2012; Harvey and Slabbert, 2014; Fava et al., 2015).”
BackgroundResultInfluentialRead, J. (2020) · Addictive Behaviors · doi:10.1016/j.addbeh.2019.106157 · Cited by 37
“Three systematic reviews have now established that such statements and guidelines have been minimising the problem (Davies & Read, 2019a; Fava et al., 2015; 2018).”
BackgroundDepression in the Primary Care Setting
Ellis, P., Kitay, B. M., & Schmidt, C. J. (2019) · New England Journal of Medicine · doi:10.1056/nejmc1903259 · Cited by 35
How many of 1829 antidepressant users report withdrawal effects or addiction?
Read, J., Cartwright, C., & Gibson, K. (2018) · International Journal of Mental Health Nursing · doi:10.1111/inm.12488 · Cited by 36
Quagliato, L. A., Cosci, F., Shader, R. I., Silberman, E. K., Starčević, V., Balon, R., Dubovsky, S. L., Salzman, C., Krystal, J. H., Weintraub, S. J., et al. (2019) · Journal of Psychopharmacology · doi:10.1177/0269881119859372 · Cited by 40
“However, withdrawal reactions may ensue with either BZs or SSRIs (Belaise et al., 2012; Bhanji et al., 2006; Fava, 2006; Fava et al., 2015; Greenblatt et al., 1990; Nardi et al., 2010; Nielsen et al., 2012; Rickels et al., 1990; Schweizer et al., 1990).”
BackgroundMindfulness-based cognitive therapy for depression.
Riemann, D., Hertenstein, E., & Schramm, E. (2016) · The Lancet · doi:10.1016/s0140-6736(16)00660-7 · Cited by 1,290
Metadata
- Authors
- Fava, G. A., Gatti, A., Belaise, C., Guidi, J., & Offidani, E.
- Affiliations
- University of Bologna (IT)
- Weill Cornell Medicine (US)
- Corresponding author
- Fava, Giovanni A.
- Venue
- Psychotherapy and Psychosomatics
- Publisher
- S. Karger AG
- Published
- 2015
- Volume
- 84
- Issue
- 2
- Pages
- 72-81
- ISSN
- 0033-3190 (ISSN-L)
- 1423-0348
- OpenAlex
- W4292338862
- Cited by
- 436
- References
- 68
- Citations by year
- 2026: 31 · 2025: 40 · 2024: 42 · 2023: 32 · 2022: 40 · 2021: 40 · 2020: 45 · 2019: 61 · 2018: 31 · 2017: 35 · 2016: 25 · 2015: 13
- FWCI
- 4.16
- Type
- journal article
- Language
- en
- Open access
- Locations
- Psychotherapy and Psychosomatics (publishedVersion)
- PubMed (publishedVersion)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
- INFM-OAR (INFN Catania) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
- Keywords
- selective serotonin reuptake inhibitors, SSRI discontinuation, withdrawal syndrome, antidepressant discontinuation, paroxetine, fluoxetine, sertraline, fluvoxamine, citalopram, escitalopram, medication tapering, relapse, adverse drug reactions
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-11, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-11 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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