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Cited by 214Treatment of Major DepressionPharmacovigilance and Adverse Drug ReactionsElectroconvulsive Therapy Studies

The DOI matches its Crossref record; 100 of the 100 references it cites were found in a registry or an index.

Antidepressant Discontinuation Syndromes: Clinical Relevance, Prevention and Management

Haddad, Peter M.·2001·Drug Safety
DOI 10.2165/00002018-200124030-00003
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Abstract

Discontinuation symptoms are recognised with tricyclic antidepressants, monoamine oxidase inhibitors, selective serotonin reuptake inhibitors (SSRIs) and miscellaneous antidepressants. A wide variety of symptoms have been described, differing somewhat between antidepressant classes, and several symptom clusters or discontinuation syndromes appear to exist. A common feature is onset within a few days of stopping the antidepressant or, less commonly, reducing the dosage. Discontinuation syndromes are clinically relevant as they are common, can cause significant morbidity, can be misdiagnosed leading to inappropriate treatment and can adversely effect future antidepressant compliance. Preventative strategies include tapering antidepressants prior to stoppage and educating patients and healthcare professionals to ensure that antidepressants are taken consistently and not stopped abruptly. Most reactions are mild and short-lived and require no treatment other than patient reassurance. Severe cases can be treated symptomatically or the antidepressant can be reinstated before being gradually withdrawn. Reinstatement usually leads to symptom resolution within 24 hours. Some individuals require very conservative tapering schedules to prevent the re-emergence of symptoms. With SSRIs and venlafaxine another strategy to consider is switching to fluoxetine, which may suppress the discontinuation symptoms, but which has little tendency to cause such symptoms itself. Neonatal discontinuation symptoms can follow maternal use of antidepressants during pregnancy and possibly breast feeding. The patient and doctor must take this into consideration when making prescribing decisions. Discontinuation symptoms have received little systematic study with the result that most of the recommendations made here are based on anecdotal data or expert opinion. Research is needed to provide a firm evidence base for future recommendations.

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Citations

Cites

Research works printed but not linked: 25

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Metadata

Authors
Haddad, P. M.
Corresponding author
Haddad, Peter M.
ORCID
Haddad, Peter M.
Venue
Drug Safety
Publisher
Springer Science and Business Media LLC
Published
2001
Volume
24
Issue
3
Pages
183-197
ISSN
0114-5916 (ISSN-L)
DOI
10.2165/00002018-200124030-00003
OpenAlex
W1593032895
Cited by
214
References
99
Citations by year
2026: 7 · 2025: 6 · 2024: 7 · 2023: 5 · 2022: 10 · 2021: 5 · 2020: 5 · 2019: 5 · 2018: 9 · 2017: 8 · 2016: 7 · 2015: 10 · 2014: 7 · 2013: 24 · 2012: 4
FWCI
1.13
Type
journal article
Language
en
Open access
closed
Locations
  • Drug Safety (publishedVersion)
  • PubMed (publishedVersion)
  • Research Explorer (The University of Manchester) (submittedVersion)
Topics
  • Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
  • Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
Keywords
antidepressant discontinuation syndrome, antidepressant withdrawal symptoms, selective serotonin reuptake inhibitors, tricyclic antidepressants, monoamine oxidase inhibitors, antidepressant tapering, fluoxetine, venlafaxine, breastfeeding
MeSH terms
Animals, Antidepressive Agents, Antidepressive Agents, Tricyclic, Humans, Monoamine Oxidase Inhibitors, Patient Compliance, Substance Withdrawal Syndrome, Syndrome, Selective Serotonin Reuptake Inhibitors

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