Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-20T13:42:57.370Z Has data issue: false hasContentIssue false
  • English
  • Français

Survey of symptoms associated with antidepressant discontinuation

Published online by Cambridge University Press:  13 June 2014

Ashar Khan ,
Roisin Kelly  and
Michael Gill
Ashar Khan
Affiliation:
Mental Health Service, Wellington Hospital, Private Bag 7902, Wellington South, New Zealand
Roisin Kelly
Affiliation:
St. Davnet's Hospital, Monaghan, Co Monaghan, Ireland
Michael Gill
Affiliation:
Department of Psychiatry, St. James's Hospital, James's St, Dublin 8, Ireland
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: Literature reports on SSRI associated discontinuation symptoms are variable. As a result, the prevalence of an antidepressant halo effect can not be ruled out. This survey aims to assess the awareness and experience of these symptoms among doctors in Ireland.

Method: Questionnaires were sent to a random sample of 100 GPs, NCHDs and consultants. A questionnaire measured awareness, experience and reported severity, of SSRI discontinuation symptoms as opposed to TCAs, the latter being used as ‘controls’. Data was statistically analysed using SPSS (Windows Version 8.0).

Results: Response to the questionnaire was as follows: 37% of GPs (n = 37), 35% consultants (n = 35) and 18% NCHDs (n = 18). Comparisons were made between the three groups. There was significant variability in the reported recognition and severity of symptoms specific to the SSRI discontinuation syndrome within and between the groups. Overall NCHDs attribute less discontinuation symptoms to SSRIs (p = 0.038) and GPs attribute more to TCAs (p = 0.03).

Conclusions: Doctors tend to generalise discontinuation symptoms to all antidepressants with significant variation in reporting practices. Thus there is a need for randomised control studies to aid the recognition and prevention of the discontinuation syndrome.

Keywords

AntidepressantsSelective serotonin reuptake inhibitorsTricyclic antidepressantsDiscontinuation syndromeSurveyAwarenessExperience
Type
Original Papers
Information
Irish Journal of Psychological Medicine , Volume 16 , Issue 3 , September 1999 , pp. 89 - 92
Copyright
Copyright © Cambridge University Press 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Coppen, AJ. The biochemistry of affective disorders. Br J Psychiat 1967; 113: 1237–64.Google Scholar
2.Feighner, JP, Boyer, WF, eds. Selective serotonin reuptake inhibitors; advances in basic research and clinical practice. 2nd ed. Surrey, England: John Wiley, 1996.Google Scholar
3.Montgomery, SA, Kasper, S. Comparison of compliance between selective serotonin reuptake inhibitor and tricyclic antidepressant: a meta-analysis. Int Clin Psychopharmacol 1995; 6(4): 33–40.Google Scholar
4.Aguglia, E, Casacchia, M, Cassano, GBet al.Double-blind study of efficacy and safety of sertraline versus fluoxetine in major depression. Int Clin Psychopharmacol 1996; 8: 197–202.Google Scholar
5.DeWilde, J, Spiers, R, Mertens, Cet al.A double-blind comparative multi-centre study comparing paroxetine with fluoxetine in depressed patients. Acta Psychiat Scand 1993; 87: 141–5.Google Scholar
6.Mitchell, PB. Selective serotonin reuptake inhibitors: adverse effects, toxicity and interactions. Adverse Drug Reactions Toxicological Rev 1994;13: 121–44.Google Scholar
7.Kapur, S, Mieczkowski, T, Mann, JJ. Antidepressant medications and the relative risk of suicide attempt and suicide. JAMA 1992; 268: 3441–5.Google Scholar
8.Kapser, S, Moeller, HJ. Selective serotonin reuptake inhibitors and suicidality. Clin Neuropharmacol 1992; 15(1, suppl B): 36.Google Scholar
9.Kerr, JS, Fairweather, DB, Mahendran, Ret al.The effects of paroxetine, alone and in combination with alcohol on psychomotor performance and cognitive function in the elderly. Int Clin Psychopharmacol 1992; 7: 101–8.Google ScholarPubMed
10.Van-Harten, J, Stevens, LA, Raghoebar, Met al.Fluvoxamine does not interact with alcohol or potentiate alcohol-related impairment of cognitive function. Clin Pharmacology Therapeutics 1992; 52(suppl 4): 427–35.Google Scholar
11.Stembach, H. The serotonin syndrome. Am J Psychiat 1991; 148: 705–13.Google Scholar
12.Dilsaver, SC, Greden, JF. Antidepressant withdrawal phenomena. Biol Psychiat 1984; 19: 237–56.Google Scholar
13.Gamer, EM, Kelly, MW, Thompson, DF. Tricyclic antidepressant withdrawal syndrome. Ann Pharmacotherapy 1993; 27: 1068–72.Google Scholar
14.Committee on Safety of Medicines and Medicine Control Agency. Dystonia and withdrawal symptoms with paroxetine. Current problems in pharmacovigilance 1993; 19: 1.Google Scholar
15.Adverse Drug Reactions Advisory Committee. Selective serotonin reuptake inhibitors and withdrawal syndrome. Aust Adverse Drug Reactions Bull 1996; 15: 3.Google Scholar
16.Price, JS, Wailer, PC, Wood, SMet al.A comparsion of the post marketing safety of four selective serotonin reuptake inhibitors including the investigations of symptoms occurring on withdrawal. Br J Clin Pharmacol 1996; 42(suppl 6): 757–63.Google Scholar
17.Schatzberg, AF, Haddad, P, Kaplan, EMet al.Serotonin reuptake inhibitor discontinuation syndrome: a hypothetical definition, discontinuation consensus panel. J Clin Psychiat 1997; 58(suppl 7): 5–10.Google ScholarPubMed
18.Coupland, NJ, Bell, CJ, Potakar, JP. Serotonin reuptake inhibitor withdrawal. J Clin Psychopharmacology 1996; 16: 356–62.Google Scholar
19.Gillespie, C, Wudgust, H, Haddad, Pet al.Selective serotonin reuptake inhibitors and withdrawal syndrome. In: Proceedings of the 10th World Congress of Psychiatry Aug 23-28, 1996; Madrid Spain, Abstract G2389.Google Scholar
20.Lane, RM. Withdrawal symptoms after discontinuation of selective serotonin reuptake inhibitors. J Serotonin Res 1996; 3: 75–83.Google Scholar
21.Lejoyeux, M, Ades, J. Antidepressant discontinuation: a review of literature. J Clin Psychiat 1997; 58(suppl 7): 11–6.Google Scholar
22.Donoghue, J, Tylee, A, Wudgust, H. Cross sectional database analysis of antidepressant prescribing in general practice in the United Kingdom 1993-1995. BMJ 1996; 313: 861–2.Google Scholar