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Titolo:
Antidepressant discontinuation syndromes - Clinical relevance, prevention and management
Autore:
Haddad, PM;
Indirizzi:
Mental Hlth Serv Salford, Salford M30 0GT, Lancs, England Mental Hlth ServSalford Salford Lancs England M30 0GT GT, Lancs, England
Titolo Testata:
DRUG SAFETY
fascicolo: 3, volume: 24, anno: 2001,
pagine: 183 - 197
SICI:
0114-5916(2001)24:3<183:ADS-CR>2.0.ZU;2-P
Fonte:
ISI
Lingua:
ENG
Soggetto:
PAROXETINE WITHDRAWAL SYNDROME; SEROTONIN REUPTAKE INHIBITORS; OBSESSIVE-COMPULSIVE DISORDER; MONOAMINE-OXIDASE INHIBITORS; HUMAN BREAST-MILK; ABRUPT DISCONTINUATION; NURSING INFANTS; PANIC DISORDER; ADVERSE EVENTS; SYMPTOMS;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
108
Recensione:
Indirizzi per estratti:
Indirizzo: Haddad, PM Mental Hlth Serv Salford, Cromwell House,Cromwell Rd, Salford M30 0GT, Lancs, England Mental Hlth Serv Salford Cromwell House,Cromwell Rd Salford Lancs England M30 0GT
Citazione:
P.M. Haddad, "Antidepressant discontinuation syndromes - Clinical relevance, prevention and management", DRUG SAFETY, 24(3), 2001, pp. 183-197

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 stoppageand 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 Severe cases can be treated symptomatically or the antidepressant can be reinstated before being gradually withdrawn.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 leadsto 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 breastfeeding. 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 dataor expert opinion. Research is needed to provide a firm evidence base for future recommendations.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 10/07/20 alle ore 00:07:23