Zwiebel, 2022. Discontinuing antidepressants: Pearls and pitfalls

[Tridentata]

Zwiebel, S. J., & Viguera, A. C. (2022). Discontinuing antidepressants: Pearls and pitfalls. Cleveland Clinic Journal of Medicine, 89(1), 18–26. https://doi.org/10.3949/ccjm.89a.21020

 

This article falls in between the "In the Media" and "From journals and scientific sources" forums because while it is peer-reviewed it doesn't present primary research. The Cleveland Clinic Journal of Medicine's mission is "to provide its readers with up-to-date, practical, clinical information relevant to internal medicine, cardiology, and related fields" and therefore "focuses on timely review articles and other content that has a continuing-education orientation rather than on original research or case reports". As such, this article might be something more useful to share with a general-practice doctor or non-psychiatric specialist who prescribes antidepressants for pain, etc., rather than with a psychiatrist who thinks they already know everything there is to know about antidepressant withdrawal. [If a moderator thinks it belongs in the Journals & scientific sources forum, feel free to move it if you are able to.]

 

https://www.ccjm.org/content/89/1/18

 

Abstract:

 

Quote

Stopping antidepressants can be challenging due to the high rate of discontinuation symptoms. Patients with antidepressant discontinuation syndrome (ADS) commonly experience insomnia, flu-like symptoms, mood disturbances, dizziness, and paresthesias, but a broad array of adverse effects is possible. Symptoms can last for days to months, and different symptoms have different durations. Patient education, identification of patients most at risk for developing symptoms, and a slow antidepressant taper or cross-taper are important steps in mitigating the risk of ADS and managing patient concerns about ADS. Tapers should be carried out over weeks to months. Discontinuation symptoms should be managed with restarting the prior dose of antidepressant and then tapering even more slowly, with additional symptomatic management as needed.

 

Edited February 16, 2023 by Altostrata
added citation

[j1290]

Great article.  They really got it right on the side effects for tapering Bupropion.