Jump to content

Katz, 2011 Tachyphylaxis/tolerance to antidepressants in treatment of dysthymia: results of a retrospective naturalistic chart review study.


Recommended Posts

  • Administrator

Tachyphylaxis is "poop-out." Thank you, bubbles, for the pointer to this paper.


Psychiatry Clin Neurosci. 2011 Aug;65(5):499-504. doi: 10.1111/j.1440-1819.2011.02231.x.

Tachyphylaxis/tolerance to antidepressants in treatment of dysthymia: results of a retrospective naturalistic chart review study.

Katz G.


Abstract at http://www.ncbi.nlm.nih.gov/pubmed/21851459 Full text https://onlinelibrary.wiley.com/doi/full/10.1111/j.1440-1819.2011.02231.x



The main goals of this chart-review study were to examine the rate of tachyphylaxis during treatment of dysthymia with antidepressants, to compare the incidence of tolerance during trials of selective serotonin reuptake inhibitors (SSRI) and non-SSRI and to give descriptive analysis of the cases of tachyphylaxis.



The retrospective naturalistic chart review study included 52 cases of successfully treated (with different antidepressants) patients suffering from dysthymia. The overall number of the cases of tolerance to antidepressants were registered as well as the rate of these phenomena in the groups treated with SSRI and non-SSRI.



The cases of tolerance/tachyphylaxis were observed in 12 patients (23% of patients) and in 13 trials (22.4% of trials). All cases of tolerance occurred during monotherapy. No cases of tachyphylaxis were observed in the non-SSRI group while in the SSRI group, tolerance at some stage of the treatment was detected in 41.9% of the successful cases (P < 0.001).



During the treatment of dysthymia with antidepressants in the SSRI group, tachyphylaxis/tolerance might be observed in a relatively in high proportion of cases.


From the paper:



THE PHARMACOLOGIC TERM ‘tachyphylaxis’ is defined as an appearance of progressive decrease in response to a given dose after repetitive administration of a pharmacologically or physiologically active substance.1 In some studies, tachyphylaxis (or ‘poop‐out’) is defined as a relapse or recurrence of an episode of major depression after full recovery from a major depressive episode despite continued treatment with a previously effective antidepressant;2 other studies characterize the phenomenon as a return of depressed mood, apathy or decreased motivation (described by patients as ‘the blahs’), fatigue, dullness in cognitive function, sleep disturbance, weight gain, and sexual dysfunction.3 Patients frequently report the some deterioration they felt after initially achieving remission on the antidepressant, but not as bad as they felt before treatment when they were in an episode of major depression.4 Although in most clinical studies the term tachyphylaxis is used, the term ‘tolerance’ could be more correct from a pharmacologic point of view.5 While the term ‘antidepressant tachyphylaxis’ stresses mostly the possibility of habituation/sensitization mechanisms, the term tolerance is much more comprehensive and includes the mechanisms of pharmacodynamic tolerance, pharmacokinetic tolerance, increase in disease severity, change in disease pathogenesis, depleted effector substance, prominent increase of drug serum level and existence of detrimental metabolite.6 In the current report the terms tachyphylaxis and tolerance have been used interchangeably.



Edited by Altostrata

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Link to comment
Share on other sites

  • 5 years later...

2005 St John's Wort / 2006-2012 Lexapro 20mg, 2 failed attempts to stop, tapered over 4.5 months in early 2012

January 2013 started Sertraline, over time worked up to 100mg

July 2014 Sertraline dropped from 100mg to 75mg, held for six months, slower tapering until 2019 22 Dec 3.2mg

2020 Sertraline 19 Jan 3.1mg, 26 Jan 3.0mg; 1 Mar 2.9, 7 Mar 2.8, May (some drops here) 24 May 2.5, May 29 2.4, June 21 2.3, June 28 2.2mg,  July 4 2.1mg, July 24 (or maybe a bit before) 2mg, early Nov switched to home made suspension; 29 Nov 1.8mg; approx 25 Dec 1.6mg)

2021 Some time in about Jan/Feb realised probably on more like 1.8mg and poss mixing error in making suspension; doses after 10 Feb accurate; 10 Feb 1.6mg; 7 Mar 1.4, continued monthly

10% drops until 1mg, then dropped 0.1mg monthly.

May 2022,0.1mg, now dropping 0.01mg per week

29 August 2022 - first day of zero!

My thread here at SA: https://www.survivingantidepressants.org/topic/1775-bubbles/page/21/

Current: Armour Thyroid



Link to comment
Share on other sites

  • Create New...

Important Information

Terms of Use Privacy Policy