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Showing results for tags 'lancet psychiatry'.
https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(19)30182-8/fulltext This just came out as a response to the Horrowitz paper. It is proposing a much more aggressive path to discontinuation than the 10% rule and has tapering schedules for a number of drugs. Seems like they call their version mini tapering and the 10% reduction micro-tapering. They also seem to be against long holds between tapering. "This Taskforce does not consider prolonged use of any dosage of these discontinuation steps without further attempts of discontinuation as being rational pharmacotherapy. SNRI=serotonin–norepinephrine reuptake inhibitor." Here is the abstract: "In their excellent manuscript, published in The Lancet Psychiatry, Mark Horowitz and David Taylor 1 share their personal view on tapering of SSRI treatment to mitigate antidepressant withdrawal symptoms. In the Netherlands, this topic has been raising debate as well, 2 which urged representatives of the Dutch college of General Practitioners, the Royal Dutch Pharmacists Association, the Dutch Association for Psychiatry, and the patient organisation MIND to develop multidisciplinary recommendations for the discontinuation of SSRIs and serotonin–norepinephrine reuptake inhibitors (SNRIs; appendix pp 1–15). Independent of Horowitz and Taylor,1 but with identical reasoning, we proposed reducing doses of SSRIs or SNRIs hyperbolically, and we also advocated the strategy of mini-tapering (table; appendix pp 3–6)." On a positive note, there seems to be a long term trial of discontinuation of SSRIs in the Netherlands. Details here: https://opera-project.nl/