Michelson, 2000 Interruption of selective serotonin reuptake inhibitor treatment. Double-blind, placebo-controlled trial.

[Altostrata]

Br J Psychiatry. 2000 Apr;176:363-8.

Interruption of selective serotonin reuptake inhibitor treatment. Double-blind, placebo-controlled trial.

Michelson D1, Fava M, Amsterdam J, Apter J, Londborg P, Tamura R, Tepner RG.

 

Abstract at https://www.ncbi.nlm.nih.gov/pubmed/10827885 Free full text at https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/interruption-of-selective-serotonin-reuptake-inhibitor-treatment/F0241958CB073C51F366E2AABE636B5D (download PDF)

 

BACKGROUND:

Abrupt interruption of therapy with selective serotonin reuptake inhibitors (SSRIs) has been associated with somatic and psychological symptoms.

 

AIMS:

Systematically to assess symptoms and effects on daily functioning related to interruption of SSRI therapy.

 

METHOD:

Patients treated with fluoxetine, setraline or paroxetine underwent identical five-day periods of treatment interruption and continued active treatment under double-blind, order-randomised conditions, with regular assessment of new symptoms.

 

RESULTS:

Placebo substitution for paroxetine was associated with increases in the number and severity of adverse events following the second missed dose, and increases in functional impairment at five days. Placebo substitution for sertraline resulted in less pronounced changes, while interruption of fluoxetine was not associated with any significant increase in symptomatology.

 

CONCLUSIONS:

Abrupt interruption of SSRI treatment can result in a syndrome characterised by specific physical and psychological symptoms. Incidence, timing and severity of symptoms vary among SSRIs in a fashion that appears to be related to plasma elimination characteristics.

 

 

ADMIN NOTE

This is the paper presenting the presumption that severity of withdrawal syndrome is based on half-life of the drug. The "interrruption" in treatment was 5 days, observation of withdrawal symptoms 5 days before reinstatement of the drug. This is an inadequate amount of time for observation of withdrawal syndrome.

[Bunyapine]

If they are going to study  the interruption of fluoxetine surely they are going to have study a longer period to find out any significant increase in symptoms!

[Bunyapine]

I get so angry when I read this! It was sponsored by Eli Lilly! If they studied it for much longer periods, surely they would get a better idea of the real problem. But then they would have to find poor willing human guinea pigs to participate. 

[Altostrata]

Lilly was the manufacturer of Prozac, the SSRI antidepressant with the longest half-life.