Antidepressant discontinuation symptoms
Antidepressants are among the most commonly prescribed drugs worldwide.
Antidepressants are medications used to treat depression, anxiety and some chronic pain conditions.
There are several types of antidepressants.
First Generation: MAO inhibitors and tricyclic antidepressants.
And newer, second-generation antidepressants: including selective serotonin reuptake inhibitors and more recently selective serotonin and noradrenaline reuptake inhibitors.
Second Generation antidepressants are effective and with less side effects.
But problem arises when it comes to discontinue antidepressants. They have withdrawal symptoms And dependence problem. When symptoms reoccur or relapse when discontinue medication.
Withdrawal symptoms is called antidepressant discontinuation syndrome and include:
flu-like symptoms, trouble sleeping, nausea, poor balance, sensory changes;
Anxiety, and depression.
The risk is greater among those who have taken the medication for longer.
All classes of drug that are prescribed to treat depression are associated with withdrawal syndromes.
The problem usually begins within three days after stopping antidepressant intake. and may last for several months, but Most cases of discontinuation syndrome, may last between one and four weeks and resolve on their own.
The prevention of such withdrawal is gradually decreasing the dose. Usually dose is reduced by 50 % . allowing two to six weeks between dose reductions. According to some research 2 weeks is not enough for does reduction and at least 4 weeks is needed.
Dose reduction process is called tapering. According to studies tapering is most effective if it lasts at least 3 months.
Tapers over a period of months and down to doses much lower than minimum therapeutic doses have shown greater success in reducing withdrawal symptoms.
If withdrawal symptoms occurs on lower dose then back to previous dose.
Also it is possible to switch from other antidepressant to fluoxetine which is long acting antidepressant and then can then be gradually decreased.
Approximately 20–50% of people who suddenly stop an antidepressant, develop an antidepressant discontinuation syndrome.
The condition is generally not serious. Since symptoms are mild and self-limiting in the majority of cases, detailed patient education is often sufficient; if necessary.
although about half of people with symptoms describe them as severe.
And sometimes it is difficult to differentiate it is withdrawal symptoms or disease relapse.
When depression back sometimes it back with worse symptoms. It is called rebound effect.
Psychological interventions, such as cognitive behavioral therapy (CBT) and mindfulness-based cognitive therapy (MBCT) are potential alternatives to antidepressants for preventing relapse and recurrence of depression.
