Antidepressant discontinuation syndrome: A state-of-the-art clinical review
- PMID: 36345093
- DOI: 10.1016/j.euroneuro.2022.10.005
Antidepressant discontinuation syndrome: A state-of-the-art clinical review
Abstract
Antidepressant drugs are prescribed to patients with depressive, anxiety disorders, and other conditions. Evidence about antidepressant discontinuation syndrome (ADS) and related outcomes is sparse, although potentially burdensome in some patients. The present state-of-the-art review aims to appraise the most current evidence about ADS critically. ADS has been documented for most antidepressant drugs, although most literature focuses on selective serotonin reuptake inhibitors prescribed for depression. While down-titration cannot exclude the chance of ADS, it is nonetheless warranted in the clinical setting, especially for short half-life and sedative compounds such as paroxetine. Integrative management with concurrent pharmacotherapy and psychotherapy may minimize the eventual unpleasant effects arising within the discontinuation process. In addition, patient-tailored interventions and education should be part of the discontinuation strategy. Future research must rely on broadly accepted definitions for ADS and related phenomena such as antidepressant withdrawal and shed further light on the underpinning neurobiology. Discriminating between ADS-related phenomena and relapse of depression is likewise warranted, along with a neuroscience-based nomenclature instead of a class one.
Keywords: Antidepressant; Discontinuation syndrome; Review; Withdrawal.
Copyright © 2022 Elsevier B.V. and ECNP. All rights reserved.
Conflict of interest statement
Declaration of Competing Interest EV has received grants and served as consultant, advisor, or CME speaker for the following entities (unrelated to the present work): AB-Biotics, Abbvie, Aimentia, Angelini, Biogen, Boehringer -Ingelheim, Casen-Recordati, Celon, Dainippon Sumitomo Pharma, Ferrer, Gedeon Richter, GH Research, Glaxo Smith-Kline, Janssen, Lundbeck, Organon, Otsuka, Sage, Sanofi-Aventis, Sunovion, Takeda, and Viatris. All outside of the present work. MF received consulting fees & fees for non-CME/CE services from: Angelini, AstraZeneca, Boehringer Ingelheim, Bristol Meyers Squibb, Eli Lilly, GlaxoSmithKline, Innova Pharma, Lundbeck, Pfizer, Sanofi, Servier. All outside of the present work. GM has been a consultant and/or a speaker and/or has received research grants from Angelini, Doc Generici, Janssen-Cilag, Lundbeck, Otsuka, Pfizer, Servier, and Recordati. All outside of the present work. CIC received consulting fees from Lundbeck and Johnson and Johnson. All outside of the present work. FVR and DDB have no conflict of interest to disclose in conjunction with the present work.
