Antidepressant Discontinuation Syndrome Flashcards
how long would someone have had to take antidepressants continuously to be at risk of antidepressant discontinuation syndrome
at least one month (according to DSM)
*symptoms cant have been present before antidepressant dosage was reduced and are not better explained by another mental disorder
what is antidepressant discontinuation syndrome
set of symptoms that can occur after an ABRUPT cessation or marked reduction in dose of an antidepressant medication that was taken continuously for at least one month
how soon do symptoms of antidepressant discontinuation syndrome begin to arise
within about 2-4 days
what sorts of symptoms are typical of antidepressant discontinuation syndrome
specific sensory, somatic and cognitive-emotional manifestations
i.e
flashes of light
“electric shock” sensations
nausea
hyper-responsivity to noises or light
nonspecific anxiety or dread
how to alleviate symptoms of antidepressant discontinuation syndrome
restarting same med or starting a different medication with similar mechanism of action
what does the incidence of antidepressant discontinuation syndrome depend on
dosage and half life oft he medication being taken
also depends on rate at which medication is tapered
which types of antidepressants pose greatest risk for antidepressant discontinuation syndrome
short acting medications that are stopped abruptly rather than being tapered
which SSRI is the medication most commonly associated with antidepressant discontinuation syndrome
paroxetine
*but such symptoms occur with all types of antidepressants
are there any pathognomonic symptoms of antidepressant discontinuation syndrome
no
symptoms tend to be vague and variable
what symptoms of antidepressant discontinuation syndrome associated with SSRIS (like paroxetine) may be described
dizziness
ringing in the ears
“electric shocks on the head”
inability to sleep
acute anxiety
is the antidepressant discontinuation syndrome related to the reinforcing effects of an antidepressant
no–> it is based solely on pharmacological factors
what is the prevalence of antidepressant discontinuation syndrome
unknown
thought to vary according to dosage prior to discontinuation, half life and receptor binding affinity of the med
individual genetics may also play a role due to changes in metabolism
what is the course of antidepressant discontinuation syndrome
studies are lacking, little is known
symptoms appear to abate over time with very gradual dosage reductions
ddx antidepressant discontinuation syndrome
anxiety disorders
depressive disorders
SUDs
tolerance to medications
how does antidepressant discontinuation syndrome differ from substance withdrawal
antidepressants themselves have no reinforcing or euphoric effects
*med dosage not usually increased without clinician permission and individuals generally does not engage in drug seeking behavior to obtain additional medication–> criteria for SUD not met
