Antidepressant discontinuation (withdrawal) symptoms were first reported in association with imipramine (Mann & MacPherson, 1959; Andersen & Kristiansen, 1959), the first tricyclic antidepressant (TCA), shortly after it entered clinical use. These symptoms occur with all classes of antidepressant, including the TCAs, monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), serotonin and noradrenaline reuptake inhibitors (SNRIs) and miscellaneous others such as mirtazapine, a noradrenergic and specific serotonergic antidepressant (NaSSA). A PubMed review conducted when preparing this article identified reports of discontinuation symptoms with 25 antidepressants (Box 1). In recent years the phenomenon has attracted increasing interest, in both the scientific literature and in the lay media (BBC Panorama, 2002, 2003). This article provides an overview of the clinical features of antidepressant discontinuation symptoms, with the emphasis on their recognition, prevention and management. Discontinuation symptoms can occur whenever antidepressants are used, i.e. they are not dependent on the presence of any underlying psychiatric disorder. The pharmacokinetics and dynamics of antidepressants, in particular their half-life, are important determinants of discontinuation symptoms, as are individual patient characteristics, but their discussion is beyond the scope of this article (Schatzberg et al, 1997; Haddad, 1998; Bogetto et al, 2002).
http://apt.rcpsych.org/cgi/content/full/13/6/447
Can Psychiatr Assoc J. 1959 Jan;4(1):38-47.
Clinical experience with imipramine (G22355) in the treatment of depression.
MANN AM, MACPHERSON AS.
PMID: 13629473 [PubMed - indexed for MEDLINE]
MeSH Terms, SubstancesMeSH Terms:Depression/therapy*Tranquilizing Agents/therapeutic use*Substances:Tranquilizing Agents
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Friday, 29 October 2010
Antidepressant discontinuation (withdrawal) symptoms were first reported 1959 - 5 years before Fiddaman's birth
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