Studies Reporting Antidepressant Discontinuation Symptoms
| Study, Year (Design) | Duration | Outcome | Intervention (Symptom Rate) | Comparator (Symptom Rate) | Risk Ratio (95% CI) |
|---|---|---|---|---|---|
| Khan et al,38 2014 (RCT) | 4 weeks | Incidence of taper-/posttherapyemergent adverse eventsa | 1-week taper (54/139 = 39%) | Abrupt discontinuation (75/146 = 51%) | 0.76 (0.58–0.98); 1 study |
| Proportion of patients with discontinuation syndromeb | 1-week taper (30/139 = 22%) | Abrupt discontinuation (31/146 = 21%) | 1.02 (0.65–1.59); 1 study | ||
| Himei and Okamura,53 2006 (retrospective cohort study) | 8 weeks | Incidence of discontinuation syndromec | Gradual withdrawald (14/305 = 5%) | Abrupt withdrawal (27/80 = 34%) | 0.14 (0.07–0.25); study |
DESS = discontinuation emergent signs and symptoms; RCT = randomized controlled trial; SSRI = selective serotonin reuptake inhibitor.
Note: All studies took place among patients with depression only (anxiety comorbidities were excluded or not reported).
↵a Adverse events that started or increased in severity during the double blind phase.
↵b An increase of 4 or more points in DESS between baseline and mean score during the first 2 weeks of the double-blind phase.
↵c Diagnosis in medical records and reconfirmation of diagnosis according to criteria for SSRI discontinuation syndrome proposed by Black et al57: (1) symptoms of discontinuation syndrome appear within 3 days following cessation/reduction in the dosage of paroxetine; (2) 2 or more of the following symptoms are present: dizziness, light-headedness, headache, nausea, paraesthesia, loss of balance, irritability, agitation, and insomnia; (3) symptoms cannot be explained as a relapse of depression or as any other medical condition; and (4) symptoms cause significant distress or impairment in social, occupational, and other important areas of functioning.
↵d A 10-mg reduction every 2 weeks.