Table 2

Studies Reporting Antidepressant Discontinuation Symptoms

Study, Year (Design)DurationOutcomeIntervention (Symptom Rate)Comparator (Symptom Rate)Risk Ratio (95% CI)
Khan et al,38 2014 (RCT)4 weeksIncidence of taper-/posttherapyemergent adverse eventsa1-week taper (54/139 = 39%)Abrupt discontinuation (75/146 = 51%)0.76 (0.58–0.98); 1 study
Proportion of patients with discontinuation syndromeb1-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 weeksIncidence of discontinuation syndromecGradual 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.