The syndrome of discontinuation of antidepressants may occur in up to 1/5 of people taking antidepressants. What exactly is Antidepressant Discontinuation Syndrome, what are the symptoms and what to do to prevent it from occurring? How long does antidepressant discontinuation syndrome last?

Contents:

  1. Antidepressant discontinuation syndrome - causes
  2. Antidepressant discontinuation syndrome - risk factors
  3. Antidepressant discontinuation syndrome - symptoms
  4. Antidepressant discontinuation syndrome - diagnosis
  5. Antidepressant discontinuation syndrome - treatment

Antidepressant discontinuation syndromemay appear in people who have been taking antidepressants for a long time. It can cause flu-like symptoms, such as headaches, feeling crushed, muscle tremors and low-grade fever, but not only.

Many people who are prescribed some psychotropic medications by doctors have various concerns about their use. One of the most worrying possibilities is usually the risk of developing drug dependence.

Indeed, some medications recommended by psychiatrists tend to generate addiction (e.g. benzodiazepines), but most psychotropic drugs are not really addictive.

Concerns around the risk of addiction come from, among others, however, sometimes certain events that are associated with the use of psychotropic drugs are mistakenly considered to be indications of drug dependence. This group of events also includes the syndrome of discontinuation of antidepressants.

The antidepressant drug discontinuation syndrome was first mentioned in the late 1950s - it was then that patients experienced atypical ailments after they stopped taking imipramine, a tricyclic antidepressant.

A similar type of ailments began to be noticed in later years in those who stopped taking other types of antidepressants.

Finally, in 2001, the band's performance was reporteddiscontinuation of antidepressants after discontinuation of 21 antidepressants belonging to different drug classes.

Initially, little was known about this problem - some patients, as well as some doctors, suspected that the symptoms of discontinuation syndrome were nothing more than withdrawal symptoms suggesting that a person taking antidepressants simply became addicted to them.

Today's opinions about the antidepressant drug discontinuation syndrome are completely different, as it is already well known that it is definitely not a symptom of addiction to antidepressants.

Antidepressant discontinuation syndrome - causes

The cause of the syndrome of discontinuation of antidepressants has already been mentioned here - its development is led by the discontinuation of the patient's antidepressants.

Contrary to appearances, the problem occurs with a relatively high frequency - it turns out that it develops in up to 20% of all patients who stop taking antidepressants at some point in their treatment.

In fact, the antidepressant discontinuation syndrome - despite the fact that it has been watched by many specialists - is still a rather enigmatic problem.

The exact pathomechanism of it is not even known, but there are several theories about it.

The most popular seems to be the one according to which the direct cause of the antidepressant discontinuation syndrome are changes in neurotransmitters in the central nervous system.

The effect of taking antidepressants is primarily an increase in the amount of neurotransmitters such as serotonin, noradrenaline or dopamine in the nervous system.

This results in an increased amount of neurotransmitters in the vicinity of synaptic endings, but also a decrease in the number of receptors for them on the postsynaptic endings.

Patients do not feel this during treatment with antidepressants, but when they stop taking their medications, it takes some time for the body to return to normal. For this reason, they may develop the syndrome of discontinuation of antidepressants.

Antidepressant discontinuation syndrome - risk factors

The main risk factor for the syndrome of discontinuation of antidepressants is the sudden discontinuation of these types of drugs - this is especially true when they have been used by the patient for a long time.

It is mentioned that the possibility of a problem occurs for those who have been taking antidepressants throughminimum six weeks.

The half-life of the preparation also has an influence on the possibility of developing the discontinuation syndrome - a greater risk appears when the patient takes antidepressants with a short half-life.

Antidepressant discontinuation syndrome - symptoms

Symptoms resulting from the syndrome of discontinuation of antidepressants typically appear about three days after discontinuation of these medications. However, depending on the half-life of a given pharmaceutical, they can occur earlier or later.

The possible symptoms of this unit include such abnormalities as:

  • flu-like symptoms (e.g. low-grade fever, chills, general feeling of breakdown)
  • feeling very tired
  • diarrhea
  • headaches
  • lack of appetite
  • stomach pains
  • vomiting
  • insomnia
  • nightmares
  • dizziness
  • photophobia
  • visual disturbance
  • sensory disturbance (e.g. tingling)
  • akathisia
  • myoclonus
  • depressed mood
  • anxiety
  • irritability

Although these are quite rare situations, symptoms such as even strong psychomotor agitation or psychotic symptoms (e.g. in the form of hallucinations or delusions) may also appear in the course of antidepressant discontinuation syndrome.

Antidepressant discontinuation syndrome - diagnosis

Theoretically, it would seem that the diagnosis of the antidepressant discontinuation syndrome is relatively simple - it would be enough to link the occurrence of unpleasant ailments with the discontinuation of antidepressants taken by the patient for a long time.

In practice, however, there are many diagnostic difficulties, resulting for example from the fact that sometimes the patients themselves are not informed about the consequences of discontinuing antidepressant therapy.

It happens that the patient suspects that he has, for example, an infection or other serious disease. For this reason, he sometimes goes to various specialists and he has not necessarily needed tests performed.

Due to such a possibility, it is so important that the psychiatrists in the treatment should draw patients' attention to what ailments may arise after discontinuation of antidepressants.

It is worth emphasizing one thing here. Well, when suspecting the syndrome of discontinuation of antidepressants, one should consider whether it is actually himappeared in the patient, or maybe he has had a recurrence of disorders for which he was taking antidepressants (e.g. depressive disorders).

Both problems can be distinguished, among others, by by re-introducing antidepressants to the patient - in the case of discontinuation syndrome, such an event should improve the patient's condition very quickly.

Antidepressant discontinuation syndrome - treatment

As the antidepressant discontinuation syndrome happily does not last long (typically after 7-14 days it disappears completely on its own), the related ailments can even seriously hinder the patient's functioning.

In a situation where the symptoms of antidepressant discontinuation syndrome are not severe, it is possible to simply wait patiently for their resolution. However, when they become very intense, several strategies can be considered.

One of them is restarting the patient's previously used medication and then gradually, very slowly, reducing his dose.

Another option is to replace the patient's drug with a short half-life with a drug with a longer half-life, which later, gradually, will be taken by the patient in smaller and smaller doses, until finally the drug is completely discontinued.

Antidepressant Discontinuation Syndrome: Prevention

The most important in the case of the syndrome of discontinuation of antidepressants are the attempts to prevent its occurrence. First of all, patients should be informed about the possibility of its occurrence and about its symptoms.

It is worth mentioning that discontinuation syndrome is something different from addiction - after all, in the case of antidepressants, patients do not even feel compelled to obtain these drugs after stopping taking them.

The possibility of developing this problem can be reduced by gradually reducing the dose of an antidepressant - especially in those who have been taking these preparations for a very long time, it is beneficial to slowly reduce the dosage, based on regular assessment of the patient's well-being.

About the authorBow. Tomasz NęckiA graduate of the medical faculty at the Medical University of Poznań. An admirer of the Polish sea (most willingly strolling along its shores with headphones in his ears), cats and books. In working with patients, he focuses on always listening to them and spending as much time as they need.

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Category:

Psychiatry