Greater Clinical Risk Following Rapid Antidepressant Withdrawal

n patients with major depressive disorder, panic disorder, or bipolar disorder, the risk for illness recurrence is far greater following abrupt or rapid, vs gradual, discontinuation of clinically effective antidepressant treatment, according to a study published online May 17 in the American Journal of Psychiatry.

“Our findings of greater clinical risk following rapid versus gradual discontinuation of antidepressants is one of several similar findings that we have reported over the years,” Ross J. Baldessarini, MD, from Harvard Medical School, Boston, and McLean Hospital, Belmont, Massachusetts, told Medscape Psychiatry.

“We found this phenomenon first with discontinuing lithium in bipolar disorder patients and later with antipsychotic drugs in schizophrenia patients. Similar risks also are well known in rapidly stopping sedative-anxiolytics and anticonvulsants (both of which can lead to epileptic-like seizures),” he added.

According to Dr. Baldessarini, it was not easy to obtain data on effects of discontinuing the use of antidepressants rapidly vs gradually because single studies involving both conditions had virtually been unknown. “To my knowledge, our report is the first to involve such a comparison with antidepressants of various types,” he said.

Reported by Megan Brooks
Medscape Medical News

The study was supported in part by the National Institutes of Health. Dr. Baldessarini and several coauthors report being consultants or receiving research support from several pharmaceutical companies that make antidepressant medications.

Am J Psychiatry. Published online May 17, 2010

Submitted by Anna

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