Practitioner 2010; 254 (1734): 8-10

Antidepressants should be tapered down gradually before stopping

24 Nov 2010Pais-up subscribers

An observational study from Sardinia has found that rapid discontinuation of antidepressants places patients at increased risk of early relapse.There were 398 patients, 261 women and 137 men, included in the study: 224 had a DSM-IV diagnosis of recurrent major depressive disorder, 75 panic disorder and 99 bipolar disorder. Patients were followed up with regular semistructured interviews and rating scale assessments. 'The association between the speed of discontinuation and time to relapse remained highly significant after adjustment for factors known to be associated with increased risk of relapse, including the number of previous episodes, depression severity and shorter duration of antidepressant treatment.However, not all potential confounders were accounted for. It is possible, for example, that those patients who choose to stop their treatment abruptly are more likely to have personality traits or mood cycling disorders which place them at increased risk of relapse.'

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