We need to focus more on antidepressant withdrawal relief

We need to focus more on antidepressant withdrawal relief
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Researchers analyse data that can guide antidepressant discontinuation and enable an individual to experience some form of antidepressant withdrawal relief.

There has been a significant amount of attention regarding the problem’s patients face when discontinuing antidepressant drugs. However, there appears to be few indications, particularly in guidelines and reviews. Nevertheless, Giovanni Fava, MD and Carlotta Belaise, Ph.D., analyse data that can guide antidepressant discontinuation and have the potential to provide patients with antidepressant withdrawal relief. Available to read in the Journal of Psychotherapy and Psychosomatics.

The importance of highlighting adverse effects of antidepressants

The damages of miseducation regarding antidepressants are difficult to overcome. Antidepressants are important and possibly life-saving drugs if the proper indications are endorsed. However, the prescribing physician is currently driven by an overestimated consideration of potential benefits, with little attention to the likelihood of responsiveness and neglect of potential vulnerability to the adverse effects of treatment.

A rational use of antidepressants that incorporates all potential benefits and harms consists in targeting their application only to the most persistent cases of depression, limiting their use to the shortest possible time, and reducing their exploitation in anxiety disorders (unless a major depressive disorder is present or other treatments have been ineffective).

Since behavioural toxicity appears to be related to the dosages of antidepressants, the lowest dose of these agents that seems to be both effective and well tolerated should be employed. Augmenting strategies such as adding new psychotropic drugs to the regimen need to be carefully weighed, if not avoided, because of their strong link with behavioural toxicity and the risk of reducing antidepressant withdrawal relief.

One should be particularly concerned with young patients who are given antidepressants for anxiety disorders and prolong this treatment indefinitely without undergoing any form of psychotherapy. What will be the long-term outcome of their disturbances? Will tolerance develop and trigger deterioration and refractoriness? Will this lead to more severe cases of mental health issues?

According to the authors, the time has come to initiate research on antidepressant withdrawal relief, and to redefine the use and indications of these medications, including their differential likelihood of inducing behavioural toxicity.

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