Antidepressants Discontinuation Syndrome Vs Depression Relapse


Q: How can you clinically differentiate antidepressants discontinuation syndrome from relapse and recurrence of underlying depression?


 

(1) SYMPTOMS:

  • Distinctive symptom of discontinuation is dizziness, which is not characteristic of relapse.

 

 

(2) TIME COURSE OF ONSET OF SYMPTOMS:

  • Discontinuation symptoms emerge within few hours to days of medication discontinuation or dose reduction. 

  • Discontinuation symptoms are generally mild, short-lived, and self-limiting (but can be distressing also). 

 

  • Relapse or recurrence typically takes 2-3 weeks or longer after medication discontinuation or dose reduction. 

  • Relapse or recurrence are mostly heralded by worsening depression, insomnia, and psychomotor symptoms.

 

 

(3) RESPONSE TO RESTARTING ANTIDEPRESSANT:

  • Discontinuation symptoms are readily reversed

  • Symptoms of relapse or remission are not so readily reversed.

 

What other clinical factors can be used to differentiate them? 
You can post your comments by using the reply option below.

 


SOURCE:

  • Prim Care Companion J Clin Psychiatry. 2001; 3(4): 168–174. (pdf)

  • J Clin Psychiatry. 1997;58 Suppl 7:37-40. (pubmed)


Please do post your questions or comments below. 


Dr. Harvinder Singh, M.D. (Admin)


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Responses

  1. FINISH, F for flu-like symptoms, I for Insomnia, N for nausea, I for imbalance, S for sensory disturbances, and H for hyperarousal.

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