Furthermore,
Stopping antidepressants: symptoms but infrequent:
When stopping antidepressants. Furthermore, patients undergo some associated symptoms but with low incidence, below the clinical threshold to characterize a stop syndrome. For example, A large meta-analysis led by British researchers thus questions the preconceptions that have had “Significant effects on health policies. Similarly, attitude towards the use of antidepressants”.
Meta-analysis, published in the Jama Psychiatryincludes 50 studies, totaling nearly 18,000 patients, mainly women (67 %), aged 44 on average. Consequently, The clinical trials covered different diagnoses. Furthermore, the main ones of which were: major depressive disorder (28), generalized anxiety disorder (9) and panic disorder (4). Therefore, Researchers conclude that the tangible stop symptoms are presented, but their frequency of occurrence is much less suggested.
Dizziness. For example, nausea as the main symptoms – Stopping antidepressants: symptoms but infrequent
On average, compared to stopping a placebo or maintaining antidepressants, the treatment stop was associated with only stopping antidepressants: symptoms but infrequent an additional symptom with a post interruption week. A value which is under the threshold of clinical significance to define a stop syndrome. according to the DESS scale (discontinuization emerging Signs and Symptoms) which fixes it at least four symptoms. More specifically, this average number amounted to 1.61 for duloxetine, 1.37 for venlafaxine and 0.56 for vortioxetine.
The most frequent symptom was stunning (Odds Ratio [OR] at 5.52; Risk Difference [RD] at 6.24 %), probably because of the effects of serotonin on the vestibular system, followed by nausea (gold at 3.16; RD at 2.90 %), dizziness (gold at 6.4; RD at 2.31 %), nervousness or irritability (or 3.15; RD at 1.3 %) and agitated dreams or nightmares (gold at 3; 2.44 %).
Depressive symptoms are not due to the treatment stop
The treatment interruption was not associated with fatigue. paraesthesia, tremors or pain, or with the reappearance of depressive symptoms. stopping antidepressants: symptoms but infrequent Thus, the worsening of mood is correlated with a relapse and not to the symptoms of stopping. Conversely. the researchers observed a greater prevalence of anxiety and nervousness: before diagnosing a relapse of an anxious disorder, it will be necessary to ensure the independence of symptoms in relation to the stop of antidepressants.
In accordance with what was known. the venlafaxine stops is associated with a higher impact of symptoms due to its rapid clearance, the main one is also dizziness (17.5 % of patients). Regarding this treatment, no difference was noted between a brutal and progressive stop. However. “The question of a decreasing cessation scheme is open, given the concerns raised in different studies as well as a possible Nocebo effect. This must be carefully evaluated with real life, through randomized placebo clinical trials, with a rigorous methodology ”defend the authors. For all the antidepressants studied, the duration stopping antidepressants: symptoms but infrequent of treatment was not associated with stop symptoms.
Inform without dramatizing
The study demonstrates a lower impact of symptoms when the antidepressants stopped with the placebo. This underlines the need for a placebo control group when assessing the stop symptoms to take into account the. Nocebo effect. “However, this does not suggest that the symptoms are not real”advise researchers. And add: “Recognition of the burden of stop effects is crucial. however it is important that the speeches of health and media professionals are proportionate. »» The authors argue in particular that to focus on these symptoms increases the possibility of occurrence of real. incapacitating symptoms (Nocebo effect).
“Patients using antidepressants are obviously worried about what can happen when you stop treatment”comments Dr. Susannah Murphy, department of psychiatry at the University of Oxford, in a reaction on Science Media Centre. “The conclusions carried out by stopping antidepressants: symptoms but infrequent the study suggesting a low prevalence of symptoms could be useful to doctors to inform their patients of these potential effects. while reassuring them about their low incidence”she adds.
Professor Katharina Domschke. psychiatry professor at the University of Freiburg (Germany), salutes “The excellent methodological quality of the study, which is the most complete meta-analysis on date”. It compliments the interest of the individual analysis of molecules which highlights a favorable profile for vortioxetine. “This study is highly welcome to help reassure patients and destigmatize the use of antidepressants”she rejoices.
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