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Antidepressant Discontinuation Syndrome

Author: Dana Bartlett, RN, BSN, MSN, MA, CSPI
(Click author's name for bio)

CE: 2 hours Pharmacology: 0.5 hour
Rated 4.6 out of 5.0 based on 676 reviews

Course Summary

Antidepressant discontinuation syndrome is a clinical diagnosis. However, no evidence-based and accepted diagnostic criteria exist. Distinct clinical characteristics of three types of antidepressant discontinuation syndrome can be used to make a diagnosis. The Drug Emergent Signs and Symptoms (DESS) Scale and the Diagnostic clinical Interview for Drug Withdrawal 1 (DID-W1) are considered reliable tools for recognizing and diagnosing withdrawal symptoms. Multiple types of antidepressants can lead to antidepressant discontinuation syndrome with symptoms that vary from mild to severe, persisting for many years. It is difficult assessing the withdrawal effect from antidepressants due to the lack of conclusive evidence and study bias evaluating the duration of withdrawal symptoms. Nonetheless, study results have suggested that longer-term use of an antidepressant is typically associated with long-lasting withdrawal symptoms. Withdrawal can also be psychological and is considered common. Case studies are included that emphasize risk factors such as genetics and the pathophysiology of antidepressant discontinuation syndrome, as well as treatment.

Course Format


Course Syllabus

I. Introduction

II. Discontinuation Syndrome versus Withdrawal

III. Clinical Presentation

    1. Symptom Onset, Severity and Duration
    2. Risk Factors, Withdrawal Syndrome and Causative Agents
    3. Rationale for Discontinuing Antidepressants
    4. Differentiating Between the Types of ADS
    5. New Withdrawal Syndrome
    6. Rebound Withdrawal Syndrome
    7. Persistent Post Withdrawal Syndrome
    8. ADS versus Relapse
    9. Differential Diagnosis: Relapse versus Withdrawal

IV. Pathophysiology of ADS

    1. Discontinuing an Antidepressant

V. Treatment of ADS

    1. Basic and Supportive Care
    2. Restarting or Switching Antidepressants
    3. Cognitive Behavioral Therapy

VI. Case Study: A Diagnosis of ADS

    1. Discussion

VII. Summary


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