Talk:SSRI discontinuation syndrome

tags

The article currently has two tags applied to the entire text. The "original research" tag has been there more than a year. The "expert" tag has been there for months. However, there seems to be no current discussion as to what the tags refer to or are trying to resolve? Does anyone object if I remove the tags?TVC 15 (talk) 02:34, 13 September 2009 (UTC)

Sections of the article remain unreferenced and, in the absence of verification, constitute original research. Please leave the tags until this is resolved. For example, the following sentences and sections need references:

• "The condition often begins between 24 hours to one week after reduction in dosage or complete discontinuation, depending on the elimination half-life of the drug."
• "The prescribing labels of SSRIs acknowledge the possibility of "intolerable" discontinuation reactions, and some patients have extreme difficulty discontinuing use from SSRI drugs."
• The entire "Indicators" section.
• "Several pharmacokinetic and pharmacodynamic factors influence the frequency and onset of these symptoms. When allowed to run its course, the syndrome duration is variable (usually one to several weeks) and ranges from mild-moderate intensity in most patients, to extremely distressing in a smaller number of patients who may have side effects for months."
• "Due to a lack of peer reviewed diagnostic criteria many physicians, unaware of the potential severity of discontinuation syndrome, do not get informed consent at the time of initial prescription from the patient (though patients in clinical trials do), so this syndrome can be an unexpected barrier to patients attempting to discontinue the drug. In addition, warnings to patients not to stop taking the drug without doctor's approval, while indicated, may lead to a reluctance to discontinue SSRI therapy in patients who need not take the drugs long-term."
• "Critics argue that the pharmaceutical industry has a vested interest in creating a distinction between addiction to recreational or illegal drugs and dependence on antidepressants."
• The first two paragraphs of the "Mechanism" section.
• "The condition may be avoided by either recommencing the original, and/or lesser dose of the SSRI (or a similar SSRI), or slowly reducing the dosage over several weeks or months. While slowly reducing the dosage does not guarantee that a patient will not experience the discontinuation syndrome, it is considered a safer method than abrupt discontinuation. Gradual discontinuation, or tapering, or titration, can be accomplished by breaking pills into parts or using a graduated oral syringe with the liquid form. Alternatively, a compounding pharmacy may take one's prescription and divide it into smaller graduated doses. For example, a 20mg prescription of Cymbalta which comes in gel capsules containing tiny sphere-shaped pellets, may be divided into 20, 15, 10, 5 and 2.5mg doses."
• "Discontinuation of Duloxetine" is almost entirely unreferenced, and only cites the manufacturer's prescribing info.
• "Neonatal withdrawal" contains several unreferenced statements at the beginning.
• The last three paragraphs of "Controversy" have no references.

I'm sure you can find citations for most, if not all of these. Many can be copied over from paroxetine, I bet. Until then, the tags need to stay. Skinwalker (talk) 00:03, 16 September 2009 (UTC)

cold-turkey and sexual desire

Personally and several other anecdotes found on support forums describe returning sexual desire with a vengeance upon sudden discontinuation of SSRI's. I've searched for the last hour but can not find reputable sources. My experience was with clomipramine and it like reentering adolescence. It was the sole psychoactive drug in my system and the new found desire was accompanied by the electric shocks as the clomipramine 1/2 lives passed. I had seen Scientific American article on human love where low serotonin/ high dopamine levels were involved. I found this poor source upon quick search but I believe there is better. SSRI withdrawal results in lowered serotonin, and in some people whose dopamine levels were unaffected by their depression, then perhaps their mind is put into the passionate love state looking for a partner to attach to. Anyone have supporting sources? 71.86.152.127 (talk) 06:41, 22 September 2009 (UTC)

I found this for you: increase of libido upon treatment emergence is 1% or less for Cipramil Alatari (talk) 16:03, 21 October 2009 (UTC)

Spelled out name

Is there a reason we recently spelled out SSRI? Is there a policy about never using abreviations in titles? Because I know there is one saying that we need to use the most common name. This syndrome is rarely if ever spelled out. It's always SSRI discontinuation syndrome or SSRI withdrawal syndrome. In fact, I think I'll be BOLD and move it back, unless there's a good explanation in the history.— trlkly 19:25, 30 September 2009 (UTC)

Nope, you need more than "per main." WP:MAIN is just the front page. There is no other reason given. I give WP:COMMONNAME. — trlkly

Just replying to the edit summaries for the comments above: as explained in the History section of the article, "discontinuation" and "withdrawal" are used interchangeably. The manufacturers understated the likelihood of withdrawal symptoms, and chose the term discontinuation to avoid the association with addiction. However, withdrawal is the more accurate term, because the widely reported withdrawal symptoms are novel to the patients (i.e., not just relapse to prior symptoms) and thus establish physical dependence.TVC 15 (talk) 03:36, 1 October 2009 (UTC)

Needs references, balance

Hello. I'd like to suggest some edits. I tried editing Wikipedia a long time ago and had a terrible experience, and I can't even remember the protocol since it's been so long, so I thought it'd be safer to post suggestions here and let someone else who's more in the know roll with them if they'd like to.

• The introduction states, "The prescribing labels of some SSRIs note the possibility of 'intolerable' discontinuation reactions. Some patients have extreme difficulty discontinuing use of SSRI drugs." Not only are these claims not referenced, but they're misleading, given that the vast majority of patients, if they experience this syndrome, do not find the reactions intolerable and don't have "extreme difficulty" discontinuing. The introduction also says studies demonstrate "statistically and clinically significant indications of difficulties with the discontinuing of SSRIs," thus further espousing the difficulties of discontinuing SSRIs without balancing that with the fact that most people don't have major problems.

• In the history section, last paragraph, fluoxetine is said to have "the highest number of drug dependence reports." The WHO site was down when I tried to check the reference, so I don't know what year that report was from or whether it really says people become dependent on fluoxetine (given that the quoted paragraph above this claim, from WHO, seems to dispute that notion), but to my understanding, it's generally accepted that people do not become dependent on antidepressants, in the way that the general public thinks of dependence.

• Why is the section about sexual dysfunction in this article? It seems to be straight fear mongering. It even states, "It should be duly noted that this condition has not been well-established or proven in the field of medicine, thus patients are not warned of the potential condition by their physicians and it is not listed in consumer information leaflets." Um ... so ... again, why is it in here? It then lists a bunch of scary things that may--or apparently may not--happen to you when you go off antidepressants. It does not mention that one side effect of being on antidepressants is a low libido and so getting off them can actually result in a raised libido, as one of the comments above notes.

• The controversy section is completely one-sided. Arguments from critics are explained in detail, but the other sides are not. There is no indication that these criticisms are from the minority or have evidence against them.

Overall, parts of this article seem misleading to me, and it concerns me because many myths and baseless fear mongering is out there about antidepressants already. People who are depressed deserve to know the facts, and to understand that these drugs are approved because the benefits far outweigh the risks, according to mainstream medicine. This is literally a life-or-death topic and must be handled in an unbiased manner. I'm obviously not arguing for side effects and concerns to be deleted. I'm urging for them to be presented appropriately, with the weight that most experts believe they actually carry--no more and no less. JustFactsPlease (talk) 07:23, 15 October 2010 (UTC)

5-htp

5-htp also has the SSRI discontinuation syndrome. I think it's because of the tolerance of the serotonin receptors so anything that rises the serotonin levels daily, will produce tolerance low slowly. — Preceding unsigned comment added by 134.147.35.48 (talk) 17:43, 1 September 2011 (UTC)