Patients wishing to stop taking SSRIs should seek professional advice
first
Patients concerned that they may experience withdrawal effects when they
stop taking their prescribed antidepressant should not do anything sudden
and should discuss the matter with their doctor or with a psychiatric
pharmacist, Stephen Bazire, pharmacy services director, Norfolk Mental
Health Care NHS Trust, said this week. His comments follow a Panorama
programme broadcast on 13 October that looked at the problems some patients
have had while being treated with paroxetine (Seroxat).
Mr Bazire explained that the withdrawal reactions and adverse effects
sometimes associated with antidepressant treatment can be minimised by
starting and stopping treatment slowly. “There are several ways patients
can minimise discontinuation reactions — using the syrup, which can
be diluted, or by breaking tablets. Another way is to switch to fluoxetine,
which has a much longer half-life.”
He commented that the programme had confused the two issues of starting
and stopping selective serotonin reuptake inhibitors (SSRIs) by presenting
them together. “These problems are separate and can happen when most
SSRIs and, in fact, most antidepressants, are either started or stopped,”
he said. To minimise the risk of akathisia (motor restlessness) when treatment
is started, Mr Bazire recommends patients “start with a half dose
for a few days then go to the full dose”.
The Medicines Control Agency has also responded to the Panorama programme.
It points out that reports of serious symptoms on withdrawal of SSRIs,
such as severe electric shock sensations, vertigo and manic reactions,
have been isolated.
The fact that paroxetine is eliminated from the body more quickly than
other SSRIs might explain the higher number of yellow card reports of
withdrawal reactions associated with it, it adds.
A web link to the MCA response can be found on the PJ Online links page
(www.
pjonline.com/links).
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