Abstract
Background: Antidepressant discontinuation syndrome (ADS) occurs frequently in patients undergoing an abrupt discontinuation of their antidepressant medication.
Methods: We evaluated 25 consecutive outpatients with depression who discontinued escitalopram. The presence of ADS was evaluated according to the Anti-Depressants Discontinuation Syndrome (ADDS) checklist.
Results: ADS was observed in 14 of the 25 patients. Frequent symptoms were dizziness (44%), muscle tension (44%), chills (44%), confusion or trouble concentrating (40%), amnesia (28%) and crying (28%). The treatment doses and plasma concentrations of escitalopram were significantly higher in patients with ADS compared to patients without ADS. No group differences were observed regarding age, sex or duration of escitalopram treatment prior to the discontinuation.
Conclusion: These findings suggest that a higher dose and lower clearance of escitalopram lead to a higher risk of ADS. Very slow tapering is recommended for all patients.