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General practitioners’ and psychiatrists’ attitudes towards antidepressant withdrawal

BACKGROUND: There has been a recent rise in antidepressant prescriptions. After the episode for which it was prescribed, the patient should ideally be supported in withdrawing the medication. There is increasing evidence for withdrawal symptoms (sometimes called discontinuation symptoms) occurring o...

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Autores principales: McCabe, Joanne, Wilcock, Mike, Atkinson, Kate, Laugharne, Richard, Shankar, Rohit
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7345735/
https://www.ncbi.nlm.nih.gov/pubmed/32552920
http://dx.doi.org/10.1192/bjo.2020.48
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author McCabe, Joanne
Wilcock, Mike
Atkinson, Kate
Laugharne, Richard
Shankar, Rohit
author_facet McCabe, Joanne
Wilcock, Mike
Atkinson, Kate
Laugharne, Richard
Shankar, Rohit
author_sort McCabe, Joanne
collection PubMed
description BACKGROUND: There has been a recent rise in antidepressant prescriptions. After the episode for which it was prescribed, the patient should ideally be supported in withdrawing the medication. There is increasing evidence for withdrawal symptoms (sometimes called discontinuation symptoms) occurring on ceasing treatment, sometimes having severe or prolonged effects. AIMS: To identify and compare current knowledge, attitudes and practices of general practitioners (GPs) and psychiatrists in Cornwall, UK, concerning antidepressant withdrawal symptoms. METHOD: Questions about withdrawal symptoms and management were asked of GPs and psychiatrists in a multiple-choice cross-sectional study co-designed with a lived experience expert. RESULTS: Psychiatrists thought that withdrawal symptoms were more severe than GPs did (P = 0.003); 53% (22/42) of GPs and 69% (18/26) of psychiatrists thought that withdrawal symptoms typically last between 1 and 4 weeks, although there was a wide range of answers given; 35% (9/26) of psychiatrists but no GPs identified a pharmacist as someone they may use to help manage antidepressant withdrawal. About three-quarters of respondents claimed they usually or always informed patients of potential withdrawal symptoms when they started a patient on antidepressants, but patient surveys say only 1% are warned. CONCLUSIONS: Psychiatrists and GPs need to effectively warn patients of potential withdrawal effects. Community pharmacists might be useful in supporting GP-managed antidepressant withdrawal. The wide variation in responses to most questions posed to participants reflects the variation in results of research on the topic. This highlights a need for more reproducible studies to be carried out on antidepressant withdrawal, which could inform future guidelines.
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spelling pubmed-73457352020-07-17 General practitioners’ and psychiatrists’ attitudes towards antidepressant withdrawal McCabe, Joanne Wilcock, Mike Atkinson, Kate Laugharne, Richard Shankar, Rohit BJPsych Open Papers BACKGROUND: There has been a recent rise in antidepressant prescriptions. After the episode for which it was prescribed, the patient should ideally be supported in withdrawing the medication. There is increasing evidence for withdrawal symptoms (sometimes called discontinuation symptoms) occurring on ceasing treatment, sometimes having severe or prolonged effects. AIMS: To identify and compare current knowledge, attitudes and practices of general practitioners (GPs) and psychiatrists in Cornwall, UK, concerning antidepressant withdrawal symptoms. METHOD: Questions about withdrawal symptoms and management were asked of GPs and psychiatrists in a multiple-choice cross-sectional study co-designed with a lived experience expert. RESULTS: Psychiatrists thought that withdrawal symptoms were more severe than GPs did (P = 0.003); 53% (22/42) of GPs and 69% (18/26) of psychiatrists thought that withdrawal symptoms typically last between 1 and 4 weeks, although there was a wide range of answers given; 35% (9/26) of psychiatrists but no GPs identified a pharmacist as someone they may use to help manage antidepressant withdrawal. About three-quarters of respondents claimed they usually or always informed patients of potential withdrawal symptoms when they started a patient on antidepressants, but patient surveys say only 1% are warned. CONCLUSIONS: Psychiatrists and GPs need to effectively warn patients of potential withdrawal effects. Community pharmacists might be useful in supporting GP-managed antidepressant withdrawal. The wide variation in responses to most questions posed to participants reflects the variation in results of research on the topic. This highlights a need for more reproducible studies to be carried out on antidepressant withdrawal, which could inform future guidelines. Cambridge University Press 2020-06-18 /pmc/articles/PMC7345735/ /pubmed/32552920 http://dx.doi.org/10.1192/bjo.2020.48 Text en © The Author(s) 2020 http://creativecommons.org/licenses/by/4.0/ http://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Papers
McCabe, Joanne
Wilcock, Mike
Atkinson, Kate
Laugharne, Richard
Shankar, Rohit
General practitioners’ and psychiatrists’ attitudes towards antidepressant withdrawal
title General practitioners’ and psychiatrists’ attitudes towards antidepressant withdrawal
title_full General practitioners’ and psychiatrists’ attitudes towards antidepressant withdrawal
title_fullStr General practitioners’ and psychiatrists’ attitudes towards antidepressant withdrawal
title_full_unstemmed General practitioners’ and psychiatrists’ attitudes towards antidepressant withdrawal
title_short General practitioners’ and psychiatrists’ attitudes towards antidepressant withdrawal
title_sort general practitioners’ and psychiatrists’ attitudes towards antidepressant withdrawal
topic Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7345735/
https://www.ncbi.nlm.nih.gov/pubmed/32552920
http://dx.doi.org/10.1192/bjo.2020.48
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