Rapid discontinuation was associated with a significantly shorter time to relapse than gradual discontinuation (median, 3.6 vs. 8.4 months). The authors estimated that time to relapse after rapid discontinuation was only 25% of the average time to earlier relapses in the same patients. The findings were most evident for bipolar I and panic disorders. After rapid discontinuation, the intervals preceding relapse were similar among different drug types, but after gradual discontinuation, time to relapse was substantially longer with tricyclics than with modern antidepressants. Relapse risk was the least pronounced for medications with prolonged half-lives and was not associated with antidepressant dose, duration of illness or treatment, or concurrent treatment.
Rapid vs. Gradual Discontinuation of Antidepressants
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