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停用抗抑郁药长期治疗的漫长曲折之路:从我的经验中学习。

The long and winding road of discontinuing long-term use of antidepressants: Learning from my experience.

机构信息

Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Chelmsford, UK.

出版信息

J Psychiatr Ment Health Nurs. 2020 Dec;27(6):850-856. doi: 10.1111/jpm.12623. Epub 2020 Mar 20.

Abstract

WHAT IS KNOWN ON THE SUBJECT?: More people experience withdrawal symptoms when weaning off antidepressants than previously thought; particularly after taking them for a long time. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: I explore my own experience of weaning off antidepressants; detailing conflicting advice I have received from healthcare professionals, and the mental and physical withdrawal symptoms I experienced. I relate my experiences to a growing body of research, which have important implications for improving care. WHAT ARE THE IMPLICATIONS FOR MENTAL HEALTH NURSING?: Healthcare professionals should make patients aware of potential withdrawal symptoms they may experience before they wean off antidepressants; regularly review their progress; consider helping them access psychological support whilst weaning off; and engage in open and collaborative conversations with patients throughout. Clinical guidance needs to be updated to provide appropriate evidence-based information/advice/recommendations for how best to support patients when coming off of antidepressants. ABSTRACT: A significant proportion of the UK population are taking antidepressants, and have been taking them for at least a year. Clinical guidelines have controversially stated that withdrawal symptoms when weaning off antidepressants are mild and resolve after one week, with the proviso that they can be severe only if the drug is stopped abruptly. However, recent evidence suggests this is not the case. I describe my own experiences of tapering the dose of my antidepressants after several years of taking them. I describe my encounters with healthcare professionals throughout this period, detailing conflicting advice I have received, along with describing the mental and physical withdrawal symptoms I have experienced. My experiences relate to a growing body of research, which have important implications for improving care. Potential learning outcomes are that healthcare professionals should make patients aware of potential withdrawal symptoms they may experience before they wean off antidepressants; regularly review their progress; consider helping them access psychological support whilst weaning off; and engage in open and collaborative conversations with patients throughout the process. Clinical guidance needs to be updated to provide appropriate evidence-based information, advice, and recommendations for how best to support patients when coming off of antidepressants.

摘要

已知信息

相较于之前的认知,更多人在停用抗抑郁药时会出现戒断症状,尤其是长期服药后。本研究的新增信息:本文详细阐述了我自身停用抗抑郁药的经历,包括我收到的相互矛盾的专业建议,以及我经历的精神和身体戒断症状。我将自己的经历与越来越多的研究联系起来,这些研究对抗抑郁药停药护理具有重要意义。对精神健康护理的意义:医务人员应在患者停药前告知其可能出现的戒断症状;定期评估进展;考虑在停药过程中为患者提供心理支持;并在整个过程中与患者进行开放和协作的对话。临床指南需要更新,以提供有关如何最好地支持患者停药的适当基于证据的信息/建议/推荐。

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