McCabe Joanne, Wilcock Mike, Atkinson Kate, Laugharne Richard, Shankar Rohit
University of Exeter Medical School Knowledge Spa, Royal Cornwall Hospital, Truro, UK.
Royal Cornwall Hospitals NHS Trust, Treliske, Truro, UK.
BJPsych Open. 2020 Jun 18;6(4):e64. doi: 10.1192/bjo.2020.48.
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.
To identify and compare current knowledge, attitudes and practices of general practitioners (GPs) and psychiatrists in Cornwall, UK, concerning antidepressant withdrawal symptoms.
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.
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.
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.
近期抗抑郁药处方量有所上升。在药物被开具用于治疗的疗程结束后，理想情况下应帮助患者停用药物。越来越多的证据表明，停药时会出现戒断症状（有时称为停药症状），有时会产生严重或持久的影响。
识别并比较英国康沃尔郡全科医生（GP）和精神科医生关于抗抑郁药戒断症状的现有知识、态度和做法。
在一项与有实际经验的专家共同设计的多项选择横断面研究中，向全科医生和精神科医生询问有关戒断症状及管理的问题。
精神科医生认为戒断症状比全科医生认为的更严重（P = 0.003）；53%（22/42）的全科医生和69%（18/26）的精神科医生认为戒断症状通常持续1至4周，尽管给出的答案范围很广；35%（9/26）的精神科医生但没有全科医生认为药剂师可用于帮助管理抗抑郁药戒断。约四分之三的受访者称，当开始给患者使用抗抑郁药时，他们通常或总是会告知患者潜在的戒断症状，但患者调查显示只有1%的患者得到过警告。
精神科医生和全科医生需要有效地警告患者潜在的戒断影响。社区药剂师可能有助于支持全科医生管理的抗抑郁药停药。参与者对大多数问题的回答差异很大，这反映了该主题研究结果的差异。这突出表明需要对抗抑郁药戒断进行更多可重复的研究，为未来的指南提供参考。
