Department of Psychology, University of Bath, Bath, UK.
Bristol Medical School, Centre for Academic Mental Health, Population Health Sciences, University of Bristol, Bristol, UK.
Health Expect. 2024 Feb;27(1):e13966. doi: 10.1111/hex.13966.
Our knowledge of the broader impacts of antidepressant withdrawal, beyond physical side effects, is limited. Further research is needed to investigate the lived experiences of withdrawal, to aid clinicians on how to guide patients through the process.
To explore antidepressant users' experiences and views on the withdrawal process and how it affected their quality of life across multiple life domains.
We conducted in-depth qualitative interviews with 20 individuals from the community who had attempted to withdraw from Serotonin Reuptake Inhibitor antidepressants in the past year.
Semi-structured interviews were conducted online. A topic guide was used to ensure consistency across interviews. The interviews were audio-recorded and transcribed verbatim and analysed using inductive reflexive thematic analysis.
Five themes were generated. The first highlighted the challenges of managing the release from emotional blunting and cognitive suppression following antidepressant discontinuation. The second related to the negative impact of withdrawal on close relationships and social interactions. The third showed that concurrent with negative physical symptoms, there was a positive impact on health (exercise was reported by some as a coping mechanism). The fourth theme focused on support from GPs and families, emphasising the importance of mental health literacy in others. The final theme underscored the importance of gradual and flexible tapering in enabling a manageable withdrawal experience, and the consideration of timing.
The lived experience of withdrawal significantly impacts individuals' well-being. Participants emphasised that withdrawal is not just about physical side effects but also affects their emotional, cognitive, and social functioning.
PATIENT AND PUBLIC INVOLVEMENT (PPI): Eight people attended individual online meetings to share their experiences of antidepressant withdrawal to help inform the study design and recruitment strategy. Insights from these meetings informed the development of the topic guide. Questions about GP involvement, family relationships, and mood and thinking changes were included based on this PPI work. This ensured the inclusion of topics important to antidepressant users and facilitated the researcher's questioning during the interviews.
我们对抗抑郁药戒断除了身体副作用之外的更广泛影响知之甚少。需要进一步研究来调查戒断的真实体验，以帮助临床医生指导患者度过这一过程。
探索抗抑郁药使用者对戒断过程的体验和看法，以及戒断过程如何影响他们在多个生活领域的生活质量。
我们对过去一年中试图停止使用选择性 5-羟色胺再摄取抑制剂类抗抑郁药的 20 名社区居民进行了深入的定性访谈。
在线进行半结构化访谈。使用主题指南来确保访谈的一致性。访谈进行了录音，并逐字转录，采用归纳性反思主题分析方法进行分析。
生成了五个主题。第一个主题强调了在停止使用抗抑郁药后，从情绪麻木和认知抑制中恢复所面临的挑战。第二个主题涉及戒断对亲密关系和社交互动的负面影响。第三个主题表明，与负面身体症状同时出现的是对健康的积极影响（一些人报告说锻炼是一种应对机制）。第四个主题侧重于全科医生和家庭的支持，强调了他人心理健康素养的重要性。最后一个主题强调了逐渐和灵活地逐渐减少剂量以使戒断过程更易于管理，并考虑时机的重要性。
戒断的真实体验会对个人的幸福感产生重大影响。参与者强调，戒断不仅仅是身体副作用的问题，还会影响他们的情绪、认知和社交功能。
患者和公众参与（PPI）：八人参加了单独的在线会议，分享他们对抗抑郁药戒断的体验，以帮助确定研究设计和招募策略。从这些会议中获得的见解为主题指南的制定提供了信息。根据这项 PPI 工作，包括了有关全科医生参与、家庭关系以及情绪和思维变化的问题。这确保了纳入了抗抑郁药使用者重要的主题，并促进了研究人员在访谈中的提问。
