A.H. Young, A Currie, Physicians' knowledge of antidepressant withdrawal effects: a survey, J Clin Psychiatry, 1997, 58 (suppl 7), 28-30.

This paper was presented at the closed symposium 'SSRI Discontinuation Events' held December 17, 1996 in Phoenix, Ariz., and sponsored by an unrestricted educational grant from Eli Lilly and Company.

Authors' abstract: "Background: While the incidence of discontinuation events in controlled studies of serotonin re-uptake inhibitors ranges between 34.5% and 86%, only a small number of discontinuation reactions are reported to national data bases of spontaneously reported adverse drug reactions. It was hypothesized that the disparity was due to lack of knowledge amongst physicians about the potential for antidepressant discontinuation reactions. Method: Therefore, a questionnaire was mailed to 100 psychiatrists and 100 general practitioners (GPs) in northeast England to assess the knowledge base and to validate this assumption. Results: Fifty psychiatrists (50%) and 53 GPs (53%) responded to the questionnaire. Of the respondents, 36 (72%) of the psychiatrists and 16 (30%) of the GPs were aware that patients may experience antidepressant discontinuation events; 33 (66%) psychiatrists and 22 (42%) GPs had had experience with patients who had discontinuation symptoms; and 10 (20%) psychiatrists and 9 (17%) GPs said they always caution patients about the possibility of discontinuation events. Conclusion: According, to the results of the survey, a sizable minority of physicians denied being confidently aware of the existence of antidepressant withdrawal symptoms. Education about discontinuation reactions, including the hallmark features, symptoms, and course. is needed for both psychiatrists and family practice physicians."

A copy of this paper was sent to Medicines Control Agency (Dr Jones), by way of commenting on the Agency's belief that the risk of withdrawal reactions from SSRIs is so low as to be "undetectable except through spontaneous reporting where drug exposure is high".

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