Evidence map›Paper›PMID 36400895›Full record

ArticleDrug safety2022

Withdrawal Syndrome Following Discontinuation of 28 Antidepressants: Pharmacovigilance Analysis of 31,688 Reports from the WHO Spontaneous Reporting Database.

Chiara Gastaldon, Georgios Schoretsanitis, Elena Arzenton, Emanuel Raschi, Davide Papola, Giovanni Ostuzzi, Ugo Moretti, Erich Seifritz, John M Kane, Gianluca Trifirò and 1 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Drug safety, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 4 pooled it
7.4field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 4 syntheses or guidelines pooled it, 50 citations in OpenAlex.

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  18. Rebound activation of 5-HT neurons following SSRI discontinuation.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 3 countries.

Chiara Gastaldon *WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Piazzale L.A. Scuro, 10, 37134, Verona, Italy. chiara.gastaldon@gmail.com.ORCID 0000-0001-7257-2962
Georgios Schoretsanitis *The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA.
Elena ArzentonSection of Pharmacology, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
Emanuel RaschiPharmacology Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Davide PapolaWHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Piazzale L.A. Scuro, 10, 37134, Verona, Italy.
Giovanni OstuzziWHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Piazzale L.A. Scuro, 10, 37134, Verona, Italy.
Ugo MorettiSection of Pharmacology, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
Erich SeifritzDepartment of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland.
John M KaneThe Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA.
Gianluca TrifiròSection of Pharmacology, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
Corrado BarbuiWHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Piazzale L.A. Scuro, 10, 37134, Verona, Italy.
University of Verona · ITNorthwell Health · USUniversity of Bologna · ITUniversity of Zurich · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionEvidence is lacking on withdrawal syndrome related to individual antidepressants and relevant risk factors for severe reactions.

objectiveTo ascertain whether antidepressants are associated with an increased reporting of withdrawal syndrome as compared with other medications, and to investigate risk factors for severe reactions.

methodsThis is a case/non-case pharmacovigilance study, based on the VigiBase

resultsThere were 31,688 reports of antidepressant-related withdrawal syndrome were found. A disproportionate reporting was detected for 23 antidepressants. The estimated ROR for antidepressants altogether, compared to all other drugs, was 14.26 (95% CI 14.08-14.45), 17.01 for other antidepressants (95% CI 16.73-17.29), 13.65 for SSRIs (95% CI 13.41-13.90) and 2.8 for tricyclics (95% CI 2.59-3.02). Based on clinical priority ranking, the strongest disproportionate reporting was found for paroxetine, duloxetine, venlafaxine and desvenlafaxine, being comparable to buprenorphine. Withdrawal syndrome was reported as severe more often in males, adolescents, persons in polypharmacy, and with a longer antidepressant treatment duration (p < 0.05).

conclusionsAntidepressants are associated with an increased reporting of withdrawal syndrome compared with other drug classes. When prescribing and discontinuing antidepressants, clinicians should be aware of the potentially different proclivity of withdrawal syndrome across individual antidepressants, and the liability to experience more severe withdrawal symptoms in relation to specific patient characteristics.

Indexed as

BuprenorphineSubstance Withdrawal SyndromeAdolescentAntidepressive AgentsBayes TheoremHumansMalePharmacovigilanceSelective Serotonin Reuptake InhibitorsWorld Health OrganizationAntidepressive AgentsBuprenorphineSelective Serotonin Reuptake Inhibitors

Identifiers

PMID36400895
PMCPMC9676852
OpenAlexW4309328263

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.