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Antidepressants: Course and Duration of Therapy, Withdrawal Syndromes, and Resistance to Therapy

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NeuroPsychopharmacotherapy

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Abstract

The course and duration of therapy, withdrawal syndromes, and resistance to therapy are important clinical topics in antidepressant therapy. The reviewed clinical evidence may help to guide clinicians and patients when planning the pharmacological part of the therapy.

The treatment with antidepressants is typically divided into different phases that each require specific considerations.

The recommended course and duration of treatment may vary depending on the respective treatment phase, as well as on individual patient characteristics. Insufficient treatment response occurs frequently and a series of therapeutic options are available such as increase in dosage, combining the current antidepressant with an additional antidepressant, augmentation with another pharmacological substance, and switching to a different antidepressant.

When antidepressant therapy is discontinued, patients may experience withdrawal symptoms/syndromes. Symptoms are generally mild and transient, but, depending on the individual drug, can be severe and impairing for individual patients. Recognizing discontinuation syndromes and differentiating those from re-emergence of the primary disorder is of crucial importance and will have major consequences for further treatment. Indications and guidance for gradual tapering of antidepressants will be discussed.

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Authors and Affiliations

  1. Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany

    Lasse Brandt, Andreas Heinz & Jonathan Henssler

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  1. Lasse Brandt
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  2. Andreas Heinz
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  3. Jonathan Henssler
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Corresponding author

Correspondence to Andreas Heinz .

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Editors and Affiliations

  1. Clinic and Policlinic for Psychiatry, Psychosomatics and Psychotherapy, University Hospital Wuerzburg, Wuerzburg, Germany

    Peter Riederer

  2. Institute of Psychological Medicine (IPM), Soyen, Germany

    Gerd Laux

  3. Centre for Research Promotion and Support, Fujita Health University, Toyoake, Aichi, Japan

    Toshiharu Nagatsu

  4. Center Translational Res Neurol Diseases, Dalian Med Uni Shanghai Inst Health Sc Center Translational Res Neurol Diseases, Dalian, China

    Weidong Le

  5. Würzburg, Germany

    Christian Riederer

Section Editor information

  1. Facharzt für Psychiatrie, Psychotherapie und Neurologie, Dipl.-Psychologe, Institut für Psychologische Medizin (IPM), Soyen, Deutschland

    Gerd Laux Dipl.-Psych.

  2. Department of Psychiatry, Ludwig-Maximilians-University Munich, Munich, Germany

    Hans-Jürgen Möller

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Brandt, L., Heinz, A., Henssler, J. (2022). Antidepressants: Course and Duration of Therapy, Withdrawal Syndromes, and Resistance to Therapy. In: Riederer, P., Laux, G., Nagatsu, T., Le, W., Riederer, C. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-030-62059-2_28

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  • DOI: https://doi.org/10.1007/978-3-030-62059-2_28

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