Addressing Clinical Challenges of Antidepressant Discontinuation

TO THE EDITOR: Jha and associates (1), in the December 2018 issue of the Journal, addressed the clinical challenges that are entailed when discontinuing selective serotonin reuptake inhibitor (SSRI) medication. The authors cited a systematic review stating that “up to 40% of patients reported new-onset symptoms after abruptly discontinuing SSRIs” (2). Actually, the review concluded that withdrawal syndromes are likely to occur with both abrupt and gradual tapering, without any significant advantage of the latter (2). The idea that by slowly tapering we can avoid withdrawal syndromes is simply not supported by the literature, both in the case of SSRIs (2) and serotonin-norepinephrine euptake inhibitors (3).