Interruption of selective serotonin reuptake inhibitor treatment - Double-blind, placebo-controlled trial

Background Abrupt interruption of therapy with selective serotonin reuptake inhibitors (SSRIs) has been associated with somatic and psychological symp toms. Aims Systematically to assess symptoms and effects on daily functioning rel ated to interruption of SSRI therapy. Method Patients treated with fluoxetine, setraline or paroxetine underwent identical five-day periods of treatment interruption and continued active t reatment under double-blind order-randomised conditions, with regular asses sment of new symptoms. Results Placebo substitution for paroxetine was associated with increases i n the number and severity of adverse events following the second missed dos e, and increases in functional impairment at five days. Placebo substitutio n for sertraline resulted in less pronounced changes, while interruption of fluoxetine was not associated with any significant increase in symptomatol ogy. Conclusions Abrupt interruption of SSRI treatment can result in a syndrome characterised by specific physical and psychological symptoms. Incidence, t iming and severity of symptoms vary among SSRIs in a fashion that appears t o be related to plasma elimination characteristics. Declaration of interest This work was sponsored by Eli Lilly and Company.