Book contents
- CASE STUDIES Stahl’s Essential Psychopharmacology
- Reviews
- CASE STUDIES: Stahl’s Essential Psychopharmacology
- Copyright page
- Contents
- Introduction
- List of icons
- Abbreviations
- Case 1: The salutatorian who couldn’t speak: selective serotonin reuptake inhibitor (SSRI)-refractory anxiety in an adolescent
- Case 2: From anxious to activated: selective serotonin reuptake inhibitor (SSRI)-related activation
- Case 3: The girl who couldn’t sleep: posttraumatic stress disorder (PTSD) in a young girl
- Case 4: Depressed and still depressed: major depressive disorder (MDD) in an adolescent
- Case 5: A 13-year-old adolescent who feels “amazing”: selective serotonin reuptake inhibitor (SSRI)-induced mania in an adolescent
- Case 6: Counting on a cure: obsessive compulsive disorder (OCD) in an adolescent
- Case 7: Struggles in the second grade: attention-deficit hyperactivity disorder (ADHD) in a child
- Case 8: From prodrome to psychosis: early-onset schizophrenia
- Case 9: Too much, too little, or just right? Lithium dosing in an adolescent
- Case 10: Tic, tic, tic: motor and vocal tics in a boy
- Case 11: How slow can you go? Selective serotonin reuptake inhibitor (SSRI) withdrawal and discontinuation in an adolescent
- Case 12: The adolescent who doesn’t eat: anorexia nervosa in an adolescent
- Case 13: High or higher antidepressant concentrations? Cannabis-related drug interactions in an adolescent
- Case 14: The boy whose bed was always wet: nocturnal enuresis in a child
- Case 15: Counting sheep and counting treatment trials: insomnia disorder in an adolescent
- Case 16: Second-generation antipsychotics/mixed dopamine–serotonin receptor agonists (SGAs), side effects, and the autism spectrum: SGA-related side effects in a boy with autism spectrum disorder (ASD)
- Case 17: The “standard treatment” is earning a “D”: treatment-resistant schizophrenia
- Case 18: Symptoms, side effects, or both? Selective serotonin reuptake inhibitor (SSRI) tolerability and physical symptoms in an anxious adolescent
- Book part
- Case Studies Index
- Drugs Index
- References
Case 11: How slow can you go? Selective serotonin reuptake inhibitor (SSRI) withdrawal and discontinuation in an adolescent
Published online by Cambridge University Press: 09 February 2024
Book contents
- CASE STUDIES Stahl’s Essential Psychopharmacology
- Reviews
- CASE STUDIES: Stahl’s Essential Psychopharmacology
- Copyright page
- Contents
- Introduction
- List of icons
- Abbreviations
- Case 1: The salutatorian who couldn’t speak: selective serotonin reuptake inhibitor (SSRI)-refractory anxiety in an adolescent
- Case 2: From anxious to activated: selective serotonin reuptake inhibitor (SSRI)-related activation
- Case 3: The girl who couldn’t sleep: posttraumatic stress disorder (PTSD) in a young girl
- Case 4: Depressed and still depressed: major depressive disorder (MDD) in an adolescent
- Case 5: A 13-year-old adolescent who feels “amazing”: selective serotonin reuptake inhibitor (SSRI)-induced mania in an adolescent
- Case 6: Counting on a cure: obsessive compulsive disorder (OCD) in an adolescent
- Case 7: Struggles in the second grade: attention-deficit hyperactivity disorder (ADHD) in a child
- Case 8: From prodrome to psychosis: early-onset schizophrenia
- Case 9: Too much, too little, or just right? Lithium dosing in an adolescent
- Case 10: Tic, tic, tic: motor and vocal tics in a boy
- Case 11: How slow can you go? Selective serotonin reuptake inhibitor (SSRI) withdrawal and discontinuation in an adolescent
- Case 12: The adolescent who doesn’t eat: anorexia nervosa in an adolescent
- Case 13: High or higher antidepressant concentrations? Cannabis-related drug interactions in an adolescent
- Case 14: The boy whose bed was always wet: nocturnal enuresis in a child
- Case 15: Counting sheep and counting treatment trials: insomnia disorder in an adolescent
- Case 16: Second-generation antipsychotics/mixed dopamine–serotonin receptor agonists (SGAs), side effects, and the autism spectrum: SGA-related side effects in a boy with autism spectrum disorder (ASD)
- Case 17: The “standard treatment” is earning a “D”: treatment-resistant schizophrenia
- Case 18: Symptoms, side effects, or both? Selective serotonin reuptake inhibitor (SSRI) tolerability and physical symptoms in an anxious adolescent
- Book part
- Case Studies Index
- Drugs Index
- References
Summary
When discontinuing an SSRI in an adolescent with major depressive disorder following 12 months of treatment, the highest risk of relapse occurs:
- Type
- Chapter
- Information
- Case Studies: Stahl's Essential PsychopharmacologyChildren and Adolescents, pp. 173 - 184Publisher: Cambridge University PressPrint publication year: 2023
References
Emslie, G. J., Heiligenstein, J. H., Hoog, S. L., et al. Fluoxetine treatment for prevention of relapse of depression in children and adolescents: a double-blind, placebo-controlled study. J Am Acad Child Adolesc Psychiatry 2004; 43(11): 1397–405. https://doi.org/10.1097/01.chi.0000140453.89323.57Google Scholar
Emslie, G. J., Kennard, B. D., Mayes, T. L., et al. Fluoxetine versus placebo in preventing relapse of major depression in children and adolescents. Am J Psychiatry 2008; 165(4): 459–67. https://doi.org/10.1176/appi.ajp.2007.07091453Google Scholar
Fava, G. A., Gatti, A., Belaise, C., Guidi, J., Offidani, E. Withdrawal symptoms after selective serotonin reuptake inhibitor discontinuation: a systematic review. Psychother Psychosom 2015; 84(2): 72–81. https://doi.org/10.1159/000370338Google Scholar
Ginsburg, G. S., Becker-Haimes, E. M., Keeton, C., et al. Results from the Child/Adolescent Anxiety Multimodal Extended Long-Term Study (CAMELS): primary anxiety outcomes. J Am Acad Child Adolesc Psychiatry 2018; 57(7): 471–80. https://doi.org/10.1016/j.jaac.2018.03.017Google Scholar
Harvey, B. H., McEwen, B. S., Stein, D. J. Neurobiology of antidepressant withdrawal: implications for the longitudinal outcome of depression. Biol Psychiatry 2003; 54(10): 1105–17. https://doi.org/10.1016/s0006-3223(03)00528-6Google Scholar
Hathaway, E. E., Walkup, J. T., Strawn, J. R. Antidepressant treatment duration in pediatric depressive and anxiety disorders: how long is long enough? Curr Probl Pediatr Adolesc Health Care 2017; 48(2): 31–39. https://doi.org/10.1016/j.cppeds.2017.12.002Google Scholar
Horowitz, M. A., Taylor, D. Tapering of SSRI treatment to mitigate withdrawal symptoms. Lancet Psychiatry 2019; 6(6): 538–46. https://doi.org/10.1016/S2215-0366(19)30032-XGoogle Scholar
Kennard, B. D., Emslie, G. J., Mayes, T. L., et al. Sequential treatment with fluoxetine and relapse-prevention CBT to improve outcomes in pediatric depression. Am J Psychiatry 2014; 171(10): 1083–90. https://doi.org/10.1176/appi.ajp.2014.13111460Google Scholar
Rickels, K., Etemad, B., Khalid-Khan, S., et al. Time to relapse after 6 and 12 months’ treatment of generalized anxiety disorder with venlafaxine extended release. Arch Gen Psychiatry 2010; 67(12): 1274–81. https://doi.org/10.1001/archgenpsychiatry.2010.170Google Scholar
Rosenbaum, J. F., Fava, M., Hoog, S. L., Ascroft, R. C., Krebs, W. B. Selective serotonin reuptake inhibitor discontinuation syndrome: a randomized clinical trial. Biol Psychiatry 1998; 44(2): 77–87. https://doi.org/10.1016/s0006-3223(98)00126-7Google Scholar
Shapiro, B. B. Subtherapeutic doses of SSRI antidepressants demonstrate considerable serotonin transporter occupancy: implications for tapering SSRIs. Psychopharmacology (Berl) 2018; 235(9): 2779–81. https://doi.org/10.1007/s00213-018-4995-4Google Scholar
Strawn, J. R., Lu, L., Peris, T. S., Levine, A., Walkup, J. T. Research review: pediatric anxiety disorders – what have we learnt in the last 10 years? J Child Psychol Psychiatry Allied Discipl 2021; 62(2): 114–39. https://doi.org/10.1111/jcpp.13262Google Scholar
Strawn, J. R., Mills, J. A., Poweleit, E. A., Ramsey, L. B., Croarkin, P. E. Adverse effects of antidepressant medications and their management in children and adolescents. Pharmacotherapy 2023. https://doi.org/10.1002/phar.2767. Epub ahead of print. PMID: 36651686.Google Scholar
Strawn, J. R., Mills, J. A., Suresh, V., et al. Combining selective serotonin reuptake inhibitors and cognitive behavioral therapy in youth with depression and anxiety. J Affect Dis 2022; 298(Pt A): 292–300. https://doi.org/10.1016/j.jad.2021.10.047Google Scholar
Strawn, J. R., Poweleit, E. A., Uppugunduri, C. R. S., Ramsey, L. B. Pediatric therapeutic drug monitoring for selective serotonin reuptake inhibitors. Front Pharmacol 2021; 12: 749692. https://doi.org/10.3389/fphar.2021.749692Google Scholar