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Tardive dysphoria: antidepressant-induced chronic depression

Published online by Cambridge University Press:  13 June 2014

Rif S El-Mallakh ,
R Jeannie Roberts ,
Alan Swann ,
Pat R. Rutherford Jr.  and
Anton Surja
Rif S El-Mallakh
Affiliation:
Department of Psychiatry and Behavioural Sciences, University of Louisville School of Medicine, Louisville, Kentucky
R Jeannie Roberts
Affiliation:
Department of Psychiatry and Behavioural Sciences, University of Louisville School of Medicine, Louisville, Kentucky
Alan Swann
Affiliation:
Department of Psychiatry and Behavioural Sciences, University of Texas, Houston Health Science Centre, Houston, Texas
Pat R. Rutherford Jr.
Affiliation:
Department of Psychiatry and Behavioural Sciences, University of Texas, Houston Health Science Centre, Houston, Texas
Anton Surja*
Affiliation:
Department of Psychiatry and Behavioural Sciences, University of Louisville School of Medicine, Louisville, Kentucky, United States
*
*Correspondence Email: rselma01@louisville.edu
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Abstract

Objectives: A significant number of depressed individuals experience inadequate benefit from long-term antidepressant use. This paper investigates the hypothesis that in some individuals persistent use of antidepressants may be prodepressant.

Methods: Literature regarding the effect of long-term use of antidepressants was reviewed by searching PubMed and Ovid data bases with terms: antidepressant tachyphylaxis, treatment-resistant depression, chronic depression and antidepressant tolerance.

Results: Antidepressant treatment-resistant patients frequently had a positive initial response to antidepressants. When resistance appeared, initial increases in dose or medication changes usually resulted in transient improvement. Eventually, the episodic course of the original depressive illness was replaced with a continuous, unresponsive depressive syndrome. We propose the term tardive dysphoria to describe this phenomenon.

Conclusions: The phenomenon of antidepressantinduced depression, or tardive dysphoria, needs to be experimentally examined in blinded, randomised antidepressant discontinuation studies.

Keywords

AntidepressantsAntidepressant adverse effectChronic DepressionMajor Depressive DisorderTachyphylaxisTardive Dysphoria
Type
Review
Information
Irish Journal of Psychological Medicine , Volume 28 , Issue 1 , March 2011 , pp. 38 - 41
Copyright
Copyright © Cambridge University Press 2011

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