Discontinuation of SSRI's in traumatized refugees

To conduct a preliminary study on the discontinuation of SSRI's in a population of traumatized refugees from Bosnia.

Subjects were the 33 Bosnian refugees being treated in our clinical program who had discontinued SSRI's over a six month period. All had been on SSRI's for over one year and had shown a therapeutic response. The discontinuations were either planned with their clinician or self-initiated. Their age were ranged between 36 and 64, with a means of 56. Ten were men and twenty three were women. Standardized assessments were done approximately 2 months after discontinuation.

Upon reassessment after discontinuation, fourteen (43%) met symptom criteria for PTSD. He means PTSD severity rating was 16.0 and the BDI score was 8.5. Seven persons (21%) restarted SSRI's and twenty-six (79%) did not. Statistical analysis showed that the group that restarted differed from the others in terms of lower age, higher PTSD diagnosis and severity, higher BDI score, poorer sleep, and higher subjective with either PTSD or BDI scores.

This preliminary study suggests that when traumatized refugees discontinue SSRI's, still they have significant PTSD and depressive symptoms, indicating chronicity. The choice of discontinue or restart SSRI's is in part related to symptom severity, but other psychosocial factors appear entering into the equation. There is a need for further research.