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Related Concept Videos

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Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
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Antidepressant drugs are a class of medications primarily used for treating various mood disorders, including major depression, anxiety disorders, and other related conditions. These medicines work by modulating the neurotransmitter balance within the brain, alleviating depressive symptoms. Antidepressants can be broadly categorized into several groups according to their mechanism of action and chemical structure: Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin-Norepinephrine...
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Electroconvulsive Therapy01:30

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Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early...
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Drugs Affecting Neurotransmitter Release or Uptake01:21

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Certain drugs can affect how neurotransmitters called catecholamines, are released or taken back up in the adrenergic neuron. They can have different effects on the body's sympathetic transmission. Reserpine, a natural compound found in the Rauwolfia shrub, blocks a transporter called vesicular monoamine transporter (VMAT), which leads to a buildup of catecholamines in the cell and reduces sympathetic transmission. Another drug called guanethidine works in multiple ways, including blocking...
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Updated: May 24, 2025

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Stopping antidepressants or not?

Jeffrey Cl Looi1, Stephen Allison2, Tarun Bastiampillai3

  • 1MBBS, MD, DMedSc, FRANZCP, AFRACMA, Associate Professor of Neuropsychiatry, Old Age Psychiatry and Psychiatry and Head, Academic Unit of Psychiatry and Addiction Medicine, The Australian National University School of Medicine and Psychology, Canberra Hospital, Canberra, ACT; Coordinator, Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA), Canberra, ACT.

Australian Journal of General Practice
|March 5, 2025
PubMed
Summary
This summary is machine-generated.

Discontinuing antidepressant medication for moderate-to-severe depression carries risks of relapse, especially after a first episode. Continued treatment for 9-12 months post-remission is recommended, with careful benefit-risk assessment for withdrawal.

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Area of Science:

  • Psychiatry
  • General Practice
  • Pharmacology

Background:

  • Public and media interest in discontinuing antidepressant treatment is growing, particularly within primary care settings.
  • This review addresses the maintenance or discontinuation of antidepressant medication for adults with moderate-to-severe depression.

Purpose of the Study:

  • To provide a primary care update on antidepressant medication management for moderate-to-severe depression.
  • To review current evidence on the maintenance and discontinuation of antidepressants.

Main Methods:

  • Qualitative narrative review of recent research and systematic reviews.
  • Commentary on existing evidence regarding antidepressant treatment and withdrawal.

Main Results:

  • Substantial risks of depressive relapse are associated with antidepressant discontinuation in primary care.
  • For a first episode of depression, continued antidepressant use for 9-12 months post-remission is advised.
  • Limited evidence supports the benefits of ceasing antidepressant treatment for recurrent depression; harms like relapse are noted.

Conclusions:

  • Decisions regarding antidepressant maintenance or discontinuation require a careful benefit-risk assessment.
  • The evidence base for antidepressant withdrawal is limited, with potential harms outweighing benefits in many cases.
  • Further research is needed to clarify optimal strategies for antidepressant discontinuation.