Complications
Abrupt discontinuation of serotonergic agents with a short half-life (e.g., paroxetine) may cause acute withdrawal symptoms (e.g., dizziness, irritability, nausea, rebound anxiety).
Restarting the agent and scheduling a slow, gradually tapering schedule under close medical supervision is recommended.[136]
Substance misuse may develop as a means of regulating anxiety symptoms and social skills deficits.
Referral for substance misuse treatment programmes may be indicated.
Sexual dysfunction may occur during treatment with selective serotonin-reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs), and there is some evidence that it can persist after treatment discontinuation in some patients.[173] Symptoms include genital numbness, decreased sex drive, erectile dysfuncion, vaginal dryness, failure to become aroused or orgasm, and premature ejaculation. Prevalence and incidence are both currently unclear, as are the cause and possible mechanisms of post-SSRI sexual dysfunction.[174]
There is an increased risk of suicidality in children, adolescents, and young adults with major depressive or other psychiatric disorders, especially during the first months of treatment with antidepressants versus placebo.[172]
Use of this content is subject to our disclaimer