Monitoring
Practitioners should review individuals and consider administering one of the recommended assessment instruments on a monthly basis to monitor symptom change over time. The time between appointments may vary depending on the severity of symptoms and other factors.
Patients who are prescribed antidepressants should be advised of the potential adverse effects and potential discontinuation/withdrawal symptoms, particularly with paroxetine. Doses of antidepressants should be reduced gradually over a period of 4 weeks, or longer if necessary. Where discontinuation/withdrawal symptoms are mild, the patient should be reassured and monitoring arranged. Where symptoms are severe, consideration should be given to reintroducing the original antidepressant (or another with a longer half-life from the same class) and reducing it gradually while monitoring symptoms.[43]
Patients with PTSD have an increased risk of developing various health conditions, such as cardiovascular disease, autoimmune disease, infections and dementia. Clinicians should consider this during the assessment and monitoring of patients with chronic PTSD.[122][123][124][127]
Patients who are prescribed selective serotonin-reuptake inhibitors should be monitored for signs of akathisia, suicidal ideation, and increased anxiety and agitation. If marked and/or prolonged akathisia develops, the use of the drug should be reviewed.[43]
Frequent monitoring of people assessed as being at increased risk of suicide, and all patients in the 18 to 29 age group who are started on antidepressants, is recommended, until the risk is assessed as having diminished.[43] Otherwise, people prescribed antidepressants, and who are not considered to be at increased risk of suicide, should normally be seen after 2 weeks and thereafter on a regular basis at appropriate intervals.[43]
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