Pharmacological Strategies and Options

The treatment strategy for discontinuing antidepressant medications is presented in this chapter. The various pharmacological options are reviewed as to their advantages and disadvantages, with particular reference to staging and methods of discontinuation. Rapid and slow taperings are compared; and potential interactions with other medications are reviewed. There is a lack of appropriate randomized controlled studies comparing different methods. Treatment choices are based entirely on clinical judgment and decision sharing with the patient. In this chapter, the author outlines the dilemmas and potential solutions that the clinician encounters, referring to both the literature that is available on various aspects of antidepressant medications and his own clinical and conceptual appraisal of the problem.