Discontinuation symptoms

Abrupt discontinuation should be avoided. When stopping treatment with escitalopram the dose should be gradually reduced over a period of at least one to two weeks in order to reduce the risk of discontinuation symptoms.

Cipralex gives fewer discontinuation symptoms compared with paroxetine and venlafaxine XR.

There is evidence that antidepressants, even of the same class, differ markedly in their discontinuation profile.
Discontinuation symptoms with Cipralex versus venlafaxine XR were investigated in comparative depression studies and in SAD and GAD studies versus paroxetine. The DESS scale (Discontinuation Emergent Signs and Symptoms) was used to check for symptoms before, and at 1 and 2 weeks after treatment discontinuation. Whilst only modest and transient increases in the DESS score were observed for Cipralex, the increase in DESS score was significantly higher for venlafaxine XR and paroxetine.
The discontinuation symptoms returned towards baseline values after 2 weeks.

Fewer discontinuation symptoms with Cipralex vs. paroxetine and venlafaxine XR (ref.1)

Fewer discontinuation symptoms with escitalopram vs. paroextine and venlafaxine XR in MDD

Significantly fewer discontinuation symptoms vs. paroxetine and venlafaxine XR in MDD
Significantly fewer discontinuation symptoms vs. paroxetine in SAD and GAD

Cipralex vs. paroxetine (mean DESS score) (ref.1)

Mean DESS scores for all treatment during the run-out period following 24 weeks on escitalopram, paroxetine and placebo in the dose-finding study in social anxiety disorder.

# Significantly different from paroxetine, p<0.05
### Significantly different from paroxetine, p<0.001

References:

1. Baldwin et al. Int J Neuropharmacol 2007;10:73-84

Published: 04/05/2006 Last updated: 09/01/2012