An estimated 1.5 billion daily doses of tablets for depression are prescribed every year in Germany. © atelierk/stock.adobe.com

An estimated 1.5 billion daily doses of tablets for depression are prescribed every year in Germany. © atelierk/stock.adobe.com

Does anxiety intensify the discontinuation symptoms of antidepressants?

Patients with depression often face a difficult path to finding a medication that helps them. That is why they often feel anxious when an effective medication is discontinued at the end of their treatment. It is common for this anxiety to be accompanied by unpleasant mental and physical symptoms. These may not be due entirely to discontinuation of the active pharmaceutical ingredient, but also controlled by patient anxieties or previous experiences. This project investigates the effect that these fears have on the different symptoms experienced when antidepressants are discontinued.

Research summary

Separating the pharmacological and expectation effects of discontinuing antidepressants – a randomised, balanced, open-label and deceptive study

This project applies placebo and nocebo research findings to the discontinuation of antidepressants. Based on the observation that dysfunctional expectations of the discontinuation of a medication contribute to the development of troublesome symptoms and increase the risk of relapse after antidepressant treatment ends, this project is a randomised, balanced, open-label and deceptive study of the discontinuation of SSRIs/SNRIs (selective serotonin reuptake inhibitors/serotonin-noradrenaline reuptake inhibitors) in patients. Two factors, treatment and expectation, will be varied for a systematic investigation of their contribution to the development of discontinuation symptoms.

Recommended reading:

Nestoriuc Y, Orav EJ, Liang MH, Horne R, Barsky AJ (2010) Prediction of nonspecific side effects in rheumatoid arthritis patients by beliefs about medicines. Arthritis Care Res. 62:791-9. PubMed

Nestoriuc Y, v Blanckenburg P, Schuricht F, Barsky AJ, Hadji P, Albert US, Rief W (2016) Is it best to expect the worst? Influence of patients’ side effect expectations on endocrine treatment outcome in a two-year prospective clinical cohort study. Ann Onc. 27:1909-1915. PubMed

Sass K, Habel U, Kellermann T, Mathiak K, Gauggel S, Kircher T (2014) The influence of positive and negative emotional associations on semantic processing in depression: an fMRI study. Hum Brain Mapp 35:471-82. PubMed

In close cooperation with these projects

A08

A08

Do positive expectations improve the effect of antidepressants?

Prof. Dr. Tilo Kircher
PD Dr. Irina Falkenberg

A09

A09

How is the effect of antidepressants influenced by treatment experiences?

Prof. Dr. Markus Wöhr
Prof. Dr. Rainer K.W. Schwarting

A10

A10

A11

A11

A13

A13
Olpimi

Can migraine symptoms be relieved by patients knowingly taking tablets without an active ingredient?

Prof. Dr. Ulrike Bingel
Dr. Julian Kleine-Borgmann
Dr. Katharina Schmidt

Project Lead

Prof. Dr. Yvonne Nestoriuc

Prof. Dr. Yvonne Nestoriuc
Psychologist

Prof. Dr. Tilo Kircher

Prof. Dr. Tilo Kircher
Psychiatrist

Team

Dr. Tahmine Fadai
Clinician Scientist, Psychiatry Registrar

Carina Meißner
PhD Student, Psychologist

Dr. Christoph Vogelbacher
Postdoc

Laila Noor
Study Doctor

Alexandros Matsingos
Study Doctor