{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:46:33Z","timestamp":1791229593361,"version":"4.1.0"},"reference-count":70,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Stefan Hearst","award":["na"],"award-info":[{"award-number":["na"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Psychopharmacology"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Protracted withdrawal syndrome (PWS) after stopping antidepressants (frequently also referred to as post-acute withdrawal syndrome or PAWS) has been described in a few case reports. However, a detailed quantitative analysis of specific symptom manifestations in antidepressant PWS is still lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We extracted patient narratives from a large English-language internet forum SurvivingAntidepressants.org , a peer support site concerned about withdrawal from antidepressants. PWS was ascertained based on diagnostic criteria proposed by Chouinard and Chouinard, specifically \u2a7e6\u2009months of continuous antidepressant use, with emergence of new and\/or more intense symptoms after discontinuation that last beyond the initial 6\u2009weeks of acute withdrawal. We assessed medication history, outcome of PWS, and the prevalence of specific symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>In total, n\u2009=\u200969 individual reports of protracted withdrawal were selected for analysis. At time of the subjects\u2019 most recent reports, duration of PWS ranged from 5 to 166\u2009months, mean\u2009=\u200937\u2009months, median\u2009=\u200926\u2009months. Length of time on the antidepressant causing protracted withdrawal ranged from 6 to 278\u2009months, mean\u2009=\u200996\u2009months, and median\u2009=\u200979\u2009months. Throughout the withdrawal experience, affective symptoms, mostly anxiety, depression, emerging suicidality and agitation, were reported by 81%. Somatic symptoms, mostly headache, fatigue, dizziness, brain zaps, visual changes, muscle aches, tremor, diarrhea, and nausea were reported by 75%. Sleep problems (44%) and cognitive impairments (32%) were mentioned less frequently. These broad symptom domains were largely uncorrelated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>PWS or PAWS from antidepressants can be severe and long-lasting, and its manifestations clinically heterogeneous. Long-term antidepressant exposure may cause multiple body system impairments. Although both somatic and affective symptoms are frequent, they are mostly unrelated in terms of occurrence. Proper recognition and detection of PWS thus requires a comprehensive assessment of medication history, duration of the withdrawal syndrome, and its various somatic, affective, sleep, and cognitive symptoms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2045125320980573","type":"journal-article","created":{"date-parts":[[2020,12,24]],"date-time":"2020-12-24T07:26:41Z","timestamp":1608794801000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":74,"title":["Protracted withdrawal syndrome after stopping antidepressants: a descriptive quantitative analysis of consumer narratives from a large internet forum"],"prefix":"10.1177","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2956-2969","authenticated-orcid":false,"given":"Michael P.","family":"Hengartner","sequence":"first","affiliation":[{"name":"Department of Applied Psychology, Zurich University of Applied Sciences (ZHAW), PO Box 707, Zurich, 8037, Switzerland"},{"name":"Medical Faculty, University of Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Schulthess","sequence":"additional","affiliation":[{"name":"Department of Applied Psychology, Zurich University of Applied Sciences, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Sorensen","sequence":"additional","affiliation":[{"name":"Nordic Cochrane Centre, Rigshospitalet, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4094-6744","authenticated-orcid":false,"given":"Adele","family":"Framer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,12,24]]},"reference":[{"key":"bibr1-2045125320980573","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-019-2178-4"},{"key":"bibr2-2045125320980573","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.114.156786"},{"key":"bibr3-2045125320980573","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(19)30331-1"},{"key":"bibr4-2045125320980573","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2016.7507"},{"key":"bibr5-2045125320980573","doi-asserted-by":"publisher","DOI":"10.1159\/000480456"},{"key":"bibr6-2045125320980573","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-016-1306-4"},{"key":"bibr7-2045125320980573","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.13m08443"},{"key":"bibr8-2045125320980573","volume-title":"Antidepressant 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