Substituting a longer-acting antidepressant, most notably fluoxetine, for a shorter-acting one may also decrease the risk of withdrawal syndrome.58 This is particularly helpful for find more Patients who have already demonstrated problems tapering another antidepressant because of discontinuation emergent adverse events. The addition of benzodiazepines for irritability, anxiety, or sleep disturbance related to discontinuation or nonsteroidal anti-inflammatory agents for pain may improve patient experience. Communication with patients about. the short duration of withdrawal symptoms Inhibitors,research,lifescience,medical may help patients cope with these typically self-limited symptoms. Other management techniques for preventing relapse

or discontinuation due to side effects Patient education A critical component to side-effect management is education of patients prior to prescribing an antidepressant. This should include discussion of common side effects and when they would be most, likely to emerge. It Inhibitors,research,lifescience,medical is important, to discuss with patients which side Inhibitors,research,lifescience,medical effects require a prompt evaluation (eg, rash, agitation, worsening suicidally) and which side effects

are likely to be selflimiting (eg, mild nausea or jitteriness). Patients may assign a different, value to certain side effects than their clinician; given the large number of agents available it is important, to reach agreement on how the anticipated risks and benefits of treatment Inhibitors,research,lifescience,medical will factor into choice of agent. Patients may harbor certain preconceptions about,

side effects which can be addressed at this time. Examples of this would include the mistaken belief that. side effects necessarily indicate toxicity or indicate that, the medication is a poor match for the patient. It is often helpful to let patients know that antidepressants are associated with a range of side effects that typically do not. indicate a safety concern nor predict poor response. Patients are often Inhibitors,research,lifescience,medical reassured also to learn about the availability of strategies to address most side effects including dose changes, pharmacological antidotes, and the option to switch to other medications. Some clinicians are reluctant to discuss side effects in advance because of a concern that it will make patients anxious and may magnify side effect concerns. The literature offers some support, of this and in a naturalistic study showing that patients who recalled being informed of potential adverse events by their physicians were 55% more likely to report experiencing mild or moderate adverse effects.10 Although these patients were more likely to report, side effects, this same study, as well as a naturalistic study done by Bull et al,2 found that discussing adverse effects with patients during treatment was associated with the same or less premature discontinuation and with a higher rate of switching medications.