Tapering Off Antidepressants

As abrupt cessation of antidepressant medication can cause distressing symptoms (including
and not limited to worsened mood, irritability/agitation, anxiety, dizziness, confusion, and
headache), the aim of this study is to compare the tolerance of two tapering regimens with
the hypothesis that tapering the antidepressant dose over the course of two weeks will yield
less discontinuation symptoms than a one week taper regimen. Additionally, it is suspected
that discontinuing medications that inhibit the serotonin transporter , such as selective
serotonin reuptake inhibitors (SSRI) and serotonin norepinephrine reuptake inhibitors (SNRI)
will have a greater difference in the frequency of discontinuation symptoms between the two
and one-week tapering regimens versus antidepressants that don't inhibit serotonin
transporter.

Demographic and clinical features will also be identified that may predict discontinuation
symptoms with the hypothesis that patients on SSRIs and SNRIs may experience more
discontinuation symptoms versus patients on non-SSRI/SNRI medications. Whether or not the
treatment duration is positively associated with the number of discontinuation symptoms will
also be determined.

Inclusion Criteria:

- Currently taking an FDA-approved antidepressant for at least four weeks on the list of
approved medications: SSRIs (citalopram, escitalopram, fluoxetine, fluvoxamine,
paroxetine, sertraline, vilazodone or vortioxetine), SNRIs (desvenlafaxine,
duloxetine, levomilnacipran, venlafaxine) and other classes (amitriptyline, bupropion,
desipramine, doxepin, mirtazapine, nefazodone, nortriptyline, phenelzine, selegiline,
or tranylcypromine). Clomipramine, a tricyclic antidepressant approved for the
treatment of OCD, will also be included, but will be classed as an SSRI for this study
because inhibition of the serotonin transporter is its primary therapeutic mechanism.

- No longer wish to take the antidepressant medication they are currently prescribed,
due to one of the following reasons: 1) ineffective for symptoms; 2) intolerable side
effect; 3) improvement of their illness for sufficient duration that it is clinically
appropriate to consider tapering the medication.

- Primary psychiatric diagnosis of major depressive disorder, an anxiety disorder, OCD,
or PTSD.

- Ability to read and understand English language.

Exclusion Criteria:

- Has met criteria at any time during their life for a primary psychotic disorder (e.g.
schizophrenia), or dementia.

- Meets criteria for DSM-5-defined substance use disorder within three months of the
screening visit.

- Currently taking two or more antidepressants.

- Presents with a clinically significant suicide risk, as assessed by a study physician.

- Presence of any unstable or central nervous system-related medical illness that would
interfere with cognition or participation.

- Women who are currently pregnant or lactating, or plan to become pregnant during the
study.