Atypical Antipsychotics: CATIE Study, Drug-Induced Movement Disorder and Resulting Iatrogenic Psychiatric-Like Symptoms, Supersensitivity Rebound Psychosis and Withdrawal Discontinuation Syndromes

Chouinard, Guy; Chouinard, Virginie-Anne

doi:10.1159/000112883

Cited by 149 publications

(199 citation statements)

References 116 publications

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“…These negative effects lend support to the observation of Fava et al [[50], p. 262] that successive pharmacological manipulations ‘may propel depressive illness into a refractory phase’ by fostering oppositional tolerance in which the antidepressant sensitizes some patients to depression. Chouinard and Chouinard [[51], p. 75] document similar risks with atypical antipsychotics and estimate that 50% of treatment-resistant schizophrenia cases are related to supersensitivity psychosis. The following issue remains to be determined: the extent that diminishing outcomes of STAR*D are due to a subset developing such oppositional tolerance, patients’ natural diminished expectations of improvement following each failure (i.e.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Effectiveness of Antidepressants: Current Status of Research

Pigott¹,

Leventhal

Alter³

et al. 2010

Psychother Psychosom

297

214

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Background: This paper examines the current status of research on the efficacy and effectiveness of antidepressants. Methods: This paper reviews four meta-analyses of efficacy trials submitted to America’s Food and Drug Administration (FDA) and analyzes STAR*D (Sequenced Treatment Alternatives to Relieve Depression), the largest antidepressant effectiveness trial ever conducted. Results: Meta-analyses of FDA trials suggest that antidepressants are only marginally efficacious compared to placebos and document profound publication bias that inflates their apparent efficacy. These meta-analyses also document a second form of bias in which researchers fail to report the negative results for the pre-specified primary outcome measure submitted to the FDA, while highlighting in published studies positive results from a secondary or even a new measure as though it was their primary measure of interest. The STAR*D analysis found that the effectiveness of antidepressant therapies was probably even lower than the modest one reported by the study authors with an apparent progressively increasing dropout rate across each study phase. Conclusions: The reviewed findings argue for a reappraisal of the current recommended standard of care of depression.

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Section: Discussionmentioning

confidence: 99%

Efficacy and Effectiveness of Antidepressants: Current Status of Research

Pigott¹,

Leventhal

Alter³

et al. 2010

Psychother Psychosom

297

214

View full text Add to dashboard Cite

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“…But treatments that are helpful for some may be harmful to others [11,12]. During CBT, patients are encouraged to gradually increase their daily activity, and concerns have been raised this might cause symptom deterioration.…”

Section: Introductionmentioning

confidence: 99%

Possible Detrimental Effects of Cognitive Behaviour Therapy for Chronic Fatigue Syndrome

Heins¹,

Knoop²,

Prins³

et al. 2010

Psychother Psychosom

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Background: Cognitive behaviour therapy (CBT) for chronic fatigue syndrome (CFS) can decrease the level of fatigue and disabilities, but it has been suggested that during therapy some patients experience a deterioration of their symptoms rather than an improvement. The aim of this study is to examine the frequency and severity of symptom deterioration during CBT for CFS. Methods: Data from 3 randomised controlled trials on CBT for CFS were pooled and reanalysed. Symptom deterioration during the trial was rated by patients and measured as deterioration in fatigue, pain, functional impairment and psychological distress. Both the frequency and severity of deterioration in these domains were compared between the patients receiving CBT and those in the control group. Predictors of symptom deterioration were identified by comparing their means in patients with and without an increase in fatigue. Statistically significant predictors were then combined in a logistic regression model. Results: The frequency of symptom deterioration varied from 2 to 12% in patients receiving CBT and from 7 to 17% in the control group. None of the measures showed a significantly higher frequency of symptom deterioration in the CBT group. The severity of deterioration was also comparable in the CBT and in the control group. No predictors of symptom deterioration specific to CBT were found. Conclusion: Patients receiving CBT do not experience more frequent or more severe symptom deterioration than untreated patients. The reported deterioration during CBT seems to reflect the natural variation in symptoms. Thus, CBT is not only a helpful, but also a safe treatment for CFS.

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“…In patients who have used the drugs over a long period, the dosage should be gradually reduced. There is some documentation showing that moodstabilising antiepileptic drugs may have an effect on withdrawal reactions, as a monotherapy and in combination with antidepressants during discontinuation (26).…”

Section: Discussionmentioning

confidence: 99%

“…This manifests itself primarily during discontinuation of the medication (26). Most symptoms are of relatively short duration.…”

Section: Development Of Tolerancementioning

confidence: 99%