New Classification of Selective Serotonin Reuptake Inhibitor Withdrawal

Clinical Pharmacopsychology: Conceptual Foundations and Emerging Tasks

“…Examples related to antidepressant drug use may be the onset of suicidality and aggression, switching from unipolar to bipolar course, withdrawal phenomena upon discontinuation, and postwithdrawal persistent disorders [59,62]. Such phenomena require adequate clinimetric indices for their detection, as the late recognition of withdrawal syndromes after antidepressant drug discontinuation teaches [63,64]. Behavioral toxicity may apply also to drugs directed to medical conditions [65,66,67], which may induce depression, anxiety, and other psychiatric symptoms.…”

The Hidden Costs of Financial Conflicts of Interest in Medicine

“…The risk is particularly serious in view of the fact that financial conflicts of interest are substantial in medical societies and guidelines for authors [27,28] . A major hidden cost is entailed by the influence of financial conflicts of interest in textbook chapters, reviews and guidelines: physicians are forced into prescribing patterns that are detrimental, costly and that clash with clinical reality, as portrayed by the substitution of benzodiazepines with antidepressant drugs in anxiety disorders [9][10][11][12] .…”

“…When withdrawal reactions started being described following the discontinuation of second-generation antidepressant drugs (selective serotonin reuptake inhibitors, SSRI) they were promptly labeled as 'discontinuation syndromes' [9] . The name successfully conferred a harmless nature, which was in sharp contrast with the withdrawal reactions that occurred with other drugs like benzodiazepines [10] . SSRI thus replaced benzodiazepines in the treatment of anxiety disorders, even though discontinuation syndromes of SSRI are actually withdrawal reactions [10] , and the clinical evidence was pointing to just the opposite (benzodiazepines are more effective, with fewer side effects) [11] .…”

“…The name successfully conferred a harmless nature, which was in sharp contrast with the withdrawal reactions that occurred with other drugs like benzodiazepines [10] . SSRI thus replaced benzodiazepines in the treatment of anxiety disorders, even though discontinuation syndromes of SSRI are actually withdrawal reactions [10] , and the clinical evidence was pointing to just the opposite (benzodiazepines are more effective, with fewer side effects) [11] . The shift from benzodiazepines to SSRI has probably been the most successful achievement of pharmaceutical propaganda in psychiatry, with full endorsement of guidelines and professional societies [12] .…”

Alternative Paths of Green Entrepreneurship: The Environmental Legacies of the North Face's Doug Tompkins and Patagonia's Yvon Chouinard

“…Catalogs were printed on recycled paper, and R&D dollars were spent on developing recycled polyester. 54 From 1991 to 1994, Patagonia took a deep dive to understand and map the full environmental impact of its supply chain, focusing in particular on the damage caused by using its four main inputs: cotton, wool, polyester, and nylon. In the words of Rick Ridgeway, VP of Public Engagement at Patagonia and lifelong friend of both Tompkins and Chouinard:…”