What it's used for
- Depression
- OCD
- Bulimia nervosa
- Premenstrual dysphoric disorder
Read about: Depression, Persistent depressive disorder, Perinatal & postnatal depression, Seasonal affective disorder, Premenstrual dysphoric disorder, Health anxiety, Obsessive-compulsive disorder, Post-traumatic stress disorder, Bulimia nervosa
How it works: Blocks the serotonin transporter; its active metabolite lasts for weeks.
Common side effects
- Nausea
- Restlessness or anxiety early on
- Insomnia
- Sexual side effects
Tapering considerations
- The long half-life gives a built-in 'self-taper', but withdrawal can still occur and appear late.
- Liquid allows small steps.
For prescribers & facilitators
- Sometimes used as a bridge when tapering shorter-acting SSRIs — specialist decision.
- Strong CYP2D6 inhibitor; check interactions.
Sources
- 01Incidence of antidepressant discontinuation symptoms: a systematic review and meta-analysis
Henssler et al., The Lancet Psychiatry, 2024
- 02Tapering of SSRI treatment to mitigate withdrawal symptoms
Horowitz & Taylor, The Lancet Psychiatry, 2019
- 03A systematic review into the incidence, severity and duration of antidepressant withdrawal effects
Davies & Read, Addictive Behaviors, 2019
- 04
- 05Stopping antidepressants
Royal College of Psychiatrists, 2020
- 06Newer-generation antidepressants and withdrawal effects: reconsidering the role of antidepressants and helping patients to stop
Hengartner, Davies & Read, Drug and Therapeutics Bulletin, 2020
- 07Approaches for discontinuation versus continuation of long-term antidepressant use
Van Leeuwen et al., Cochrane Database of Systematic Reviews, 2021
- 08The Maudsley Deprescribing Guidelines
Horowitz & Taylor, Wiley-Blackwell, 2024