What it's used for
- Depression
- Often used off-label for sleep and appetite
Read about: Depression, Insomnia
How it works: Blocks alpha-2 receptors and some serotonin and histamine receptors (hence sedation).
Common side effects
- Drowsiness
- Increased appetite and weight gain
- Dry mouth
Tapering considerations
- Rebound insomnia and anxiety are common when reducing.
- Liquid helps with small steps.
For prescribers & facilitators
- Lower doses are paradoxically more sedating due to antihistamine effect.
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