Case Report: Antidepressant Discontinuation Linked to a Suicide Attempt
Understanding the possible connection between stopping medication and suicide risk
A recent case report published in the Journal of Clinical Psychology is the first known report of antidepressant discontinuation syndrome (ADS) and a suicide attempt.
The patient in question was a 22-year-old woman with a history of major depressive disorder (MDD), generalized anxiety disorder (GAD), alcohol use disorder (AUD), and anorexia nervosa (AN). She had been taking escitalopram, a selective serotonin reuptake inhibitor (SSRI) best known by the brand name Lexapro, for two years, before discontinuing the medication seven days before the suicide attempt.
While this is the first known, documented instance of an actual suicide attempt related to discontinuing antidepressants, previous studies have shown a link between ADS and suicidal ideation. More research is needed, but there is enough evidence to raise red flags that discontinuing antidepressants may increase the risk of suicide.
What is antidepressant discontinuation syndrome?
Antidepressant discontinuation syndrome (ADS), sometimes called antidepressant withdrawal, is a medical condition that occurs in people who stop taking an antidepressant after continuously using it for at least a month. The risk is higher for those who have been taking the medication for longer, and it can be reduced but not eliminated by tapering — that is, slowly reducing the dosage of the medication instead of stopping it all at once. Symptoms of ADS can include:
- Flu-like symptoms (nausea, vomiting, headaches, sweating).
- Sleep disturbances, such as insomnia and nightmares.
- Sensory and movement disturbances, such as tremors and vertigo.
- Mood disturbances, such as anxiety and agitation.
- In rare instances, acute psychosis.
ADS is usually mild, with symptoms ending in one to four weeks. However, especially in patients already at elevated risk of suicide, there is a risk of much more severe consequences, including increased suicidality.
Doctors need to be aware of suicide risk and monitor patients appropriately.
ADS is just one example of a condition that may put a patient at an elevated risk of suicide during treatment. Other high-risk moments include medication changes more broadly, transitions from inpatient to outpatient care, and discharges from a psychiatric hospital or emergency room when mental health has been evaluated. In these situations, medical professionals need to be aware of the elevated risk of suicide and respond appropriately. That may include proactively scheduling follow-up appointments and check-ins, ensuring that patients have support resources in place, and communicating thoroughly during discharges and transitions to ensure that the patient doesn’t slip through the cracks.
Unfortunately, when medical professionals do not meet this standard of care, preventable tragedies can occur. If you lost a loved one to death by suicide, we would be honored to listen to your story and explain your rights and options. Our conversation is confidential, and there is no obligation, just answers. Contact the Law Offices of Skip Simpson for a free consultation. We’re based in Texas and represent families throughout the United States.
