P03S04: Antidepressant withdrawal
Bottom line: Information on antidepressant withdrawal was used to justify
the management of the patient and to persuade the patient to make a change (do
not stop medication, but continue decreasing the dose). It contributed to
increase patient knowledge, and avoid unnecessary diagnostic evaluation.
Level 1 outcome (situational relevance): On August 17, 2008, P03 did a search at home, by themselves, and after
an encounter with a patient. They retrieved one information hit about antidepressant withdrawal side effects. The reported search objectives were: to address a clinical question,
to look up something they forgot, and to share the information with a patient
or caregiver. [This search was] specifically
looking at what withdrawal symptoms to expect when going off of this medication
[Celexa]. [
] Some of the information I did have in my head, but now I don't
recall it very much, because we haven't used the medication often. [
] That was
information to share with the patient, so they would know what to expect. [
]
[The patient was] a woman [and she was] 57 [
] and wanting to go off their
antidepressant, and just wanted to know what to expect, in terms of side
effects. According to P03, e-Therapeutics+ was the only source for information,
and the found information was relevant.
Level 2 outcome (cognitive impact): One hit was associated with a report of positive
cognitive impact (see table). Regarding practice improvement, P03 stated: It [the information] gave me specific information on patients going off
this medication and the withdrawal symptoms. [
] [My practice will be changed
and improved] because it pretty much explained to them what to expect, as well
as being able to assess them while they're going through these symptoms. [
]
Because some of the side effects, I wasn't aware of what theyd be going
through.
Retrieved information
hit(s):
1) e-Therapeutics+ (CIRT): e-CPS tab
Citalopram Celexa extract on discontinuation of
treatment (P03S04H01).
Level 3 outcome
(information use): Information on antidepressant
withdrawal side effects was retrieved, and used to better understand a specific issue with respect to the management of
the patient, to justify the management of the patient and to persuade the
patient to make changes (information used as presented in e-Therapeutics+).
Information was used to help justify to
try again to decrease the antidepressant. [Did you tell her "I'm going to
make a search and call you back"?] Exactly. [And did you call her?] Yes.
[...] It was someone who had tried to go off of these medications in the past,
and had difficulty with side effects. So this would help to better understand
why she had difficulty, and how to better support her in the future. [
] Just
to legitimize the side effects, that this had withdrawal side effects and
to help express that to the patient. [
] [I used the information to persuade
the patient] to continue with decreasing the dose even though they're
experiencing side effects.
Level 4 outcome (patient health): Regarding patient health, P03 reported that the information
contributed to increase patient knowledge, and avoid an unnecessary diagnostic
evaluation. It [the information] avoided treating the withdrawal side effects as a
separate diagnosis or disease. [
] [And for the patient] going off that
medication, [it helped] that they accept it more, knowing that they may
experience these side effects. [
] I think it just reassured [her].
Levels of outcome of information-seeking
|
Situational relevance |
Positive cognitive
impact |
Information use |
Patient health |
|
Address a clinical question Look up something forgotten Share information |
Practice improved Learned something Motivated to learn |
Persuade Justify choice Understand issue |
Avoid Patient knowledge |