Two South African researchers review scientific understanding of the brain changes that lead to antidepressant discontinuation syndrome (ADS) in Human Psycho-pharmacology: Clinical and Experimental. They then put forth a biological analysis and theory as to why the antidepressant agomelatine seems to cause less severe withdrawal problems.
“Altered serotonergic dysfunction appears central to ADS so that how an antidepressant targets serotonin will determine its relative risk for inducing ADS and thereby affect later treatment outcome,” the authors write. “Low ADS risk with agomelatine versus other antidepressants can be ascribed to its unique pharmacokinetic characteristics as well as its distinctive actions on serotonin, including melatonergic, monoaminergic and glutamatergic-nitrergic systems.”
(Abstract) New insights on the antidepressant discontinuation syndrome. (Harvey, Brian H. and Slabbert, Francois N. Human Psychopharmacology: Clinical and Experimental. Volume 29, Issue 6. November 2014. DOI: 10.1002/hup.2429)