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Tuesday, November 1, 2005

NEJM reviews depression

The current NEJM has a review on the medical management of depression.  It's solid.  One sentence of it caught my attention however, in the section about discontinuing treatment:  " The discontinuation syndrome is sometimes called the withdrawal syndrome, erroneously implying drug dependence."  Am I wrong in thinking this is a weird and misleading statement, especially from a psychiatrist?  I have been taught that (physical) drug dependence is in fact defined by the occurance of a withdrawal syndrome if the drug is discontinued (which usually prominently includes somatic symptoms and not necessarily "cravings").  I'm not sure if the author meant to write "erroneoulsy implying drug addiction" or if there's some custom of only using the term "dependence" in relation to drugs of (potential) abuse/addiction.  If so, that seems wrong to me, and not based in physiology.  Correct me, however, if there's something I'm missing.

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