[Switching and stopping antidepressants]. / Recommandations pour switcher et arrêter les antidépresseurs.

Major depressive disorder (MDD) is a common, typically recurrent, sometimes chronic and very disabling disorder, with a lifetime prevalence of 20%. Moreover, antidepressant treatments may be partially effective. Studies have found that up to 60% of patients with MDD do not fully respond to the first antidepressant prescribed. Thus, switching antidepressants is a common strategy for antidepressant non-responders. When switching between antidepressants, an appropriate switching strategy should be used, depending on the characteristics of the first and the second antidepressant and patient's background. Patients should be informed that antidepressants can cause discontinuation symptoms if stopped abruptly after prolonged used. Relapse and exacerbation of depression can also occur during a switch. Thus, all antidepressant switches must be carried out cautiously and under close observation. This article summarizes the recommendations for an optimal antidepressant switch.

[Psychiatric aspects of rheumatoid arthritis: Review of literature]. / Les manifestations psychiatriques dans la polyarthrite rhumatoïde.

BACKGROUND: Rheumatoid arthritis (RA) is a chronic inflammatory degenerative disease whose symptoms are mainly joint with significant functional impact, resulting in a restriction of the activities of the patient and increasing the impact on mental well-being. Several studies have been conducted to explore psychiatric disorders comorbid with RA. OBJECTIVE: The objective of this review is to present the various psychiatric manifestations of RA reported in the medical literature. METHODS: A literature review was conducted using the Pubmed search with the following keywords: psychiatry, psychiatric manifestations, rheumatoid arthritis. Three hundred and sixty-one articles were reviewed for relevance and 47 references were selected. RESULTS: Among the major psychiatric disorders found in RA, the anxiety and depressive disorders are prevalent (13 to 48% of patients), as well as suicide, insomnia and tiredness. The impairment of quality of life is markedly after age 65. The association between RA and schizophrenia seems negative so that factors predisposing one is protective for the other. CONCLUSION: Comorbid psychiatric disorders with RA are prevalent and may increase the impairment of quality of life for patients. The detection and treatment of psychiatric disorders improve the care of patients with RA.