• Corpus ID: 26367739

Newer antidepressants and the discontinuation syndrome.

  title={Newer antidepressants and the discontinuation syndrome.},
  author={Peter M. Haddad},
  journal={The Journal of clinical psychiatry},
  volume={58 Suppl 7},
          17-21; discussion 22
  • P. Haddad
  • Published 1997
  • Medicine
  • The Journal of clinical psychiatry
Data on discontinuation phenomena associated with serotonin selective reuptake inhibitors (SSRIs) are derived primarily from (1) published case reports, (2) data bases of adverse drug reactions that have been spontaneously reported to national monitoring bureaus, and (3) clinical studies of drug discontinuation. Some of the symptoms seen on SSRI discontinuation, such as nausea, lethargy, insomnia, and headache, are similar to those reported with tricyclic discontinuation. However, SSRI… 

Figures and Tables from this paper

Discontinuation Syndromes with Selective Serotonin Reuptake Inhibitors
SSRI discontinuation syndromes are usually mild and transient, and prevention is the most effective management strategy, but both pharmacodynamic and pharmacokinetic factors may explain differences in incidence with individual SSRIs.
Selective Serotonin Reuptake Inhibitor Antidepressant Treatment Discontinuation Syndrome: A Review of the Clinical Evidence and the Possible Mechanisms Involved
  • T. Renoir
  • Psychology, Medicine
    Front. Pharmacol.
  • 2013
A comprehensive overview of the clinical evidence and the underlying pathophysiology of the SSRI discontinuation syndrome are discussed and the use of animal models is commented on to better understand this condition.
Selective serotonin reuptake inhibitor discontinuation syndrome: proposed diagnostic criteria.
OBJECTIVE To establish specific criteria by which selective serotonin reuptake inhibitor (SSRI) discontinuation syndrome may be identified. DATA SOURCES MEDLINE and PSYCHLIT databases were searched
Discontinuation Syndrome in Dysthymic Patients Treated with Selective Serotonin Reuptake Inhibitors
A discontinuation syndrome is common after treatment with SSRIs is stopped in patients with dysthymia, and it appears to be more common in patients receiving paroxetine than in those receiving fluoxettine.
[Antidepressant discontinuation syndrome in clinical and laboratory studies--implications for clinicians and patients].
The article discusses the three systems most likely to account in the symptomatology--the serotonin, the norepinephrine, and the cholinergic systems--and the possible interactions among them.
Why does milnacipran produce so few discontinuation syndromes following abrupt withdrawal?
  • F. Okada
  • Medicine, Psychology
    Neuropsychiatric disease and treatment
  • 2007
Paroxetine has systematically been found to have the highest incidence of discontinuation syndrome (Warner et al 2006) while fluvoxamine has an incidence 10-fold lower and fluxetine 100-fold higher (Westenberg and Sandner 2006).
Prospective studies of adverse events related to antidepressant discontinuation.
  • M. Fava
  • Psychology
    The Journal of clinical psychiatry
  • 2006
Key issues in the analysis of incidence rates of antidepressant discontinuation-emergent adverse events such as the obvious bias of both clinicians' and patients' being aware of the treatment discontinuation are discussed, while making the case for, prospective studies based on systematic inquiry.
Selective serotonin reuptake inhibitors: a review of efficacy and tolerability in depression
SSRIs seem to be as well tolerated as moclobemide, mirtazapine, venlafaxine, reboxetine and nefazodone and show comparable efficacy.
Antidepressant discontinuation syndrome.
Before antidepressants are prescribed, patient education should include warnings about the potential problems associated with abrupt discontinuation, and a high index of suspicion should be maintained for the emergence of discontinuation symptoms.
A possible explanation for dizziness following SSRI discontinuation
It is suggested that the abrupt withdrawal from an SSRI is likely to cause a sudden decrease in serotonin in the VNC, which will disrupt the function of VNC neurons bilaterally, causing dizziness without vertigo.


Serotonin reuptake inhibitor withdrawal.
Reports of withdrawal symptoms in a retrospective chart review of 352 patients treated in an outpatient clinic with the nonselective serotonin reuptake inhibitor clomipramine or with one of the selective SSRIs, fluoxetine, fluvoxamine, paroxettine, or sertraline suggest a role has been suggested for serotonin in coordinating sensory and autonomic function with motor activity.
A comparison of the post-marketing safety of four selective serotonin re-uptake inhibitors including the investigation of symptoms occurring on withdrawal.
Paroxetine is the most pharmacologically specific of the SSRIs, but it is not clear whether the reactions constitute a 'serotonin withdrawal syndrome'.
The abrupt discontinuation of fluvoxamine in patients with panic disorder.
Abrupt fluvoxamine discontinuation is associated with a characteristic syndrome in many patients, and the most frequent symptoms reported were dizziness/incoordination, headaches, nausea, and irritability.
Withdrawal Phenomena Associated with Antidepressant and Antipsychotic Agents
The withdrawal of heterocyclic antidepressants and antipsychotic agents can produce nausea, emesis, anorexia, diarrhoea, rhinorrhoea, diaphoresis, myalgias, paraesthesias, anxiety, agitation, restlessness and insomnia and is usually prevented by gradually reducing the total daily dosage of the pertinent drug.
Antidepressant withdrawal phenomena.
A treatment program useful in ameliorating the distress of patients who develop antidepressant withdrawal symptoms and who cannot continue to take antidepressants is outlined, and the heuristic value of current hypotheses as to their pathophysiology are discussed.
Recurrence of depression after discontinuation of long-term amitriptyline treatment.
Patients receiving long-term amitriptyline treatment had their medication tapered and discontinued under double-blind conditions, and some patients whose amitryptyline was discontinued experienced a mild withdrawal syndrome within the first 2 weeks.
Antidepressant Withdrawal Syndromes: Evidence Supporting the Cholinergic Overdrive Hypothesis
Substantial evidence supports the contention that these syndromes result from cholinergic overdrive; thus, they may have a common pathophysiological basis and lend support to the Cholinergic-adrenergic hypothesis of affective illness.
Antidepressant withdrawal syndromes: phenomenology and pathophysiology
  • S. Dilsaver
  • Psychology, Medicine
    International clinical psychopharmacology
  • 1987
Evidence that antidepressant‐induced supersensitiviry of central and peripheral muscarinic cholinergic mechanisms may account for commonly observed antidepressant withdrawal phenomena is summarized.
Antidepressant withdrawal symptoms treated with anticholinergic agents.
Three patients who developed withdrawal symptoms after discontinuation of antidepressants were treated with atropine and central cholinergic overdrive is implicated in the genesis of the symptoms.