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Understand the facts

 

Scientific research has long suggested that the reduction or discontinuation, both gradual and abrupt, of antidepressants determines the appearance of withdrawal symptoms. Usually the patient interprets these symptoms as a recurrence of the disease following therapy reduction. On the contrary, this phenomenon has been described as caused by the abstinence from SSRI (Selective Serotonin Reuptake Inhibitor) antidepressants and SNRI (Serotonin and Noradrenaline Reuptake Inhibitor) antidepressants. Withdrawal symptoms occur after 24 - 96 hours after the drug has been reduced or discontinued and may last several weeks but also months or years. Below is a list of withdrawal symptoms that may arise:

 

General symptoms

Flue-like symptoms, sweating, chills, hot flashes, fatigue, weakness, tiredness, drowsiness

Visaul symptoms

Altered vision, fogged vision

Cardiovascular symptoms

Dizziness, empty head, palpitations, difficulty in breathing

Gastroenteric symptoms

Diarrhea, stool loss, abdominal pain, nausea, vomiting, lack of appetite

Sensorial symptoms

Tinglings, electric shock sensation, shock in the brain, itching, taste alteration, tinnitus

Neuromuscular symptoms

Shocking, restlessness, muscle stiffness, muscle pain, tremor, neuralgia, muscle spasms, sensations like facial bites, difficulty in coordinating movements

Cognitive symptoms

Confusion, amnesia, disorientation, poor concentration

Affective symptoms

Anxiety, agitation, tension, panic, depression, intensification of suicidal ideation, irritability, impulsivity, aggression, anger, tears, rapid mood swings, derealization, depersonalization

Psychotic symptoms

Visual and auditory allucinations

Sleep plroblems

Insomnia, vivid dreams, nightmares, hypersonnia

Sexual symptoms

Premature ejaculation, genital hypersensitivity

 

Adapted from Chouinard G, Chouinard VA. New Classification of Selective Serotonin Reuptake Inhibitor Withdrawal. Psychotherapy and Psychosomatics 2015;84(2):63-71

 

REFERENCES

Chouinard G, Chouinard VA. New Classification of Selective Serotonin Reuptake Inhibitor Withdrawal. Psychotherapy and Psychosomatics 2015;84(2):63-71

Fava GA, Gatti A, Belaise C, Guidi J, Offidani E. Withdrawal Symptoms after Selective Serotonin Reuptake Inhibitor Discontinuation: A Systematic Review. Psychotherapy and Psychosomatics 2015;84(2):72-81

Belaise C, Gatti A, Chouinard VA, Chouinard G. Patient online report of selective serotonin reuptake inhibitor-induced persistent postwithdrawal anxiety and mood disorders. Psychotherapy and Psychosomatics 2012;81(6):386-388

Demily C, Chouinard VA, Chouinard G. Iatrogenic psychiatric-like symptoms recognition.

Encephale. 2010 Oct;36(5):417-24.

Bhanji NH, Chouinard G, Kolivakis T, Margolese HC. Persistent tardive rebound panic disorder, rebound anxiety and insomnia following paroxetine withdrawal: a review of rebound-withdrawal phenomena. Canadian Journal of Clinical Pharmacology 2006;13(1):e69-74

Dallal A, Chouinard G. Withdrawal and rebound symptoms associated with abrupt discontinuation of venlafaxine. Journal of Clinical Psychopharmacology 1998;18(4):343-4

 
last update: 27-June-2017
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