Discontinuation Symptoms After Treatment With Serotonin Reuptake Inhibitors: A Literature Review

Zajecka, John; Tracy, Katherine A.; Mitchell, Sunny

doi:10.4088/jcp.v58n0702

Cited by 209Treatment of Major DepressionElectroconvulsive Therapy StudiesBipolar Disorder and Treatment

Discontinuation Symptoms After Treatment With Serotonin Reuptake Inhibitors: A Literature Review

Zajecka, John, Tracy, Katherine A., Mitchell, Sunny·1997·The Journal of Clinical Psychiatry

DOI 10.4088/jcp.v58n0702

Open this paper in CoChat — free account

Abstract

BACKGROUND: The discontinuation of many pharmacologic agents is associated with characteristic withdrawal symptoms. Antidepressants, particularly the tricyclic antidepressants (TCAs), are known to be associated with a group of common symptoms upon discontinuation. Serotonin reuptake inhibitors (SRIs) are also taking their respective place in the literature with reports of discontinuation symptoms. This review summarizes case reports and reports that allow systematic assessment of discontinuation symptoms following SRI discontinuation. METHOD: A computerized literature search was conducted using a MEDLINE search to identify reports of withdrawal effects following discontinuation of SRIs. Additional reports were found in the bibliographies of various published reports. RESULTS: SRI discontinuation symptoms in adults are summarized in 24 case reports and 9 reports from controlled clinical trials. Additionally, 3 case reports addressing SRI discontinuation in the neonate are described. The reports describe clusters of symptoms commonly associated with the discontinuation of an SRI. CONCLUSION: We propose to define an antidepressant discontinuation syndrome as the onset of a cluster of somatic and psychic symptoms following the discontinuation of an SRI and not attributable to other causes (e.g., concomitant medication, illness). These symptoms include dizziness, light-headedness, insomnia, fatigue, anxiety/agitation, nausea, headache, and sensory disturbance. The syndrome may last up to 3 weeks and may be improved by restarting the antidepressant or starting an antidepressant with a similar pharmacologic profile.

Integrity signals

Registry

Crossref · 10.4088/jcp.v58n0702

Cites

18 of 18 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Cardiac arrhythmia rebound after discontinuation of imipramine was described.
“Cardiac arrhythmia rebound after discontinuation of imipramine was described [96]”
From Acute and Persistent Withdrawal Syndromes Following Discontinuation of Psychotropic Medications (2020) · cites this paper as [96]
Existing checklists such as the Discontinuation-Emergent Signs and Symptoms (DESS) and criteria for SSRI withdrawal symptoms do not differentiate between different types of withdrawal.
“Existing checklists, such as the Discontinuation-Emergent Signs and Symptoms (DESS) [20] , and criteria for SSRI withdrawal symptoms [12,21] do not differentiate between different types of withdrawal.”
From New Classification of Selective Serotonin Reuptake Inhibitor Withdrawal (2015) · cites this paper as [20]
In the Rosenbaum et al. and the other study, drug interruption was short (5-8 days), and it is unlikely that rebound with fluoxetine would be seen; as fluoxetine has a long half-life, it is also less likely to cause rebound.
“In this study and the study by Rosenbaum et al. [20] , the drug interruption was short (5-8 days), and it is unlikely that rebound with fluoxetine would be seen.However, as fluoxetine has a long half-life, it is also less likely to cause rebound.”
From New Classification of Selective Serotonin Reuptake Inhibitor Withdrawal (2015) · cites this paper as [20]
Examination of various studies shows that rebound withdrawal occurs with SSRIs as well as with other CNS drugs.
“However, examination of various studies [20,34,35] shows us that this type of withdrawal occurs with SSRIs as well as with other CNS drugs.”
From New Classification of Selective Serotonin Reuptake Inhibitor Withdrawal (2015) · cites this paper as [20]
Data from controlled trials, case reports, and online patient reports show that paroxetine is most likely to be associated with new withdrawal symptoms, and fluoxetine the least.
“Data from controlled trials [15,20,29] , case reports [16] , and online patient reports [26] show that paroxetine is most likely to be associated with new withdrawal symptoms, and fluoxetine the least.”
From New Classification of Selective Serotonin Reuptake Inhibitor Withdrawal (2015) · cites this paper as [20]

In Rosenbaum et al.'s study, patients taking paroxetine and sertraline developed worsened depressive symptoms on the Hamilton Depression Rating Scale and Montgomery-Asberg Depression Rating Scale after treatment interruption, and returned to baseline depression measurements after reinstitution of treatment.
“In this study, patients taking paroxetine and sertraline developed worsened depressive symptoms on the Hamilton Depression Rating Scale and Montgomery-Asberg Depression Rating Scale after treatment interruption, and returned to baseline depression measurements after reinstitution of the treatment.”
From New Classification of Selective Serotonin Reuptake Inhibitor Withdrawal (2015) · cites this paper as [20]
New withdrawal symptoms, measured using the DESS, also appeared after paroxetine and sertraline discontinuation.
“New withdrawal symptoms, measured using the DESS, also appeared after paroxetine and sertraline discontinuation.”
From New Classification of Selective Serotonin Reuptake Inhibitor Withdrawal (2015) · cites this paper as [20]
Severity of new SSRI withdrawal symptoms may vary mainly according to the SSRI used.
“Severity may also vary mainly according to the SSRI used [1,20] .”
From New Classification of Selective Serotonin Reuptake Inhibitor Withdrawal (2015) · cites this paper as [20]
Rosenbaum et al. demonstrated rebound major depression, although not described as such, in a double-blind withdrawal trial (5-8 days) in 242 patients with major depression who had maintenance paroxetine, sertraline or fluoxetine treatment interrupted.
“Rosenbaum et al. [20] demonstrated rebound major depression, although the authors did not describe it as such, in a double-blind withdrawal trial (5-8 days) conducted in 242 patients with major depression who had their maintenance paroxetine, sertraline or fluoxetine treatment interrupted [20] .”
From New Classification of Selective Serotonin Reuptake Inhibitor Withdrawal (2015) · cites this paper as [20]
Checklists such as the DESS are helpful to ensure that all new withdrawal symptoms are inquired about, particularly if the medication is withdrawn before 6 months of continuous intake.
“Checklists, such as the DESS [20] , are also helpful to ensure that all new withdrawal symptoms are inquired about, particularly if the medication is withdrawn before 6 months of continuous intake.”
From New Classification of Selective Serotonin Reuptake Inhibitor Withdrawal (2015) · cites this paper as [20]
According to most studies, even with gradual tapering, withdrawal symptoms still occur.
“According to most studies [1,15,16,20,29] , even with gradual tapering, withdrawal symptoms still occur.”
From New Classification of Selective Serotonin Reuptake Inhibitor Withdrawal (2015) · cites this paper as [20]

MANIC DEPRESSIVE ILLNESS
Davenport, Y. B., Adland, M. L., Gold, P. W., & Goodwin, F. K. (1984) · The Lancet · doi:10.1016/s0140-6736(84)92810-1 · Cited by 2,925 · see citing works
Serotonin Reuptake Inhibitor Withdrawal
Coupland, N. J., Bell, C. J., & Potokar, J. P. (1996) · Journal of Clinical Psychopharmacology · doi:10.1097/00004714-199610000-00003 · Cited by 303 · see citing works
Paroxetine in the Treatment of Panic Disorder a Randomised, Double-Blind, Placebo-Controlled Study
Oehrberg, S., Christiansen, P. E., Behnke, K., Borup, A. L., Severin, B., Soegaard, J., Calberg, H., Judge, R., Ohrstrom, J. K., & Manniche, P. M. (1995) · British Journal of Psychiatry · doi:10.1192/bjp.167.3.374 · Cited by 261 · see citing works
Antidepressant withdrawal phenomena.
Dilsaver, S. C., & Greden, J. F. (1984) · PubMed · Cited by 156 · see citing works
Effects of Third Trimester Fluoxetine Exposure on the Newborn
GOLDSTEIN, D. J. (1995) · Journal of Clinical Psychopharmacology · doi:10.1097/00004714-199512000-00005 · Cited by 116 · see citing works
Antidepressant Withdrawal Syndromes: Phenomenology and Pathophysiology
Dilsaver, S. C., Greden, J. F., & Snider, R. M. (1987) · International Clinical Psychopharmacology · doi:10.1097/00004850-198701000-00001 · Cited by 82 · see citing works
The abrupt discontinuation of fluvoxamine in patients with panic disorder.
Black, D. W., Wesner, R. B., & Gabel, J. (1993) · PubMed · Cited by 77 · see citing works
Suspected congenital sertraline dependence
Kent, L., & Laidlaw, J. (1995) · The British Journal of Psychiatry · doi:10.1192/bjp.167.3.412b · Cited by 64 · see citing works
Adverse events after the abrupt discontinuation of paroxetine
Dominguez, R. A., & Goodnick, P. J. (1995) · Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy · doi:10.1002/j.1875-9114.1995.tb02896.x · Cited by 57 · see citing works
Extrapyramidal symptoms upon discontinuation of fluoxetine
Stoukides, J., & Stoukides, C. A. (1991) · American Journal of Psychiatry · doi:10.1176/ajp.148.9.1263a · Cited by 57 · see citing works
Medication Withdrawal Symptoms in Obsessive-Compulsive Disorder Patients Treated with Paroxetine
Keuthen, N. J., Cyr, P., Ricciardi, J. A., Minichiello, W. E., Buttolph, M. L., & Jenike, M. A. (1994) · Journal of Clinical Psychopharmacology · doi:10.1097/00004714-199406000-00010 · Cited by 53 · see citing works
Shock-like sensations after discontinuation of selective serotonin reuptake inhibitors
Frost, L., & Lal, S. (1995) · American Journal of Psychiatry · doi:10.1176/ajp.152.5.810a · Cited by 49 · see citing works
Withdrawal Syndromes After Paroxetine and Sertraline Discontinuation
Fava, G. A., & Grandi, S. (1995) · Journal of Clinical Psychopharmacology · doi:10.1097/00004714-199510000-00012 · Cited by 46 · see citing works
Severe psychiatric symptoms associated with paroxetine withdrawal
Bloch, M., Stager, S., Braun, A., & Rubinow, D. (1995) · The Lancet · doi:10.1016/s0140-6736(95)92691-7 · Cited by 45 · see citing works
Discontinuation reactions following sertraline
Leiter, F. L., Nierenberg, A. A., Sanders, K. M., & Stern, T. A. (1995) · Biological Psychiatry · doi:10.1016/0006-3223(95)00311-8 · Cited by 40 · see citing works
Holding On: Depression, Sensitization by Antidepressant Drugs, and the Prodigal Experts
Fava, G. A. (2010) · Psychotherapy and Psychosomatics · doi:10.1159/000288992 · Cited by 33 · see citing works
Potential Withdrawal Syndrome Associated with Ssri Discontinuation
Lazowick, A. L., & Levin, G. M. (1995) · Annals of Pharmacotherapy · doi:10.1177/106002809502901215 · Cited by 29 · see citing works
A double-blind, randomized study to provide safety information on switching fluoxetine-treated patients to paroxetine without an intervening washout period.
Kreider, M. S., Bushnell, W. D., Oakes, R., & Wheadon, D. E. (1995) · PubMed · Cited by 17 · see citing works

Flagged first, then by citations

Sorted by citations

Practice parameter for the assessment and treatment of children and adolescents with depressive disorders
Birmaher, B., & Brent, D. (2007) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/chi.0b013e318145ae1c · Cited by 1,056 · see citing works
Neurological bases for balance–anxiety links
Balaban, C. D., & Thayer, J. F. (2001) · Journal of Anxiety Disorders · doi:10.1016/s0887-6185(00)00042-6 · Cited by 439 · see citing works
Chemotherapy in Psychiatry
Baldessarini, R. J. (2013) · doi:10.1007/978-1-4614-3710-9 · Cited by 365 · see citing works
Practice Parameters for the Assessment and Treatment of Children and Adolescents With Depressive Disorders
Birmaher, B. B., & Brent, D. A. (1998) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199810001-00005 · Cited by 315 · see citing works
Antidepressant‐induced mania: an overview of current controversies
Goldberg, J. F., & Truman, C. J. (2003) · Bipolar Disorders · doi:10.1046/j.1399-5618.2003.00067.x · Cited by 310 · see citing works
Obsessive Compulsive Disorder
Hudak, R., & Gannon, J. M. (2022) · Current clinical practice · doi:10.1007/978-3-030-98709-1_5 · Cited by 306 · see citing works
Impact of Antidepressant Discontinuation After Acute Bipolar Depression Remission on Rates of Depressive Relapse at 1-Year Follow-Up
Altshuler, L., Suppes, T., Black, D., Nolen, W. A., Keck, P. E., Frye, M. A., McElroy, S., Kupka, R., Grunze, H., Walden, J., et al. (2003) · American Journal of Psychiatry · doi:10.1176/appi.ajp.160.7.1252 · Cited by 287 · see citing works
Paroxetine
Wagstaff, A. J., Cheer, S. M., Matheson, A. J., Ormrod, D. J., & Goa, K. L. (2002) · Drugs · doi:10.2165/00003495-200262040-00010 · Cited by 289 · see citing works
Review of sertraline and its clinical applications in psychiatric disorders
McRae‐Clark, A. L., & Brady, K. T. (2001) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.2.5.883 · Cited by 287 · see citing works
Acute and Persistent Withdrawal Syndromes Following Discontinuation of Psychotropic Medications
Cosci, F., & Chouinard, G. (2020) · Psychotherapy and Psychosomatics · doi:10.1159/000506868 · Cited by 265 · see citing works
Can long-term treatment with antidepressant drugs worsen the course of depression?
Fava, G. A. (2003) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v64n0204 · Cited by 223 · see citing works
Antidepressants for the Treatment of Chronic Pain
Verdu, B., Décosterd, I., Buclin, T., Stiefel, F., & Berney, A. (2008) · Drugs · doi:10.2165/0003495-200868180-00007 · Cited by 215 · see citing works
Paroxetine and fluoxetine in pregnancy: a prospective, multicentre, controlled, observational study
Diav‐Citrin, O., Shechtman, S., Weinbaum, D., Wajnberg, R. S., Avgil, M., Gianantonio, E. D., Clementi, M., Weber‐Schoendorfer, C., Schaefer, C., & Ornoy, A. (2008) · British Journal of Clinical Pharmacology · doi:10.1111/j.1365-2125.2008.03261.x · Cited by 207 · see citing works
Absence of discontinuation symptoms with agomelatine and occurrence of discontinuation symptoms with paroxetine: a randomized, double-blind, placebo-controlled discontinuation study
Montgomery, S. A., Kennedy, S. H., Burrows, G. D., Lejoyeux, M., & Hindmarch, I. (2004) · International Clinical Psychopharmacology · doi:10.1097/01.yic.0000137184.64610.c8 · Cited by 196 · see citing works
Efficacy and Safety of Dapoxetine for the Treatment of Premature Ejaculation: Integrated Analysis of Results from Five Phase 3 Trials
McMahon, C. G., Althof, S. E., Kaufman, J. M., Buvat, J., Levine, S. B., Aquilina, J. W., Tesfaye, F., Rothman, M. L., Rivas, D. A., & Porst, H. (2010) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2010.02097.x · Cited by 179 · see citing works
Escitalopram in the treatment of generalized anxiety disorder: Double‐blind, placebo controlled, flexible‐dose study
Davidson, J. R. T., Bose, A., Korotzer, A., & Zheng, H. (2004) · Depression and Anxiety · doi:10.1002/da.10146 · Cited by 183 · see citing works
Efficacy and Tolerability of Benzodiazepines versus Antidepressants in Anxiety Disorders: A Systematic Review and Meta-Analysis
Offidani, E., Guidi, J., Tomba, E., & Fava, G. A. (2013) · Psychotherapy and Psychosomatics · doi:10.1159/000353198 · Cited by 166 · see citing works
New Classification of Selective Serotonin Reuptake Inhibitor Withdrawal
Chouinard, G., & Chouinard, V.-A. (2015) · Psychotherapy and Psychosomatics · doi:10.1159/000371865 · Cited by 164 · see citing works
Clinical Guidelines for the Treatment of Depressive Disorders IV. Medications and Other Biological Treatments
Kennedy, S. H., Lam, R. W. M., Cohen, N. L., Ravindran, A. V., & The CANMAT Depression Work Group (2001) · The Canadian Journal of Psychiatry · doi:10.1177/070674372001460101004 · Cited by 162 · see citing works
The mechanisms of tolerance in antidepressant action
Fava, G. A., & Offidani, E. (2011) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2010.07.026 · Cited by 158 · see citing works
Sexual Dysfunction Associated with the Treatment of Depression: A Placebo-Controlled Comparison of Bupropion Sustained Release and Sertraline Treatment
Coleman, C. C., Cunningham, L. A., Foster, V. J., Batey, S. R., Donahue, R. M. J., Houser, T. L., & Ascher, J. A. (1999) · Annals of Clinical Psychiatry · doi:10.1023/a:1022309428886 · Cited by 131 · see citing works
Unmet need for services and interventions among adolescents with mental disorders
Wang, P. S., Sherrill, J., & Vitiello, B. (2007) · American Journal of Psychiatry · doi:10.1176/ajp.2007.164.1.1 · Cited by 123 · see citing works
Psychotropic Drugs and the Perioperative Period: A Proposal for a Guideline in Elective Surgery
Huyse, F. J., Touw, D. J., van Schijndel, R. J. M. S., de Lange, J. J., & Slaets, J. P. J. (2005) · Psychosomatics · doi:10.1176/appi.psy.47.1.8 · Cited by 123 · see citing works
Trauma and Posttraumatic Stress Disorder in an Urban Xhosa Primary Care Population: Prevalence, Comorbidity, and Service Use Patterns
Carey, P. D., Stein, D. J., Zungu‐Dirwayi, N., & Seedat, S. (2003) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000061143.66146.a8 · Cited by 119 · see citing works
Clinical issues in long-term treatment with antidepressants.
Zajecka, J. M. (2000) · PubMed · Cited by 114 · see citing works
Self-citation
Selective Serotonin Reuptake Inhibitor Antidepressant Treatment Discontinuation Syndrome: A Review of the Clinical Evidence and the Possible Mechanisms Involved
Renoir, T. (2013) · Frontiers in Pharmacology · doi:10.3389/fphar.2013.00045 · Cited by 107 · see citing works
Neonatal paroxetine withdrawal syndrome
Stiskal, J. A., Kulin, N., Koren, G., Ho, T., & Ito, S. (2001) · Archives of Disease in Childhood Fetal & Neonatal · doi:10.1136/fn.84.2.f134 · Cited by 110 · see citing works
Dapoxetine: a new option in the medical management of premature ejaculation
McMahon, C. G. (2012) · Therapeutic Advances in Urology · doi:10.1177/1756287212453866 · Cited by 109 · see citing works
Discontinuation of Antidepressant Medication Among Latinos in the USA
Hodgkin, D., Volpe-Vartanian, J., & Alegria, M. M. (2007) · The Journal of Behavioral Health Services & Research · doi:10.1007/s11414-007-9070-6 · Cited by 101 · see citing works
ANTIDEPRESSANTS, OLD AND NEW
Sarko, J. A. (2000) · Emergency Medicine Clinics of North America · doi:10.1016/s0733-8627(05)70151-6 · Cited by 101 · see citing works
A review of the management of antidepressant discontinuation symptoms
Wilson, E., & Lader, M. (2015) · Therapeutic Advances in Psychopharmacology · doi:10.1177/2045125315612334 · Cited by 103 · see citing works
Pharmacological and Psychological Treatments for Depressed Older Patients: A Meta-analysis and Overview of Recent Findings
Gerson, S. C., Belin, T. R., Kaufman, A., Mintz, J., & Jarvik, L. (1999) · Harvard Review of Psychiatry · doi:10.1093/hrp/7.1.1 · Cited by 99 · see citing works
Differential effects of withdrawal from chronic amphetamine or fluoxetine administration on brain stimulation reward in the rat - interactions between the two drugs
Lin, D. C.-H., Koob, G. F., & Markou, A. (1999) · Psychopharmacology · doi:10.1007/s002130051060 · Cited by 92 · see citing works
Discontinuation symptoms: comparison of brief interruption in fluoxetine and paroxetine treatment
Judge, R., Parry, M. G., Quail, D., & Jacobson, J. G. (2002) · International Clinical Psychopharmacology · doi:10.1097/00004850-200209000-00002 · Cited by 87 · see citing works
Serotonin: modulator of a drive to withdraw.
Tops, M., Russo, S., Boksem, M. A. S., & Tucker, D. M. (2009) · Brain and Cognition · doi:10.1016/j.bandc.2009.03.009 · Cited by 86 · see citing works
Safety of Abrupt Discontinuation of Fluoxetine: A Randomized, Placebo-Controlled Study
Zajecka, J., Fawcett, J., Amsterdam, J., Quitkin, F., Reimherr, F., Rosenbaum, J., Michelson, D., & Beasley, C. (1998) · Journal of Clinical Psychopharmacology · doi:10.1097/00004714-199806000-00003 · Cited by 85 · see citing works
Self-citation
Strategies for the treatment of antidepressant-related sexual dysfunction.
Zajecka, J. (2001) · PubMed · Cited by 86 · see citing works
Self-citation
Discontinuation Syndrome in Dysthymic Patients Treated with Selective Serotonin Reuptake Inhibitors: A Clinical Investigation
Bogetto, F., Bellino, S., Revello, R. B., & Patria, L. (2002) · CNS Drugs · doi:10.2165/00023210-200216040-00006 · Cited by 80 · see citing works
The Recognition and Management of Mood Disorders as a Comorbidity of Epilepsy
Barry, J. J. (2003) · Epilepsia · doi:10.1046/j.1528-1157.44.s4.4.x · Cited by 84 · see citing works
The pharmacological properties of antidepressants
Racagni, G., & Popoli, M. (2010) · International Clinical Psychopharmacology · doi:10.1097/yic.0b013e3283311acd · Cited by 83 · see citing works
Effects of gradual discontinuation of selective serotonin reuptake inhibitors in panic disorder with agoraphobia
Fava, G. A., Bernardi, M., Tomba, E., & Rafanelli, C. (2007) · The International Journal of Neuropsychopharmacology · doi:10.1017/s1461145706007462 · Cited by 80 · see citing works
Antidepressant discontinuation syndrome: consensus panel recommendations for clinical management and additional research.
Schatzberg, A. F., Blier, P., Delgado, P. L., D, M. F. M., Haddad, P. M., & Shelton, R. C. (2006) · PubMed · Cited by 78 · see citing works
Organization of projections from the raphe nuclei to the vestibular nuclei in rats
Halberstadt, A. L., & Balaban, C. D. (2003) · Neuroscience · doi:10.1016/s0306-4522(02)00952-1 · Cited by 77 · see citing works
When Discontinuing SSRI Antidepressants Is a Challenge: Management Tips
Jha, M. K., Rush, A. J., & Trivedi, M. H. (2018) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2018.18060692 · Cited by 73 · see citing works
Consumer Use of St. John's Wort: A Survey on Effectiveness, Safety, and Tolerability
Beckman, S. E., Sommi, R. W., & Switzer, J. (2000) · Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy · doi:10.1592/phco.20.6.568.35152 · Cited by 71 · see citing works
Selective serotonin reuptake inhibitor discontinuation syndrome: A review
Tamam, L., & Özpoyraz, N. (2002) · Advances in Therapy · doi:10.1007/bf02850015 · Cited by 69 · see citing works
Efficacy and tolerance profile of agomelatine and practical use in depressed patients
Rouillon, F. (2006) · International Clinical Psychopharmacology · doi:10.1097/01.yic.0000195659.99148.09 · Cited by 69 · see citing works
Hot flushes in breast cancer patients
Mom, C. H., Buijs, C., Willemse, P. H. B., Mourits, M. J. E., & de Vries, E. G. E. (2005) · Critical Reviews in Oncology/Hematology · doi:10.1016/j.critrevonc.2005.04.009 · Cited by 68 · see citing works
Potential Medical and Surgical Complications of Serotonergic Antidepressant Medications
Looper, K. J. (2007) · Psychosomatics · doi:10.1176/appi.psy.48.1.1 · Cited by 66 · see citing works
Treatment of Recurrent Depression
Fava, G. A., Ruini, C., & Sonino, N. (2003) · CNS Drugs · doi:10.2165/00023210-200317150-00005 · Cited by 65 · see citing works
Neurobiology of antidepressant withdrawal: implications for the longitudinal outcome of depression
Harvey, B. H., McEwen, B. S., & Stein, D. J. (2003) · Biological Psychiatry · doi:10.1016/s0006-3223(03)00528-6 · Cited by 63 · see citing works
Selective Serotonin Reuptake Inhibitors
Preskorn, S., ROSS, R. W., & Stanga, C. Y. (2004) · Handbook of experimental pharmacology · doi:10.1007/978-3-642-18500-7_9 · Cited by 62 · see citing works
Pharmacological Treatment of Obsessive-Compulsive Disorder
Simpson, H. B. (2009) · Current topics in behavioral neurosciences · doi:10.1007/7854_2009_12 · Cited by 59 · see citing works
New insights on the antidepressant discontinuation syndrome
Harvey, B. H., & Slabbert, F. N. (2014) · Human Psychopharmacology Clinical and Experimental · doi:10.1002/hup.2429 · Cited by 61 · see citing works
Issues in the pharmacological treatment of obsessive-compulsive disorder
Math, S. B., & Reddy, Y. C. J. (2007) · International Journal of Clinical Practice · doi:10.1111/j.1742-1241.2007.01356.x · Cited by 58 · see citing works
Why do we need new and better antidepressants?
Montgomery, S. (2006) · International Clinical Psychopharmacology · doi:10.1097/01.yic.0000199455.39552.1c · Cited by 59 · see citing works
Limitations of current medical treatments for depression: Disturbed circadian rhythms as a possible therapeutic target
LADER, M. H. (2007) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2007.05.004 · Cited by 59 · see citing works
St. John's Wort: Three Cases of Possible Mania Induction
Moses, E. L., & Mallinger, A. G. (2000) · Journal of Clinical Psychopharmacology · doi:10.1097/00004714-200002000-00027 · Cited by 56 · see citing works
A review of antidepressant treatments today
Kennedy, S. H. (2006) · European Neuropsychopharmacology · doi:10.1016/s0924-977x(06)70007-4 · Cited by 55 · see citing works
SSRIs and SNRIs (SRI) in Pregnancy: Effects on the Course of Pregnancy and the Offspring: How Far Are We from Having All the Answers?
Ornoy, A., & Koren, G. (2019) · International Journal of Molecular Sciences · doi:10.3390/ijms20102370 · Cited by 54 · see citing works
Effects of Treatment Discontinuation in Clinical Psychopharmacology
Baldessarini, R. J., & Tondo, L. (2019) · Psychotherapy and Psychosomatics · doi:10.1159/000497334 · Cited by 52 · see citing works
Controlled, Double-Blind Investigation of the Clozapine Discontinuation Symptoms With Conversion to Either Olanzapine or Placebo
Tollefson, G. D., Dellva, M. A., Mattler, C. A., Kane, J. M., Wirshing, D. A., & Kinon, B. J. (1999) · Journal of Clinical Psychopharmacology · doi:10.1097/00004714-199910000-00007 · Cited by 50 · see citing works
How user knowledge of psychotropic drug withdrawal resulted in the development of person-specific tapering medication
Groot, P. C., & van Os, J. (2020) · Therapeutic Advances in Psychopharmacology · doi:10.1177/2045125320932452 · Cited by 49 · see citing works
Patient Online Report of Selective Serotonin Reuptake Inhibitor-Induced Persistent Postwithdrawal Anxiety and Mood Disorders
Belaise, C., Gatti, A., Chouinard, V.-A., & Chouinard, G. (2012) · Psychotherapy and Psychosomatics · doi:10.1159/000341178 · Cited by 45 · see citing works
Sustained Desensitization of Hypothalamic 5-Hydroxytryptamine1A Receptors after Discontinuation of Fluoxetine: Inhibited Neuroendocrine Responses to 8-Hydroxy-2-(Dipropylamino)Tetralin in the Absence of Changes in Gi/o/z Proteins
Raap, D. K., García, F., Muma, N. A., Wolf, W. A., Battaglia, G., & de Kar, L. D. V. (1999) · Journal of Pharmacology and Experimental Therapeutics · doi:10.1016/s0022-3565(24)37990-x · Cited by 46 · see citing works
PHARMACOLOGIC TREATMENT FOR CHILDREN AND ADOLESCENTS WITH ANXIETY DISORDERS
Birmaher, B. B., Yelovich, A. K., & Renaud, J. (1998) · Pediatric Clinics of North America · doi:10.1016/s0031-3955(05)70069-9 · Cited by 45 · see citing works
Pediatric Psychopharmacology for Treatment of ADHD, Depression, and Anxiety
Southammakosane, C., & Schmitz, K. (2015) · PEDIATRICS · doi:10.1542/peds.2014-1581 · Cited by 45 · see citing works
Selective serotonin reuptake inhibitors in human pregnancy: On the way to resolving the controversy
Ornoy, A., & Koren, G. (2013) · Seminars in Fetal and Neonatal Medicine · doi:10.1016/j.siny.2013.11.007 · Cited by 41 · see citing works
Switch to Mania upon Discontinuation of Antidepressants in Patients with Mood Disorders: A Review of the Literature
Ali, O., & Milev, R. V. (2003) · The Canadian Journal of Psychiatry · doi:10.1177/070674370304800410 · Cited by 41 · see citing works
Crossroads of Pain and Addiction:
Bailey, J. A., Hurley, R. W., & Gold, M. S. (2010) · Pain Medicine · doi:10.1111/j.1526-4637.2010.00982.x · Cited by 42 · see citing works
Effects of the serotonin 1A, 2A, 2C, 3A, and 3B and serotonin transporter gene polymorphisms on the occurrence of paroxetine discontinuation syndrome
Murata, Y., Kobayashi, D., Imuta, N., Haraguchi, K., Ieiri, I., Nishimura, R., Koyama, S., & Mine, K. (2010) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e3181c8ae80 · Cited by 37 · see citing works
Selective Serotonin Reuptake Inhibitors in Human Pregnancy: To Treat or Not to Treat?
Diav‐Citrin, O., & Ornoy, A. (2011) · Obstetrics and Gynecology International · doi:10.1155/2012/698947 · Cited by 34 · see citing works
Antidepressant withdrawal reactions.
Wolfe, R. (1997) · PubMed · Cited by 34 · see citing works
Selective Serotonin Reuptake Inhibitors during Pregnancy: Do We Have Now More Definite Answers Related to Prenatal Exposure?
Ornoy, A., & Koren, G. (2017) · Birth Defects Research · doi:10.1002/bdr2.1078 · Cited by 32 · see citing works
Pharmacological management of panic disorder
Marchesi, C. (2008) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s1557 · Cited by 33 · see citing works
How Good Are Current Approaches to Nonclinical Evaluation of Abuse and Dependence?
Moser, P. C., Wolinsky, T. D., Duxon, M. S., & Porsolt, R. D. (2010) · Journal of Pharmacology and Experimental Therapeutics · doi:10.1124/jpet.110.169979 · Cited by 33 · see citing works
Untitled work
(2006) · PubMed · Cited by 33 · see citing works
Anxiety disorders in the child and teen
Varley, C. K., & Smith, C. J. (2003) · Pediatric Clinics of North America · doi:10.1016/s0031-3955(03)00070-1 · Cited by 33 · see citing works
Assessment of Sexual Dysfunction Using the Arizona Sexual Experiences Scale (ASEX) and Implications for the Treatment of Depression
McGahuey, C. A., Delgado, P. L., & Gelenberg, A. J. (1999) · Psychiatric Annals · doi:10.3928/0048-5713-19990101-10 · Cited by 32 · see citing works
Profile of vortioxetine in the treatment of major depressive disorder: an overview of the primary and secondary literature
Bobo, W. V., Kelliny, M., Croarkin, P. E., & Moore, K. M. (2015) · Therapeutics and Clinical Risk Management · doi:10.2147/tcrm.s55313 · Cited by 32 · see citing works
Diagnosis and Treatment of Agoraphobia with Panic Disorder
Perugi, G., Frare, F., & Toni, C. (2007) · CNS Drugs · doi:10.2165/00023210-200721090-00004 · Cited by 30 · see citing works
Anterograde tracing of projections from the dorsal raphe nucleus to the vestibular nuclei
Halberstadt, A. L., & Balaban, C. D. (2006) · Neuroscience · doi:10.1016/j.neuroscience.2006.08.013 · Cited by 29 · see citing works
Treatment of panic disorder
Argyropolous, S., Feeney, A., & Nutt, D. (2001) · CRC Press eBooks · doi:10.3109/9780203215418-13 · Cited by 29 · see citing works
THE NEW ANTIDEPRESSANTS
Labellarte, M. J., Walkup, J. T., & Riddle, M. A. (1998) · Pediatric Clinics of North America · doi:10.1016/s0031-3955(05)70066-3 · Cited by 28 · see citing works
Antidepressant discontinuation syndrome: A state-of-the-art clinical review
Fornaro, M., Cattaneo, C. I., Berardis, D. D., Ressico, F. V., Martinotti, G., & Vieta, E. (2022) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2022.10.005 · Cited by 29 · see citing works
The Use of Videogames and Virtual Reality for the Assessment of Anxiety and Depression: A Scoping Review
Chitale, V., Baghaei, N., Playne, D. P., Liang, H., Zhao, Y., Erensoy, A., & Ahmad, Y. (2022) · Games for Health Journal · doi:10.1089/g4h.2021.0227 · Cited by 28 · see citing works
Role of serotonin transporter inhibition in the regulation of tryptophan hydroxylase in brainstem raphe nuclei: time course and regional specificity
MacGillivray, L., Lagrou, L. M., Reynolds, K. B., Rosebush, P. I., & Mazurek, M. F. (2010) · Neuroscience · doi:10.1016/j.neuroscience.2010.08.055 · Cited by 27 · see citing works
Antidepressants and Bleeding Risk After Face-lift Surgery
Harirchian, S., Zoumalan, R. A., & Rosenberg, D. B. (2012) · Archives of Facial Plastic Surgery · doi:10.1001/archfaci.2012.2 · Cited by 27 · see citing works
Current approaches and issues in non-clinical evaluation of abuse and dependence
Moser, P. C., Wolinsky, T. D., Castagné, V., & Duxon, M. S. (2010) · Journal of Pharmacological and Toxicological Methods · doi:10.1016/j.vascn.2010.09.004 · Cited by 27 · see citing works
Dapoxetine for premature ejaculation
McMahon, C. G. (2010) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.2010.493174 · Cited by 26 · see citing works
Recurrence of symptoms of premenstrual dysphoric disorder after the cessation of luteal-phase fluoxetine treatment
Pearlstein, T. B., Joliat, M. J., Brown, E. B., & Miner, C. M. (2003) · American Journal of Obstetrics and Gynecology · doi:10.1067/mob.2003.207 · Cited by 26 · see citing works
A Risk-Benefit Assessment of Pharmacotherapies for Clinical Depression in Children and Adolescents
Renaud, J., Axelson, D., & Birmaher, B. B. (1999) · Drug Safety · doi:10.2165/00002018-199920010-00006 · Cited by 26 · see citing works
Discontinuation symptoms and taper/poststudy-emergent adverse events with desvenlafaxine treatment for major depressive disorder
Montgomery, S. A., Fava, M., Padmanabhan, S. K., J. Guico-Pabia, C., & Tourian, K. A. (2009) · International Clinical Psychopharmacology · doi:10.1097/yic.0b013e32832fbb5a · Cited by 27 · see citing works
Steps Following Attainment of Remission: Discontinuation of Antidepressant
Shelton, R. C. (2001) · The Primary Care Companion For CNS Disorders · doi:10.4088/pcc.v03n0404 · Cited by 43 · see citing works
Fluvoxamine as a cause of stimulation, mania and aggression with a critical analysis of the FDA‐approved label
Breggin, P. R. (2001) · International Journal of Risk & Safety in Medicine · doi:10.3233/jrs-2001-253 · Cited by 25 · see citing works
Update on pharmacotherapy in psychodermatological disorders
Munoli, R. N., Shenoi, S. D., Soman, S., & Prabhu, S. S. (2020) · Indian Dermatology Online Journal · doi:10.4103/idoj.idoj_330_19 · Cited by 25 · see citing works
Effects of Antidepressants on Quality of Life in Women with Premenstrual Dysphoric Disorder
Freeman, E. W. (2005) · PharmacoEconomics · doi:10.2165/00019053-200523050-00003 · Cited by 25 · see citing works
Association of Selective Serotonin Reuptake Inhibitors with Transfusion in Surgical Patients
Sajan, F., Conte, J. V., Tamargo, R. J., Riley, L. H., Rock, P., & Faraday, N. R. (2016) · Anesthesia & Analgesia · doi:10.1213/ane.0000000000001319 · Cited by 24 · see citing works
Potential Sensitising Effects of Antidepressant Drugs on Depression
Fava, G. A. (1999) · CNS Drugs · doi:10.2165/00023210-199912040-00001 · Cited by 23 · see citing works
Current strategies for tapering psychiatric drugs: Differing recommendations, impractical doses, and other barriers
Eserian, J. K., Blanco, V. P., Mercuri, L. P., Matos, J. D. R., & Galduróz, J. C. F. (2023) · Psychiatry Research · doi:10.1016/j.psychres.2023.115537 · Cited by 15 · see citing works

Authors: Zajecka, J., Tracy, K. A., & Mitchell, S.
Affiliations: Rush University Medical Center (US)
ORCID: Zajecka, John
Venue: The Journal of Clinical Psychiatry
Publisher: Physicians Postgraduate Press, Inc
Published: 1997-07-15
Volume: 58
Issue: 7
Pages: 291-297
ISSN: 0160-6689 (ISSN-L)
DOI: 10.4088/jcp.v58n0702
OpenAlex: W2032519777
Cited by: 209
References: 18
Citations by year: 2025: 3 · 2024: 4 · 2023: 2 · 2022: 9 · 2021: 2 · 2020: 4 · 2019: 2 · 2018: 3 · 2017: 1 · 2016: 1 · 2015: 7 · 2014: 2 · 2013: 8 · 2012: 11
FWCI: 10.42
Type: journal article
Language: en
Open access: closed
Locations: The Journal of Clinical Psychiatry (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
Keywords: serotonin reuptake inhibitors, antidepressant discontinuation syndrome, drug withdrawal symptoms, antidepressant discontinuation, tricyclic antidepressants
MeSH terms: Venlafaxine Hydrochloride, Adolescent, Adult, Mental Disorders, Child, Clinical Trials as Topic, Cyclohexanols, Dizziness, Female, Fluoxetine, Headache, Humans, Infant, Infant, Newborn, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Nausea, Sensation Disorders, Substance Withdrawal Syndrome, 1-Naphthylamine, MEDLINE, Fluvoxamine, Selective Serotonin Reuptake Inhibitors, Paroxetine, Sertraline

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Discontinuation Symptoms After Treatment With Serotonin Reuptake Inhibitors: A Literature Review

Abstract

Integrity signals

Claims the paper makes

Claims other papers make about this one

Cites

Cited by

Related

Record

About these checks