The DOI matches its Crossref record; 18 of the 18 references it cites were found in a registry or an index.
Discontinuation Symptoms After Treatment With Serotonin Reuptake Inhibitors: A Literature Review
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.
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In the citing paper
“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]
In the citing paper
“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 citing paper
“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]
In the citing paper
“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]
In the citing paper
“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 the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
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Metadata
- 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)
- 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 (medical) › 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
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