Posted by Sunnely on July 11, 2000, at 21:26:02
A MNEMONIC FOR SRI WITHDRAWAL SYMPTOMS (not all symptoms may be present):
F = Flu-like symptoms (lethargy, fatigue, headache, achiness, sweating)
I = Insomnia (with vivid dreams or nightmares)
N = Nausea (sometimes vomiting)
I = Imbalance (dizziness, vertigo, lightheadedness)
S = Sensory disturbances ("burning," "tingling," "electric-like" or "shock-like" sensations)
H = Hyperarousal (anxiety, irritability, agitation, aggression, mania, jerkiness)
OTHER FEATURES:
1) Onset = Usually begin between 2 and 5 days after the last dose of medication; in some cases, even before the medicine is totally discontinued. (Note: Withdrawal symptoms from Effexor can occur even after missing a single dose.)
2) Withdrawal symptoms occur more quickly than recurrence of depression.
3) Duration = Withdrawal symptoms can last up to several weeks; typically mitigated by reintroducing the withdrawn antidepressant.
4) Cause = Unclear. Hypothesis: Patients on long-term serotonin-boosting antidepressants have "down-regulation" (decreased number) of postsynaptic serotonin receptors. When medication is stopped abruptly, less serotonin is present in a "down-regulated" state ----> withdrawal symptoms.
5) Most common with shorter acting antidepressants (practically all SRIs except Prozac; Effexor, most rapid and severe), those without active metabolites (daughter compounds), and when treatment has lasted at least a month.
6) May occur if a patient is switched from an antidepressant that boosts serotonin to one that does not have this action. For example: Paxil ----> Wellbutrin.
7) May be hard to separate from infectious causes. (No fever or elevated white cell count with SRI withdrawal, however.)
All f i n i s h e d!
References:
1) Primary Psychiatry, August 1999.
2) SRI Withdrawal Reactions. In: Biological Therapies in Psychiatry Newsletter, AJ Gelenberg, MD (editor), June 1998.
poster:Sunnely
thread:40124
URL: http://www.dr-bob.org/babble/20000708/msgs/40124.html