Text Version
Entrez PubMed
Overview
Help | FAQ
Tutorial
New/Noteworthy
E-Utilities
PubMed Services
Journals Database
MeSH Database
Single Citation Matcher
Batch Citation Matcher
Clinical Queries
LinkOut
Cubby
Related Resources
Order Documents
NLM
Gateway
TOXNET
Consumer
Health
Clinical Alerts
ClinicalTrials.gov
PubMed
Central
Privacy Policy
|
 |
-
Comment in:
Selective
serotonin reuptake inhibitor discontinuation syndrome: proposed
diagnostic criteria.
Black K, Shea C, Dursun S,
Kutcher S.
Department of Psychiatry, Dalhousie University,
Halifax, NS.
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 for case reports published from 1986 to 1997 inclusive, and
references of relevant articles were also searched. STUDY SELECTION:
Forty-six case reports of symptoms following the discontinuation of
fluoxetine, fluvoxamine, paroxetine or sertraline were selected. Three
studies of SSRI discontinuation were also reviewed. DATA EXTRACTION:
Demographic and treatment information, as well as the timing, duration,
number, nature and frequency of dicontinuation symptoms. DATA SYNTHESIS:
Paroxetine was most frequently implicated. The drug had been tapered in
half of the cases. In some cases, symptom onset began during taper,
whereas, in most cases, symptoms began within 1 to 3 days of drug
discontinuation. Fifty-three different symptoms were reported, with
dizziness being the most common. Other common symptoms were nausea or
emesis, fatigue, headache, gait instability and insomnia. Shock-like
sensations, paresthesia and visual disturbances were the most rare.
Without intervention, symptoms persisted for more than a week in half of
the cases. In cases in which the SSRI was restarted, symptoms resolved
within 72 hours. In some cases, withdrawal symptoms recurred when the
same SSRI was again discontinued. CONCLUSIONS: Findings were used to
construct diagnostic criteria for the SSRI discontinuation syndrome.
These criteria are 2 or more of the following symptoms developing within
1 to 7 days of discontinuation or reduction in dosage of an SSRI after
at least 1 month's use, when these symptoms cause clinically significant
distress or impairment and are not due to a general medical condition or
recurrence of a mental disorder: dizziness, light-headedness, vertigo or
feeling faint; shock-like sensations or paresthesia; anxiety; diarrhea;
fatigue; gait instability; headache; insomnia; irritability; nausea or
emesis; tremor; and visual disturbances.
Publication Types:
PMID: 10863885 [PubMed - indexed for
MEDLINE]
|