Antidepressant withdrawal syndromes: phenomenology and pathophysiology

Dilsaver, Steven C.

doi:10.1111/j.1600-0447.1989.tb08578.x

Cited by 45 publications

(28 citation statements)

References 29 publications

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“…There is now an extensive literature describing the consequences of discontinuing (either via taper or abrupt withdrawal) tricyclic and related antidepressants (35)(36)(37)(38)(39), antipsychotic agents (40), antiparkinsonian antimuscarinic drugs (41)(42)(43)' lithium carbonate (44)(45)(46)(47) and benzodiazepines (48)(49)(50)(51)(52)(53). There is now an extensive literature describing the consequences of discontinuing (either via taper or abrupt withdrawal) tricyclic and related antidepressants (35)(36)(37)(38)(39), antipsychotic agents (40), antiparkinsonian antimuscarinic drugs (41)(42)(43)' lithium carbonate (44)(45)(46)(47) and benzodiazepines (48)(49)(50)(51)(52)(53).…”

Section: Discussionmentioning

confidence: 99%

“…The withdrawal of any psychotropic agent commonly used by psychiatrists can produce untoward effects. There is now an extensive literature describing the consequences of discontinuing (either via taper or abrupt withdrawal) tricyclic and related antidepressants (35)(36)(37)(38)(39), antipsychotic agents (40), antiparkinsonian antimuscarinic drugs (41-43)' lithium carbonate (44)(45)(46)(47) and benzodiazepines (48)(49)(50)(51)(52)(53). Consequences of withdrawing these agents can be the recurrence of the psychiatric disorder for which the drug was initially prescribed or non-specific symptoms such as anxiety, agitation, sleeplessness, nausea, vomiting, etc.…”

Section: Discussionmentioning

confidence: 99%

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Monoamine oxidase inhibitor withdrawal phenomena: symptoms and pathophysiology

Dilsaver

1988

Acta Psychiatr Scand

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The author reviews the literature reporting the untoward effects of withdrawing monoamine oxidase inhibitors (MAOIs). The withdrawal of these agents can result in severe anxiety, agitation, pressured speech, sleeplessness or drowsiness, hallucinations, delirium and paranoid psychosis. MAOI withdrawal phenomena resemble the symptoms produced by the discontinuation of chronically administered psychostimulants. The capacity of MAOI to exert amphetamine-like effects presynaptically, and the propensity of somatic treatments for depression to subsensitize presynaptic receptors regulating the release of catecholamines, can provide a basis for the development of psychotic syndromes upon the withdrawal of MAOIs. Evidence for this hypothesis is reviewed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Monoamine oxidase inhibitor withdrawal phenomena: symptoms and pathophysiology

Dilsaver

1988

Acta Psychiatr Scand

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“…Moreover, tolerance and dependence develop to a variety of effects from drugs with low addiction potential, such as antidepressants and antipsychotics. Pharmacological withdrawal syndromes for antidepressant and antipsychotic medications have been described, whereas the addictive potential has remained low for these drugs (except for those with anticholinergic effects) (Jaffe 1990;Dilsauer, Greden & Snider 1989;Dilsauer & Alessi 1988).…”

Section: Role Of Tolerance and Dependencementioning

confidence: 98%

A Neurochemical Basis for Alcohol and Other Drug Addiction

Miller

Gold

1993

Journal of Psychoactive Drugs

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There are major clinical observations in alcohol and other drug addicts and neurochemical studies in animals and humans that support the hypothesis for a common neurochemical basis for alcohol and other drug addiction. The common occurrence of concurrent alcohol and multiple drug dependence in clinical and general populations, family history and genetic studies, and basic and clinical research in the neurochemistry of addictive behavior provide evidence for a common genealogical vulnerability to combined alcohol and other drug addiction. Clinical neurochemical models for addictive behaviors can be derived from neurochemical pathways for the initiation and sustenance of addictive disorders. The role of tolerance and dependence is not specific to addiction but indicates a homeostatic response of the brain to the presence of a foreign substance. Animal and human studies are analyzed for clinical synthesis of a neurochemical basis for addictive disorders.

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“…Withdrawal symptoms following tricyclic antidepressant discontinuation are well documented, and include anxiety, gastrointestinal and autonomic symptoms, sleep and mood changes, paraesthesias, rhinorrhoea, diaphoresis and movement disorders (Dilsaver et al, 1987;Dilsaver, 1990;Garner et al., 1993) -4 syndrome including dizziness, incoordination, headache, weakness, tingling extremities, nausea and irritability has been described following discontinuation of fluvoxamine in patients with panic disorder (Black et al, 1993) and OCD (Mallya et al, 1993). Withdrawal symptoms following sertraline discontinuation has been described (Louie et al, 1994).…”

Section: Introductionmentioning

confidence: 99%